Opioids contributed to 84.5 percent of the over 3,000 Ohio overdose deaths in 2015 alone. People are often quick to point the finger at users. What could they do differently? How could they allow themselves to get into such a scenario? They are always the easiest scapegoat. But drug epidemics like the one raging in Ohio are much more complex. The conversation has evolved beyond the myopic, user-blaming viewpoint with a new shift in thinking. More than ever, action is being directed at the source: opioid prescriptions.
Actually, prescription opioid overdoses are on the decline in Ohio, down to 21.9 percent from 26.6 percent in 2014. Why present a statistic that makes a problem look like less of a problem? Seems counter-intuitive to the argument, right? You might be making the same mistake that many do — assuming this overdose decline is a good sign. While overdoses may be down, the real danger of prescription opioids lies in their addictive nature. And the ease of transitioning to cheaper, more potent and more addictive alternatives like heroin or fentanyl. Not to mention the new opioid on the block, carfentanil.
A 2011 study in the journal Substance Abuse and Rehabilitation found that almost half of young heroin users took prescription opioids first. Yes, the term “gateway drug” is old hat and has lost much of its value to overuse and misuse, but it’s difficult to look at the trend of pills-to-heroin or pills-to-fentanyl as anything but. These stepping stones just happen to be of the small, white variety.
Efforts Against the Epidemic
So, how do you tackle the issue at its source? Make less stepping stones. The plight of tens of thousands of Ohioans has finally been heard, and the highest levels of state government are now up for the long fight ahead. Ohio has spearheaded efforts to fight addiction starting with pill mills, prescription-happy medical locations. The logic is as follows: Limit the number of opioids in Ohio and limit the prospect of overuse. Also, prevent heroin, fentanyl and carfentanil use by proxy.
Ohio Governor John Kasich has positioned the state to adopt national opioid prescription guidelines, set opioid dosage limits for dentists and doctors, and create extensive education and addiction counseling online. In the first months of 2017, he and his contemporaries have pushed legislation through the state and national government.
Senate Bill 319:
- Requires facilities that administer suboxone, used to treat opioid addiction, must be licensed by the state.
- Allows for-profit methadone clinics to open.
- Permits homeless shelters, halfway houses, schools, treatment centers and other facilities to carry overdose-reversal drug naloxone.
- Provides civil immunity to first responders and other authorized to administer naloxone.
- Eliminates an exemption in state law that allowed distribution of controlled substances without oversight of the Ohio Board of Pharmacy.
- Limits the number of opiate pills from a single prescription to a 90-day supply.
Senate Bill 119 & House Bill 167:
- Doctors and dentists must complete eight hours of opioid and addiction training to prescribe above limits.
- Addiction treatment centers or physicians treating patients for addiction must offer naltrexone, which blocks opioids’ effects on the brain.
- State officials must make counseling and education easily accessible online.
These are by no means full-stop solutions. Ohio Senator Jay Hottinger affirms this by saying, “We’re not going to be able to legislate our way out this epidemic. But this will save lives because it will slow the pipeline of addiction caused by overprescribing.” Epidemics on a scale like this require more than ink on paper. But the direction is hopeful, and the effort is certainly not wasted. In fact, even before these latest efforts were put into place, opioid dosage rates were decreasing in Ohio. The year 2012 saw a peak of 793 million pills dispensed, but that number is down to 631 million as of last year, a 20.4 percent decrease. It can only be surmised that the newest 2017 regulations will continue this downward trend.
Even More Efforts
In July 2016, Cleveland-based station WKYC reported that upward of 2,200 lives have been saved by naloxone. The correlation is apparent: more access to naloxone means less overdose deaths. However, this is anything but a cure-all and should not be described as such. Naloxone is neither 100 percent effective in counteracting an overdose nor effective in helping against non-opioid overdoses. It is simply one tool in the arsenal against overdoses. And speaking of tools for this fight, The Opiate Action Team is an invaluable resource that comes with strategies of its own to combat the underlying causes of the Ohio epidemic.
Lawmakers and Lifesavers Alike
Overall, less opioids on Ohio’s streets might sound great to you. But, perhaps you or someone who know is suffering from illnesses where such painkillers are a necessity. Not to worry: Physicians have mirrored these concerns. The Ohio State Medical Association and its health practitioners want to address the epidemic without tying doctors’ hands — after all, every patient’s needs are different. Fortunately, the new rules and regulations take the patient perspective into account. Just as this is not a cookie-cutter problem, the solutions are not one size fits all. A necessary gray area exists so that professionals may approach care on a case-by-case basis. The hope is to strike a fair balance between the number of pills needed for pain while limiting the number of leftovers for recreational use.
As of March 30, 2017, physicians can only prescribe up to seven days of painkillers at a time. This is a vast departure from the 90-day prescriptions that came before, and the loopholes are continuing to tighten. All opioids now require a legitimate reason based on a patient’s medical record before prescribing. Plus, there must be proper reporting in the Ohio Automated Rx Reporting System (OARRS). It’s estimated that these proposed limits will lead to 109 million fewer doses. Interestingly enough, these regulations aren’t coming directly from the state government. Ohio’s medical community established these limits for itself. This is a hopeful sign of their intention for changing a corrupted system.
From colleges to jails and homeless shelters to courthouses, there are changes happening in Ohio. And there are more to come. The epidemic is facing opposition from all sides: new bills from legislators, increased regulations by doctors and reinvigorated community efforts across the state. This crisis may have a firm grip on Ohioans today, but it’s hold won’t last forever.
If you or someone you know is struggling with opioid use, know there is always hope. While new laws and regulations are addressing the drugs themselves, The Recovery Village® Columbus is here to help you deal with the aftermath of addiction. Recovery is possible, Ohio.