Each day, 115 people die in the U.S. from opioid overdoses. That’s nearly 42,000 deaths from opioids each year. This public health issue is now causing more yearly deaths than breast cancer and many more than prostate cancer. It has not been given the attention and federal action that it deserves.
While no one denies the criminal component of illegal opioid use, legislators must address the opioid epidemic in the same way as we treat other public health issues — by treating the disease. For three years, I’ve read about increased awareness of the looming national epidemic, but state legislators have been debating and developing solutions — state-by-state — for almost a decade. I urge Congress to look to the states for innovative solutions.
The public health and criminal justice infrastructures in the states comprise the front line in the fight against opioid abuse. Until recently, little had been done to halt the spread of opioid addiction, even in some of the hardest hit areas. Places like New Hampshire, West Virginia, Texas, and Maryland all struggle with an increasingly addicted population and the civil and criminal issues that result from the cycle of addiction.
State spending on corrections alone has grown faster than nearly every other budget item, topping $50 billion. But a focus on crime and prison time without equal attention to addressing the underlying causes of addiction is a futile endeavor.
I know firsthand how hard it can be to watch someone suffer in the grips of addiction. For the past five years, I have helped lead Wisconsin’s legislative efforts to combat the opioid epidemic through the Heroin, Opiate, Prevention, and Education Agenda. HOPE resulted in 30 new Wisconsin laws addressing drug treatment and law enforcement as well as the implementation of the Prescription Drug Monitoring Program, a nationwide database for doctors to monitor their patient’s opioid prescriptions, preventing abuse or “doctor shopping.”
Wrap-around programs like those implemented in Wisconsin are making a difference. Since 2015, opioid prescriptions are down nearly 30 percent in our state. But Wisconsin isn’t the only state legislature taking action; other legislatures are implementing innovative approaches and are creating a vast library of proven options for Congress to consider.
In New Hampshire, the legislature created drug courts that place non-violent offenders in treatment and diversion programs instead of prison. The cost to taxpayers is thus massively reduced. More importantly, we know that jail doesn’t fix the problem. Nationally, 60 – 80 percent of drug offenders commit a new, typically drug-related, crime upon release from prison, and 95 percent return to drug abuse.
Lawmakers in Texas have combined approaches to getting addicts the treatment they need. While addressing addiction, the court system also ensures dealers are hit with harsher sentences. Texas lawmakers Jerry Madden and John Whitmire successfully sent a bill to then-Governor Rick Perry to spend $241 million on treatment, mental health and rehabilitation programs, instead of expanding prison facilities. The results speak for themselves. In three years, taxpayers saved $2 billion, prison populations declined by 15,000, and the recidivism rate for ex-offenders dropped by 25 percent, leading to the lowest Texas crime rate since 1968.
In Maryland, the legislature passed laws that target criminals, offer new treatment options and reduce incarceration of non-violent offenders. Bills like the HOPE Act and the Prescriber Limits Act all take steps to address addiction in the state. In Maryland SB 539, the legislature took a particularly hard line on drug dealers who knowingly sell fentanyl — an opioid 50-100 times more potent than heroin. The bill allows prosecutors to seek an additional 10 years in jail for these predatory criminals.
To help curb the amount of prescription opioids available to abusers, Maryland passed the Prescriber Limits Act of 2017 that requires healthcare providers to prescribe the lowest effective dose of an opioid to patients.
It isn’t just state legislatures seeking better solutions to the opioid crisis. Pharmaceutical innovations are proving instrumental in the fight against opioid addiction. One of the most important tools for those treating and reversing opioid overdoses is naloxone, an injection that blocks the effects of opioids. First developed in the 1970’s and widely distributed to first responders since 1996, the CDC estimates this one drug has saved 26,000 lives. Probuphine, the first ever implant approved by the FDA, is a microchip developed by two American pharmaceutical companies that delivers a drug that counteracts opioid withdrawal symptoms. Incredibly, 96 percent of the Probuphine users remain opioid-free for at least four months.
These are just a few examples of non-incarceration interventions that work.
As Congress debates the opioid epidemic, it’s too easy to play the blame game. It’s the user’s fault, the dealer’s fault, the drug manufacturer’s fault. But fault-finding only obscures the issue and focuses decision-makers on regulating rather than addressing the underlying causes.
The viable solutions from Wisconsin, Maryland, and other states prove solutions do exist. In many cases, states are spending less and achieving better outcomes. Appropriation and regulation are useful, but treatment is key. Congress should pay attention to what the states have learned and apply those lessons to national solutions.
Wisconsin State Rep. John Nygren, a Republican, is the 2018 Wisconsin Pharmacy Society Legislator of the Year. He is chairman of the Health and Human Services Task Force of the American Legislative Exchange Council.
