Ohio and Indiana take different approaches to opioid epidemic

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Ohio Gov. John Kasich described drug addiction as “a common enemy” in this week’s state-of-the-state address. Kasich highlighted the challenge in terms similar to those laid out by state Speaker of the House Cliff Rosenberger, R-Clarksville, back in January when members were sworn in. But there does not yet appear to be regional consensus on how to engage this blight on civilization.

Just imagine what kind of relief Ohio could be afforded in health care, where most of $1 billion in state and federal Medicaid addiction-treatment funds go, if this problem were to be resolved. Nearly as large a cost, in terms of both wasted lives and government expenditures, stems from corrections programs for drug abusers. The costs in education, housing, social services and workplace productivity are incalculable.

As J.D. Vance, author of last year’s bestseller Hillbilly Elegy: A Memoir of a Family and Culture in Crisis, pointed out last week in a keynote address to the Federalist Society in Columbus, a policy that works has got to do something about the addict, but also for the aunts, uncles and grandmothers who shoulder the burden of child care for a mother who has succumbed to a drug overdose. In 2015, Ohio led the nation in this tragic category with 3,050, and the 2016 total may have topped 4,000. As reported in the Columbus Dispatch story linked above, Senate Minority Leader Joe Schiavoni, D-Boardman, noted at this week’s state-of-the-state joint session of the Legislature that two Ohio counties have had to rent refrigerator trucks to handle the surge in the number of corpses from lives snuffed out by overdose.

The first of Kasich’s major proposals to tackle the issue is a $20 million grant fund to accelerate treatment programs and technologies that promise to serve as useful tools in the fight against drug abuse. The money would come from the Ohio Third Frontier Commission, which votes to dole out bond proceeds for 21st century innovations. The idea is that these resources might bring some breakthrough addition-mitigating technology to market that otherwise would stall out due to lack of funding.

Currently, prescriptions for pain medications can be written for 30-90 days. According to the Ohio Department of Health, nearly 800 million doses of pain pills were prescribed in Ohio in 2012, although the Dispatch noted that general awareness of the overdose problem has helped curb that figure to about 631 million doses last year.

Number of opioid doses dispensed to Ohio patients, 2011-2015

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The governor’s second proposal is that prescriptions be limited to shorter terms—seven days for adults and five days for minors with acute pain, but not chronic conditions. Doctors could use their judgment to exceed these dosage guidelines, if they document the reasons. Apparently, the Ohio Medical Board, Dental Board and Ohio Boards of Pharmacy and Nursing will all have to sign off on the proposed legislation.

Next door in Indiana, a legislative proposal passed on the House floor this week gives up on the modern approaches to criminal justice, which include giving judges more discretion and preferring treatment over punishment. S.B. 324 instead aims to crack down on heroin dealers and those who rob pharmacies, increasing the severity of the penalties for dealing and lessening the judiciary’s discretion in sentencing. Critics argue the Legislature is “backsliding” to previous, failed attempts to address the drug epidemic, but the bill was approved by a huge 72-18 margin.

As state Rep. Ed Delaney, D-Indianapolis, noted before the vote, taking away judges’ discretion means giving more discretion to prosecutors, which isn’t an unalloyed good in the current criminal justice landscape. Even though nearly all lawmakers agree with the proposition that the goal of incarceration is to deal with the “people we are afraid of, and not the people we are mad at,” it proves difficult to convince them not to be more afraid of drug dealers than rapists and armed robbers.

I can’t yet fault the approach in either state, since all serious policymakers are at their wits’ end about the drug problem. But I have to root for Ohio’s search for innovative breakthroughs. Opioid abuse affects many precious lives, careers and billions in government expenditures, as mentioned above.

Perhaps it is time for a serious discussion of the ameliorative potential of marijuana extracts for pain relief. According to public opinion polls, most Americans would like to give medical marijuana a chance to prove its value. However, this is a place where there is a clear conflict between not just science and law, but two distinct sets of cultural values.


Image by Steve Heap

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