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Saturday, June 15, 2024

OPIOID EPIDEMIC- Using Opioid Settlement Money to Solve the Opioid Epidemic

With settlements being reached in lawsuits by state attorneys general nationwide against the pharmaceutical that produced opioids for their part in feeding the opioid epidemic, local and state governments are working to apply that money into programs to prevent future opioid overdoses and treatment and recovery programs to reduce overdoses and deaths from these dangerous drugs.

Washington State’s share of the settlement money so far is $1.29 billion according to the Washington State Attorney General’s Office.

This money comes at a time when drug overdose deaths have fallen slightly between 2022 and 2023 for most of the country, except for Washington which is among 12 states that have seen an increase in drug deaths, according to the Centers for Disease Control and Prevention (CDC). In fact, Washington and Oregon are among the three worse states for an increase in drug deaths. Washington has seen a 24.85% increase from 2022 to 2023 and Oregon has seen a 22.78% increase.

Earlier this year Representative Rick Larsen’s (D, 2nd Congressional District) office issued a report, “The Opioid Crisis in Washington’s Second Congressional District and a Comprehensive Solution,” with a plan to battle the opioid epidemic. The report focuses on four pillars to address the opioid crisis, Prevention, Interdiction, Treatment, Recovery:

 

·         Prevention- The report’s goal to prevention is “… to prevent individuals from relying on opioids, instead of implementing stopgaps that simply mitigate the impacts of the crisis.” It lists a variety of programs within the 2nd Congressional District that work on prevention including the Snohomish County Human Services contract with school districts within in the county that provide Student Support Advocates as well as youth substance use prevention for teachers and counselors. The programs concentrate on youth to try to steer them away from using opioids. The report also lists other programs that use different strategies to reduce dependence on opioids and encourages the development of help to local governments to add other strategies such as helping with mental health and chronic pain.

·         Interdiction- The report lists several federal agencies that are responsible for interdicting drugs. For example, the U.S. Coast Guard patrols our coastal waters to intercept drugs before they land on our shores. The Drug Enforcement Administration (DEA) investigates domestic and international narcotics traffickers. The U.S. Customs and Border Patrol (CBP) intercepts drugs and ports of entry and between ports of entry. In Fiscal Year 2023, CBP seized 27,023 pounds of fentanyl, an 84% increase from 2022. The report notes that more than 90% of CBP fentanyl seizures occur at Land Ports of Entry rather than between ports of entry, with an average of 1,797 pounds of fentanyl seized per day. The report advocated for improved advanced screening technology at ports of entry. The report also noted that local drug task forces have an important role in interdicting drugs before they are sold to drug users. The Snohomish Regional Drug Task Force seized more than 500,000 fentanyl pills and nearly 5,000 grams of fentanyl from January to July 2023. The report advocated for more support and resources for local drug task forces and for local tribal law enforcement.

·         Treatment- The report notes that there are many challenges to treating someone who is addicted to opioids. It notes that people with Opioid Use Disorder (OUD) are physically and psychologically reliant on opioids so that anyone who tries to stop taking opioids suffers severe withdrawal symptoms that can include generalized pain, chills, cramps, diarrhea, restlessness, anxiety, nausea, vomiting, insomnia, and intense cravings. As a result, someone with OUD is susceptible to relapses, disability, and death. It advocates for a “holistic” approach to overcome the challenges and includes normalizing harm reduction, ensuring that there are enough beds for recovery treatment, improving OUD coverage for Medicare and Medicaid, investing in a robust health care workforce, leveraging the justice system with incentives to seek treatment, and meeting patient where they are.

·         Recovery- In conjunction with treatment, someone with OUD also needs support to ensure long-term success in staying off of opioids. Individuals often need help with acquiring housing, employment, education, transportation, or legal services. Currently, support can come from local government and nonprofit organizations. The report also notes that support from family and friends can be especially important.

 

A recent article in The Herald summarized the efforts within Snohomish County to reduce overdose deaths from opioids. While the county has seen a dramatic increase in overdose deaths in recent years. However, through the end of May, there has been a 20% decline in overdose deaths compared to the same period last year. Through May, there have been 106 opioid deaths, with a peak death toll of 31 deaths in February. At least one health department official attributes the decline of deaths to the county’s efforts to prevent opioid overdoses.

Some of those prevention efforts include:

 

·         Distribution of over 500 Narcan kits since 2022.

·         In April, the county began distribution of its $28.9 million in opioid settlement money to local recovery agencies. The focus of some of the agencies are,

o   Populations of minorities bear an over-representation of overdose deaths. Native Americans represent a rate of 73.3 per 100,000 residents for opioid overdose related visits to emergency rooms while blacks represent a rate of 44.3 per 100,00. Whites, which is the largest demographic in the county, visited the hospital at a rate of 15.4 per 100,000.

o   Overdose rates are disproportionately high in rural areas such as East Snohomish County. The county is working on a multicultural communications campaign that will include multicultural outreach teams and a peer support program. Ideal Option, a recovery clinic with a new downtown Monroe office has begun to offer free shuttle along Highway 2 from Index to Monroe for those who need transportation to appointments.

o   In July, the county will begin to collaborate with local outpatient clinics to develop better opioid and polysubstance use disorder practices.

o   In conjunction with the Washington State Health Care Authority, which is working with medical, treatment and social services to create Health Engagement Hubs; a series of one-stop clinics where people who uses drugs can access a range of medical, harm reduction, and social services, the county is helping the local harm reduction center, Sound Pathways, to apply for the Health Engagement Hub program.

 

 

As local governments apply the funds from the opioid settlements, they will have to use those funds on programs that truly reduce addiction to opioids. The challenge will be to stay away from feel good or punitive programs that are based on preconceived notions and to move those funds to programs that show evidence that they are effective in keeping people away from opioids.

 The following episodes of the Freakonomics Radio podcasts give good insights into the elements and challenges of treating people with OUD and are well worth listening to.

  

Freakonomics Radio:

https://freakonomics.com/podcast/why-has-the-opioid-crisis-lasted-so-long/

https://freakonomics.com/podcast/can-55-billion-end-the-opioid-epidemic/

https://freakonomics.com/podcast/the-opioid-tragedy-how-we-got-here/

 

Centers for Disease Control and Prevention:

https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm

 

The Herald:

https://www.heraldnet.com/opinion/editorial-rep-larsen-outlines-to-do-list-for-opioid-crisis/

https://larsen.house.gov/uploadedfiles/rick_larsen_district_opioid_report_final.pdf

https://www.heraldnet.com/news/to-combat-fentanyl-snohomish-county-trickles-out-cash-to-recovery-groups/

https://www.heraldnet.com/news/as-deadly-overdoses-decline-snohomish-county-builds-on-whats-working/

https://www.heraldnet.com/news/drug-treatment-clinic-in-monroe-aims-to-reach-an-underserved-clientele/


For information on drugs and resources to find help with drug addiction check out this website from the Snohomish County Health Department,

Snohomish Overdose Prevention:

https://snohomishoverdoseprevention.com/

 

 

 

 

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