Ohio must modernize overdose treatmentNov 09, 2019
This opinion piece appeared in The Columbus Dispatch.
The opioid epidemic has been catastrophic for communities across Ohio. Families, communities, civic leaders, and law enforcement have battled drug-related death and addiction fostered by overprescribed prescription drugs for years. As tempting as it might be for state and local policymakers to focus on lawsuits and settlements, such retrospective answers should not distract them from finding prospective solutions to an evolving problem.
Ohio’s war on opioid abuse has changed and policymakers must now adapt and find new strategies to contend with a new enemy.
The opioid crisis started with drugs that were legal to prescribe and use. Doctors prescribe opioids to help patients manage pain. Their intentions in most cases, we must assume, is to help, not harm. Unfortunately, prescription opioids have been abused it seems at every level of the medical system, from the manufacturers down to the patients. That abuse at one point saw the rate of overdoses from prescribed opioids increasing at a staggering 5% per year.
In response, federal and state policymakers adopted safeguards to reduce improper opioid prescriptions. More than 30 states established waiting periods for prescription opioids and regulations required doctors to prescribe opioids for short durations, often prescribing less than a week’s supply. And Washington has spent hundreds of millions of dollars trying to teach doctors and patients how to manage prescription opioids effectively and safely.
Fortunately, those efforts have paid off. Only a quarter of today’s opioid abuse derives from improper prescriptions and fatal overdoses of prescribed opioids have been virtually flat, increasing only one-tenth of 1% in 2017. Unfortunately, the overall death rate from opioids has continued to climb as opioid abusers pivoted from illicit prescriptions to illegal narcotics. Ohio’s opioid enemy, it seems, has evolved.
In 2015, the Drug Enforcement Agency warned that drug abusers were shifting from the relatively safer prescription opioids to more dangerous drugs like heroine and fentanyl-laced narcotics. Fentanyl is a powerful, synthetic opioid that remains harder to detect and easier to import illegally. When mixed with other opioids, fentanyl proves deadly — now accounting for 3 in 4 opioid-related deaths.
The shift that the DEA warned about presents new challenges and opportunities, but will require policymakers to use different weapons in the changing war on drug addiction.
First, policymakers should ensure that first responders and other concerned citizens have access to naloxone and other medications that counteract an overdose. Ohio can and should make it easier for pharmacies across the state to distribute naloxone or other harm-reducing treatments.
Other states, for example, have adopted statewide orders allowing pharmacies to dispense naloxone. Ohio does not have a statewide order but instead relies on local health care providers and public health officials to make the call. Legislation under consideration in Columbus could take a step in the right direction by teaching pharmacists how to distribute naloxone without a prescription.
Second, Ohio should increase the number of doctors and nurses who can and do use addiction-treatment medications like methadone. Many Ohio counties, especially in rural areas, do not have medical professionals who routinely use such treatments to help their patients’ drug addiction. State and federal resources can help change that by increasing treatment options and education and by making methadone and similar treatments more widely available to pharmacies and health care clinics.
There is little to be gained by fighting yesterday’s battles again tomorrow. Even as high-profile trials for prior misconduct dominate news headlines, civic leaders and policymakers should focus less on assigning blame for the past and more on winning victories and limiting casualties in the future.
Ohio has taken great strides against the opioid epidemic, but the fight is far from over. And now that the battlefield has shifted, new strategies and tactics are required.
Rea S. Hederman Jr. is executive director of the economic research center and vice president of policy at The Buckeye Institute in Columbus.