This 2016 presidential race was a hard fought campaign. President-elect Donald J. Trump campaigned on a bold and conservative platform of making our cities safe again. After decades of neglect, urban communities across America are in desperate need of repair.
With so many partisan political issues, there remain a select few issues that unite us rather than divide us. America is facing a tragic epidemic of drug-overdose deaths, and both Republicans and Democrats agree that it is time for action.
More than 21 million Americans above the age of 12 have been diagnosed with a substance abuse problem. In 2014, we saw watched 47,000 Americans die from drug overdoses, mostly due to abuse of heroin and other opiates. Ohio had the second-highest number of overdose-related deaths in the nation, with 79 people dying from opioid overdoses every day.
These tragic statistics do not include the many examples of people who hurt others while under the influence of drugs, the spread of diseases from shared needles, or the endless violence that is inherent to the criminal drug trade.
In rural, suburban, and urban neighborhoods across Ohio, too many people suffering from chronic pain become addicted to prescribed drugs and turn to black market alternatives like heroin when obtaining new prescriptions becomes too difficult or costly. Heroin is cheap and available, despite the more than $500 the U.S. spends every second on the war on drugs. The Drug Enforcement Administration (DEA) has confirmed that Mexico is the primary supplier of heroin in the United States. These cartel traffickers are taking advantage of the Obama Administration’s failure to secure our Southern border.
And, if that wasn’t bad enough, outrageous federal loopholes currently allow manufacturers from China to ship fentanyl, a deadly opioid which is stronger and cheaper than heroin, into our communities. Dealing with the opioid epidemic requires a diverse array of treatment strategies and options that must involve our criminal justice, law enforcement, and public health systems. A multifaceted approach is required to address this issue, and it is imperative that we are making the right investments at every turn.
The Comprehensive Addiction and Recovery Act, sponsored by Ohio Senator Rob Portman recently passed with a bi-partisan vote of 92-2. The goal of this law is to shift focus away from fighting the drug war through mass incarceration, and build up America's treatment capacity. It included, among other things, greater funding for law enforcement and treatment, and increased the patient cap on doctors prescribing buprenorphine, a bridge treatment which reduces withdrawal symptoms and cravings that too often drive addicts back to drug dealers.
In Ohio, a drug known as Suboxone is the state’s preferred buprenorphine treatment paid for by Medicaid. But it is far from an ideal medication. Suboxone comes in film strip form and is available in limited dosages, meaning physicians often have to prescribe higher doses than a patient's actual needs. As a result, we are seeing patients sell their excess strips on the black market for more than twice their value. Suboxone strips are also commonly smuggled into prisons and resold to inmates, compounding drug addiction problems in our prisons.
In Columbus, Suboxone smuggling into the Franklin County Jail became such a problem that the facility had to ban all outside deliveries of underwear and socks, which were easily used to conceal film strips. And in Southwest Ohio, officials at the Warren and Lebanon Correctional Institutions report that they are seeing an influx in Suboxone smuggling and abuse in those facilities. Law enforcement in Ohio is already overwhelmed trying to fight the drug epidemic in our communities, and now a purported solution to the opiate epidemic is exacerbating the problem.
Notably, Ohio Attorney General Mike DeWine and 35 other attorneys general have sued the makers of Suboxone. The bipartisan suit argues that an aggressive pricing scheme and monopolistic practices have delayed alternatives to keep prices artificially high. Not only have their actions been a burden on taxpayers, they have prevented other drug manufacturers from offering patients and Medicaid programs more efficient options with tailored dosage levels and larger barriers to diversion into prisons and black markets.
To be clear, ensuring access to MATs is important. When used properly, these treatments save lives. But in Ohio, almost all of Medicaid’s spending on these treatments is paying for Suboxone, when there are other effective options available. Limited taxpayer resources shouldn’t be paying for medications that are ultimately costing the state in other ways.
By adopting a multi-faceted approach to addressing the opioid epidemic—expanding access to treatments, stopping well-intentioned Medicaid policies that are making the drug epidemic worse, and stopping the trafficking of illegal drugs at the border and in our communities—Ohio and America can use these evidence-based policy changes to keep more people alive and stop the opioid crisis.