Opioid epidemic demands comprehensive strategy with metrics to gauge what’s working
Published 12:01 pm Friday, October 6, 2017
From doctor’s offices to the governor’s office, Kentuckians are raising awareness of the opioid epidemic.
What’s lacking is a strategic plan for combating the scourge.
Kentucky was one of the first and hardest-hit victims of misleading prescription-drug marketing and misuse of addictive painkillers, which spawned a deadly upsurge in the use of heroin and synthetics such as fentanyl.
Overdoses claimed a record 1,404 lives in Kentucky last year.
In response, the state has taken some aggressive steps, including a new law that will limit opioid prescriptions for acute pain to three days, launching one of the first electronic systems for monitoring prescriptions and enlightened prison treatment programs.
Lawmakers recently held a daylong hearing into what was called “a public health catastrophe.” Physicians, who devoted their annual meeting to the opioid crisis, are changing their prescribing practices. Gov. Matt Bevin has created a “Don’t Let Them Die” website that provides information about treatment programs by county. And on Sept. 25 350 people gathered in Lexington for a sold-out forum on Kentucky’s substance-use crisis sponsored by the Foundation for a Healthy Kentucky.
Awareness is at an all-time high. How could it not be when so many Kentuckians have a friend or family member who has abused prescription drugs or used heroin?
Yet no one has pulled together a comprehensive statewide strategy. And Kentucky has no metrics for determining what’s working, what’s not and how to improve.
In Rhode Island, by contrast, the governor in 2015 assigned a task force of stakeholders and experts to develop a comprehensive statewide action plan that’s now tracked on a website that reports trends in such things as opioid prescribing, numbers receiving medically assisted treatment and overdose deaths (down in Rhode Island, unlike Kentucky).
In Connecticut, the governor commissioned experts in medicine and public health at Yale University to help develop a plan with detailed metrics that was released last year. Among its many recommendations: Expand opioid treatment programs and track the wait time to enter them.
One goal that Kentucky should pursue is same-day access to treatment for anyone who has overdosed or is ready to quit using. Also, patients who are treated for addiction should have a long-term recovery plan.
Northern Kentucky has developed a regional strategic plan in response to the heroin epidemic. The state needs one too.
Kentucky received $10.5 million in federal funding in April to combat opioid misuse through the 21st Century Cures Act. The Medicaid expansion has greatly increased funding for treatment, and Bevin made drug treatment a priority in his Medicaid waiver plan, which is awaiting federal approval.
The demand for prevention and treatment is huge, which makes smart planning and ways to measure program effectiveness all the more critical.
Opioids are killing Kentuckians. The Bevin administration and lawmakers should get to work on a battle plan.