Introduction
The opioid epidemic in Ohio claims 116 lives due to overdose each day. While the opioid epidemic exists across the United States, Ohio has seen one of the highest increases in their death rates. In the past 15 years, deaths caused by opioids has increased by 292%. This public health crisis impacts not only those suffering from opioid addiction, but the millions of families who have lost loved ones. Senate Bill 154, introduced in May 2017, seeks to respond effectively to this epidemic, improved prevention strategies, stricter handling and prescribing of these addictive drugs, and increased funding for treatment centers.
Problem Statement
The magnitude of the opioid epidemic is colossal, President Trump declared a health emergency stating, “No part of our society — not young or old, rich or poor, urban or rural — has been spared this plague”. Ohio is among the top five states with the highest rates of opioid-related overdose deaths, claiming more than 17,000 lives since 2003.
The stakeholders in this issue are numerous, ranging from the addicts themselves to insurance providers. The people suffering from opiate addiction are the most significant stakeholders because their lives are being directly impacted. However, the families of opioid addicts suffer alongside their loved ones, oftentimes feeling helpless and having trouble navigating the line between enabling and supporting. Doctors are key players in this epidemic because they often introduced susceptible people to potentially harmful drugs. Insurance providers are financially impacted by the rising number of people seeking costly rehabilitation treatment. Pharmaceutical companies have a major stake in opiate production and distribution, their financial interest lie in mass consumption of these products. Lastly, the public and public officials as a whole have an interest in this social issue because of the number of people it impacts and to maintain public safety in their neighborhoods.
The behavior of people suffering from opioid addiction causes negative externalities. For example, external social costs include increased healthcare costs, increased criminal justice system costs, greater tension on families and high rates of public overdoses and death.
Main arguments in support of this bill
1. Prevention strategies aimed towards younger people reduces their chances of getting addicted to opioids. Educating youth about the risks of opioid use is key to counteracting illicit use of opioids. Research based prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use.
2. Increased funding for treatment produces more effective and long-lasting results. For every dollar invested in drug treatment, the U.S. yields a return of $4-$7 in the reduction of drug-related crime and criminal justice costs. Rehabilitation results in huge social benefits, from reduction in interpersonal conflicts to fewer drug-related accidents.
3. Stricter handling and prescribing policies will restrict the availability of opioids. It is crucial to monitor the supply chain of opioids by training doctors in responsible prescribing practices to reduce the demand. Censoring the illicit procurement of opioids is another essential step in curbing opioid addiction.
Main arguments against this bill
Although morally it seems easy to support this bill, there are two main reasons that people may be opposed.
1. The financial drain on the federal budget for subsidizing treatment programs is creating a worrisome fiscal issue. “Federal expenditures for drug treatment have risen by 341 percent since 1986 -- 20 percent faster than the total drug budget, 30 percent faster than spending for drug law enforcement and 700 percent faster than overall federal spending”.
2. Critics of current drug treatment programs claim that rehabilitation centers act as a revolving door. There is a significant lack of accountability within treatment systems, leading to the establishment of inefficient programs that do not follow best practices. The success rates of the prevailing treatment system are only 30 percent, meaning they are not effective 70 percent of the time. Although this may not be intentional, ultimately, treatment centers benefit from relapse, providing them with a steady flow of clientele and income.
Recommendation
Ohio is being impacted by the opioid epidemic in a way that calls for immediate action by lawmakers. Supporting this piece of legislation, a combination of prevention strategies, increased funding for treatment and stricter handling and prescribing policies is the recommended course of action to combat this crisis.
Prevention
The Department of Education will establish a grant program that will fund school-based initiatives that educate students on opioid dependence and addiction prevention. Research has classified such prevention programs among best practices. The school-based initiatives will be targeted towards students in grades kindergarten-eighth to have the greatest impact.
Treatment
The Medicaid program will provide coverage for treatment and referral services for drug abuse and addiction. This will increase accessibility for low-income individuals suffering from opiate addiction to receive equal treatment. The implementation of medication-assisted treatment follows the best practices of effectively rehabilitating addicts and closing the revolving door of relapse.
Stricter handling prescribing policies
This bill works to limit the availability of opioids by implementing abuse-deterrent labels on opioid pill bottles warning the user of the highly addictive nature and risks of the drug. Drug take back programs are an additional method introduced to get opioids off the streets and out of the hands of addicts and into secured facilities where they can safely dispose of the drugs.
Lastly, bill sponsors are calling for a formal declaration of the opioid crisis as a public health emergency. This step would bring the opioid epidemic to the forefront of the nation’s agenda, ideally resulting in increased research on how to effectively treat this crisis.
Summary
The opioid epidemic is quite literally a matter of life and death, Ohioans are dying at historically high rates and opioids are to blame. The opioid crisis is far reaching, crossing socioeconomic, race, and geographic lines. It is in the United States’ best interest to implement prevention and treatment strategies to save its citizens from a deadly fate. Healthy, opioid-sober citizens result in reduced healthcare and criminal justice costs and overall increased social benefits. By executing more stringent policies to obtain opioids and placing more emphasis on rehabilitation treatment, we are taking valuable steps towards curbing the opioid crisis. This bill is an example of a well written policy that can address some of the root causes of the opioid epidemic, Ohio policymakers must take action before it is too late.