Opioid epidemic getting worse, more urgency needed

David Plazas
  • Editorial: People are clamoring for solutions and political leaders must heed and act upon them.

There is no sugar coating it: the opioid epidemic is bad in Tennessee and getting worse by the year.

The number of overdose deaths has exploded by more than 300 percent over the last two decades.

Nearly 1,500 people died in 2015, and the state earned the ill-fated distinction of having the second highest rate of prescriptions per capita in the nation.

Opioid pain relievers, including OxyContin and Vicodin, have been the focus of a government campaign to reduce overdose deaths.

More babies are being born drug dependent, and communities, from the east to the middle to the west of the state are reeling.

The demand for solutions and accountability is growing louder. While there are local, state and national efforts to stem the tide, they still are not enough to tame what is Tennessee’s No. 1 public health crisis — taking a grave economic, societal and emotional toll on families.

A USA TODAY NETWORK–Tennessee forum in Knoxville on Tuesday brought in numerous people, many heartbroken because they had lost or were desperate to get help for a loved one.

The message from panelists — something echoed in a similar panel held in Nashville last summer — was that there should be no one-size-fits-all approach and that addiction must be treated medically not criminally.

That is a message that federal and state political leaders must hear, heed and act upon.

It is promising that the Trump Administration announced on Wednesday the creation of a new opioid addiction commission, led by New Jersey Gov. Chris Christie.

The concern is whether the commission will be more inclined to pursue a law-and-order approach versus a treatment approach. The latter was finally endorsed by Congress in legislation passed last year though medical professionals have treated addiction like a disease for some time.

One third of the United States’ population lives with chronic pain, and medication is sometimes the answer.

However, will the commission hold medical professionals accountable for administering pain killers responsibly? And will it examine pharmaceutical companies’ role in creating effective, but highly addictive, drugs that helped get us into this mess?

Health, law enforcement and community leaders are also concerned about uncertainty in funding, given deep proposed cuts to domestic spending, in areas like healthcare and research.

The United States cannot afford to go backwards and there are numerous issues that must addressed, among them:

  • Ensuring that treatment options don’t rely on just one particular drug regimen or protocol — i.e., just naloxone or methadone — but are tailored for each addict’s need.
  • Welcoming unconventional approaches such as supporting "the cabin" in White Pine, Tenn., at the foothills of the Appalachian Mountains, or providing free or reduced-cost birth control to women who are taking pain killers so that babies are not born drug-dependent.
  • Working with private sector leaders like BlueCross BlueShield Tennessee, which has funded an expansion of Coffee County’s “Count It. Lock It. Drop It.” campaign for people to secure their medications and dispose of pills they no longer needed.
  • Ending disparities in how we treat addiction overall. Ninety percent of opioid addicts are white, and the opioid epidemic is generally being addressed medically. Meanwhile, drug addiction that afflicts minorities disproportionately, like crack cocaine or marijuana, is still criminalized.

Then, there is the issue of access. So many people afflicted by addiction do not have or cannot afford insurance to seek and complete treatment.

This speaks to the broader failure of Tennessee lawmakers not to expand health insurance coverage to 400,000 working poor individuals over the last two years and Congress’ failure in March to repeal and replace the Affordable Care Act. Congressional House Republicans voted more than 60 times over the last seven years to repeal ACA, but did not even take a vote this year. They simply moved on.

The trouble is there are people who reap the consequences of this inaction. Expanding Medicaid wholly or even piecemeal to veterans and people living with addiction or mental illness — as recommended last year by state House Speaker Beth Harwell’s 3-Star Healthy Task Force — would go a long way.

Hopefully, the ad hoc opioid task force Harwell established this year will offer some hearty solutions.

There is certainly an important law enforcement component to fighting the opioid epidemic.

While state and local officials have made great gains in controlling the distribution of prescription opioids, Tennessee is bordered by eight other states where doctor-shopping and other illicit activity may occur, which then sifts into the Volunteer State.

Authorities are blindsided because there is no national registry where they can compare and monitor prescriptions across the country. They want to see what is going on elsewhere.

Sadly, as prescription pills have become more costly and difficult to obtain, drugs like heroin and fentanyl have become alternatives.

In addition, the law is slow to adapt to how entrepreneurial drug pushers have become in offering synthetic or analog drugs to pain killers, which may not face the same consequences as drugs addressed on the books.

This will not be an easy problem to solve, but we must have the resolve to continue to fight and serve the needs of those who most need help.

Opinion and Engagement Editor David Plazas wrote this editorial on behalf of The Tennessean Editorial Board. Reach him at (615) 259-8063, email him at dplazas@tennessean.com or tweet to him at @davidplazas.