Experts Urge Better Treatment, Drug-Prevention Programs to Combat Opioid Crisis

Opioid epidemic affects rural communities with little access to other forms of medical relief

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June 8, 2017

A panel of scholars discussed implementing better treatment, increased data collection, and more drug-prevention programs to combat America's growing opioid crisis at an American Enterprise Institute presentation on Wednesday.

The panel focused on the efforts made against opioid abuse in Arizona, where Republican Gov. Doug Ducey declared a state of emergency Monday because of a glut of recent opioid overdoses.

Danny Seiden, deputy chief of staff to the Arizona governor, said that more than two Arizonans die each day from opioid overdose and that up to this point, the government has been unable to collect data fast enough to handle the problem effectively.

"The governor has declared a state of emergency because it grants the state special powers to collect data, as well as special rulemaking authority," Seiden said. "We're starting to treat this like an actual epidemic."

To combat the crisis, Arizona has recently started using the drugs Naloxone and Narcan, which are injected nasally to revive those who have overdosed on opioids. Both drugs have been made available without prescription.

"We're running pilot programs equipping our state troopers with it and from January to April we began a program to distribute it to as many at-risk communities as possible. We've documented 492 overdose reversals because of Naloxone or Narcan," Seiden said.

Professor of medicine at the University of Chicago Harold Pollack said that in general, the people who overdose and die are those who have not been sufficiently served by treatment programs. Pollock suggested a number of solutions, including making data collecting surveys more user-friendly and expanding Affordable Care Act Medicaid programs to provide a safe house for those suffering from addiction.

Seiden disagreed with Pollack's solutions, saying that simply treating opioid addicts would not prove to be a long-term solution. Seiden said Arizona has started to implement drug-prevention programs in middle schools, with the hopes of deterring children from becoming opioid users in the future.

"Maybe treating opioids with opioids is not the best solution," he said. "Wouldn't it be better to stop it?"

Since the introduction of time-release opioid pills in the mid-1990s, overdoses and deaths have skyrocketed, especially in rural America. Additionally, pills illegally laced with the opioid replacement Fentanyl have had deadly consequences. According to a New York Times study, 50-60 thousand Americans die every year due to opioid-related incidents. Princeton economists Anne Case and Angus Deaton have labeled the epidemic the "deaths of despair," a phenomenon that most frequently affects less educated whites, both men and women, between the ages of 45 and 54. According to the panelists, the rate of opioid abuse, addiction, and fatal overdose rise along with unemployment.

Senior editor at the Weekly Standard Christopher Caldwell said the opioid epidemic dwarfs other recent drug addiction outbreaks, such as the heroin problem in the 1970s when people were dying at the rate of 1.5 per 100,000 each year because of overdoses. Similarly, at the peak of the crack epidemic in the late 1980s drugs claimed two lives per 100,000 people. Because of their widespread availability through prescription medication, opioids have caused the deaths of an exponentially larger number of people.

"We're up to about 12 per 100,000. In the state of New Hampshire we're at about 30 per 100,000. In the state of West Virginia we're at 40 per 100,000," Caldwell said.

Unlike previous drug problems, the opioid epidemic affects rural communities which have little access to other forms of medical relief. AEI's Nicholas Eberstadt pointed out that non-Hispanic white life expectancy is lowest in the predominantly rural West Virginia while it is highest in the entirely urban District of Columbia.

"What we're seeing in the Anglos and especially in the rural Anglos is a sort of an echo of what happened in black America within some of our lifetimes," he said.