Polarizing Politics and Lack of Legislation — The Drug Overdose Crisis and its affect on “Trump Country”

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Promoted from the diaries by streiff. Promotion does not imply endorsement.
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Something strange is going on in Kentucky. According to the National Institute on Drug Abuse(NIDA), the Bluegrass State ranks in the top ten nationwide for opioid-related overdose deaths. In 2016, the opioid-related overdose death rate in Kentucky ran at about twice the national rate. Overdose deaths tied to heroin use doubled since 2012; synthetic-opioid-related deaths multiplied by a factor of about 6.5 (from 70 to 465).

As of 2015, Kentucky was writing far too many opioid prescriptions (97 per 100 persons, considerably higher than the 70 per 100 persons national average).

Consistent with national trends, newborn babies are increasingly being born addicted to opioids. According to NIDA, “NAS (Neonatal Abstinence Syndrome) in Kentucky increased from 0.4 cases per 1,000 births in 2000 to 15.0 cases per 1,000 births in 2013—a more than thirty-sevenfold increase… The average across the 28 states included in the 2013 analysis was 6.0 per 1,000 births.”

Many communities afflicted by the scourge of opioid-use disorder and its consequences (HIV and Hepatitis C transmission) are populated by Trump voters. Kentucky is one of the most Trumpian, and red, states in the nation. The destruction and devastation of substance-use disorders have been happening right at the back door of key Republican leaders. For example, Kentucky Senate President Robert Stivers lives in Manchester, Kentucky, which is in Clay County. In relation to opioids and its consequential relationship to overdose deaths, Manchester and Clay County more broadly has been heavily impacted:

Eleven drug stores are scattered about a tiny city of 1,500 people. Many have opened in the past decade—four in the past three years. And prescription pain medication are one of the top-selling items.

[…]

Clay’s residents filled prescriptions for 2.2 million doses of hydrocodone and about 617,000 doses of oxycodone in the 12-month period ending last September—that’s about 150 doses for every man, woman, and child. About half as many doses of each drug were reported in Allen County (population 20,640), on the Tennessee border 160 miles southwest. Even smaller quantities were used in Breckenridge (population 20,018), another central Kentucky county.

[…]

From 2009 to 2013, Clay already had the third highest rate of hospitalizations for pharmaceutical opioid overdoses among the state’s 120 counties. But use has accelerated for some drugs in the past three years, data shows. People become addicted to opioids after they buy drugs on the street or begin treatment for an injury, said Kenny Watts, manager of Kentucky Pain Management Services in Hazard, Ky., about 40 miles from Manchester.

[…]

Manchester’s closest inpatient drug treatment facility carries a waiting list of 100 people that’s grown more than 50 percent in recent years, said Tim Cesario, director of substance abuse services at the Cumberland River Comprehensive Care Center in Corbin. The facility—with 41 beds for men and 15 for women — has been at capacity for several years, he said.

You would think, given all this, that addressing the opioid crisis and making it easier for people to get treatment to help them enter long-term recovery would be a layup in this legislative session. But maybe not.

H.B. 121, which would have gutted bureaucracy and hurdles to those with a substance-use disorder (SUD) seeking the use of medication-assisted treatment to do so, was unanimously passed in the Kentucky House. But it was back-burnered in the Kentucky Senate. The state legislature finished its session last night without the Senate moving the bill.

The reason this matters: The more hoops someone has to jump through to get treatment, the less likely they are to do it. This is where the stigma associated with SUDs matters. We can eliminate the stigma for those suffering, but what happens when they go to finally seek the treatment they desperately need? Also, as we’ve seen from the above reporting, it’s not like there’s a lot of capacity for in-patient treatment in the Senate President’s neck of the woods—which you would think would mean he’d be personally pressing the legislation.

There’s a possibility that *some* of the concern doctors had about this *may* have been alleviated via a different bill that was passed. But that bill doesn’t seem to be MAT-specific, and given the opioids problem in Kentucky, this seems to be nonsensical. It looks like H.B. 121 stalled out because insurers didn’t like it. Basically, this is not just short-sighted policy—it’s also cronyism that is killing voters. With the GOP and Democrats specifically running on the drug crisis, you would think the parties would actually legislate on the issue rather than just speak on it. Or is that where our politics are these days? All talk, no action, and the desertion of compassion for human need in order to garner the support of corporate interests.

The bill was killed late in the evening last night, and with it, the lives lost due to bad governance. I recommend you call the Senate President’s office now and let him know how you feel about his nonsensical approach to the drug overdose epidemic. His number is 502-564-3120.

Taylor Weyeneth is Executive Director of End The Stigma PAC, a political action committee dedicated to ending the stigma of substance-use and mental health disorders. Most recently, Taylor served as the Deputy Chief of Staff at the White House Office of National Drug Control Policy in the Executive Office of the President, under President Trump.

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