The National Issues Forum Institute released the six-page Issue Advisory, What Should We Do About The Opioid Epidemic?, published October 2017. The issue advisory presents three options to use during deliberation on how society can address the rising opioid epidemic that has swept the U.S. The issue advisory is available for free download on NIFI’s site here, as well as, a post-forum questionnaire.
Drug abuse, a problem the United States has faced for decades, has taken a sharp and lethal turn with the rise of opioids—both legal pain- killers, such as oxycodone and fentanyl, and illegal ones like heroin.
More than 64,000 Americans were killed by drug overdoses in 2016, according to the Centers for Disease Control, and at least two-thirds of those deaths were caused by opioids. That is worse than the peak of the HIV epidemic in 1995 and more than the number of US combat deaths in the entire Vietnam War.
In the last year, doctors wrote more than 236 million prescriptions for opioids, or about one for every American adult. But many patients became addicted to the painkillers as their bodies began to tolerate higher and higher doses. Others, if they could no longer get prescriptions, switched to heroin; then came the even deadlier fentanyl.
Now drug abuse is so widespread it is even affecting productivity–employers say they can’t fill positions because too many applicants fail a drug test. The Federal Reserve reports that opioid addiction may be shrinking the number of job applicants because it is keeping otherwise able-bodied people out of the workforce.
The problem exists in almost every community throughout the United States, though it has hit hardest in the Northeast, the Midwest, and Appalachian regions, where joblessness and poverty have hollowed out many small towns and left families in desperate circumstances. In Cincinnati, Ohio, police estimated that police officers and paramedics spent at least 102 hours tending to overdose patients in just one week. Responding to the crisis is straining the budgets of many small towns and counties.
Doctors and nurses now see the epidemic’s effects on the next generation, a wave of babies born addicted to painkillers or heroin. Sara Murray and Rhonda Edmunds, nurses in Huntington, West Virginia, founded Lily’s Place, a facility for addicted babies and their mothers.
“The devil has come to Huntington,” Murray said on CNN. “We have generational addiction and that’s their normal. It was their mother’s normal. It was their grandmother’s normal. And now, it’s their normal.”
What should we do to relieve the opioid epidemic facing our communities? This issue advisory presents three options for deliberation, along with their drawbacks. Each option offers advantages as well as risks. If we increase enforcement, for example, this may result in many more people in prison. If we reduce the number of prescriptions written, we may increase suffering among people with painful illnesses.
Option 1: Focus on Treatment for All
This option says that, given the rising number of deaths from opioids, we are not devoting enough resources to treatment to make real headway in turning around the epidemic. Addiction is primarily a medical and behavioral problem, and those are the best tools for combating the crisis. Treatment should be available on demand for anyone who wants it. At the same time, the pharmaceutical companies that have profited from making and promoting opioid painkillers need to contribute more to the solution
Option 2: Focus on Enforcement
This option says that our highest priority must be keeping our communities safe and preventing people from becoming addicted in the first place. Strong enforcement measures are needed, including crackdowns and harsher sentences for dealers, distributors, and overprescribing doctors. And we should take tougher measures to cut off the supply of drugs at the source. Addiction to opioids and other hard drugs brings with it crime and other dangers, and closing our eyes to these dangers only makes the problem worse. Mandatory drug testing for more workers is needed. In the long run, a tough approach is the most compassionate.
Option 3: Focus on Individual Choice
This option recognizes that society cannot force treatment on people. We should not continue to waste money on a failed “war on drugs” in any form. Only those who wish to be free of addiction end up recovering. We should be clear that crime will not be tolerated, but if people who use drugs are not harming society or behaving dangerously, they should be tolerated and allowed to use safely, even if they are damaging their own lives. Those who do not or cannot make the decision to get well should not be forced, and communities shouldn’t spend their limited resources trying to force treatment on people.
About NIFI Issue Guides
NIFI’s Issue Guides introduce participants to several choices or approaches to consider. Rather than conforming to any single public proposal, each choice reflects widely held concerns and principles. Panels of experts review manuscripts to make sure the choices are presented accurately and fairly. By intention, Issue Guides do not identify individuals or organizations with partisan labels, such as Democratic, Republican, conservative, or liberal. The goal is to present ideas in a fresh way that encourages readers to judge them on their merit.
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