The opioid and heroin epidemic has taken center stage in the collective minds of policymakers across the nation over the past few years. Once considered an isolated problem, opioid use and subsequent overdose deaths have sadly become commonplace, coast to coast. So, it should be no surprise that the White House has made combating this drug problem a top priority. But is their approach the right one?
Just this week, President Trump visited New Hampshire to announce plans to take on the opioid problem, including a proposal to explore the death penalty for high-volume drug dealers linked to overdoses. On its face, this eye-for-an-eye approach appeals to our emotional desire to hold someone accountable who is at least partially responsible for taking the lives of so many people.
However, I do not think this blunt instrument approach is enough to deter either supply or demand of opioids and fentanyl. It certainly does not deal with treatment for recovering addicts or scratch the surface of larger issues like a strain on the foster care system created by addicts losing custody of their children. There are also jurisdictional issues as well. Some states do not use the death penalty, and it is unclear at least to me what federal laws could claim jurisdiction over a dealer to make them subject to the death penalty as a federal sentence.
For years, I was on the front lines of the opioid crisis as both a State Senator and a social worker in training. I was in the Ohio Senate as the first two bills were passed to take down so-called pill mills back in 2010 and 2011. The laws basically curbed dispensing of opioid-based painkillers that were being both overprescribed by doctors and abused by patients. The law worked to stem availability to drugs like Oxycodone, but had no plan for the patients that had become hooked. With no access to prescription painkillers, and no plan to wean them off of the drugs or provide comprehensive treatment, prescription opioid users were faced with an addiction that often led them to use heroin. Cheap and accessible heroin started to replace pills like Oxy.
Addiction and overdoses abounded over the next decade. Communities were ill equipped to deal with the rise in heroin use and related deaths. According to the most recent statistics available, Ohio is ranked second in the nation in overdose deaths related to opioids. My home county, Trumbull, is in the top ten Ohio counties, leading the state in accidental overdoses with more than 100 deaths recorded last year.
In my home state, much like many others, we did not have the infrastructure or capacity for detox and treatment beds. We weren’t sure if medically assisted treatment like Suboxone was the answer to keep people away from harder drugs. Employers didn’t know how to address a workforce increasingly less likely to pass a drug test. Social services didn’t have the capacity to take on the demand for assistance. Grandparents were faced with raising grandkids orphaned by a parent who overdosed. Coroners didn’t know where to turn as morgues ran out of room. Law enforcement didn’t know what to do when jails became overcrowded with those committing drug-related crimes.
Rehabs popped up everywhere, but treatment remained largely financially out of reach. Narcan, the trade name for the shot that reverses overdoses, was made widely available particularly through first responders. The rise of fentanyl made Narcan less effective, requiring multiple doses to reverse its effects.
Hospitals were flooded with babies withdrawing from the effects of maternal use of opioids during pregnancy. I saw many of these babies while doing my social work training in my local hospital’s NICU. The hospital social work team would have to interface with everyone from Children’s Services to law enforcement to addiction treatment services to home medical equipment companies serving fragile newborns upon hospital discharge. In the community, families and friends were burying loved ones who succumbed to drugs, some without the money to provide for a proper funeral.
Why do I share the experiences of my community in Ohio? To demonstrate that the opioid epidemic is far more complex and needs a far more comprehensive solution than just executing dealers or even just throwing money at the problem. It will take a multi-disciplinary approach with cooperation from every level of government and the private sector to eradicate this beast.
Capri Cafaro (@thehonorablecsc) is a contributor to the Washington Examiner’s Beltway Confidential blog. She is a former member of the Ohio State Senate, where she was the Senate minority leader. She is now an Executive in Residence at American University’s School of Public Affairs.
