Two reports released last week take note of the human cost of the alarming spread of opioid misuse in the United States by recommending renewed local efforts to treat addicts as victims instead of criminals.
One of the reports -- "A Prescription for Action: Local Leadership in Ending the Opioid Crisis" -- resulted from a joint task force of the National League of Cities and National Association of Counties. Little Rock Mayor Mark Stodola was co-chairman of the task force, which was formed in March.
The group's 27-page report suggests steps that local, state and federal officials can take to switch the approach to opioid abuse from a war on drugs to a public-health campaign.
"We cannot simply arrest our way out of a crisis of addiction," says a letter in the report from Stodola and his co-chairman, Gary Moore, county judge of Boone County in Kentucky.
Almost 30,000 people nationwide died from opioid overdoses in 2014, the last year national data are available, according to the federal Centers for Disease Control and Prevention. That was an increase from 19,687 overdose deaths in 2010 and nearly 13,000 in 2005.
In Arkansas, drug-related deaths have jumped 25 percent since 2006, the CDC has reported.
The city-county task force report notes that in 12 states, including Arkansas, the number of prescriptions written for pain pills exceeds the states' populations.
Americans consume most of the world's prescription opioids, the report notes.
Stodola said these numbers "suggest an epidemic that people aren't really aware of."
He said he hopes that "getting the report into the hands of people who could really make a difference" will change that.
"Now is the time to take it and make good use of it," he said. "People need to focus on the fact that this is a medical emergency. This can lead to tragic and gruesome kinds of situations."
"A Prescription For Action" encourages officials to boost education and prevention initiatives; host local "conversations" about opioid abuse; increase law enforcement training to improve the way officers respond to opioid users and reduce their arrest rate; and support substance-abuse programs, such as drug courts, safe disposal sites and treatment centers.
The report outlines how some cities have implemented measures to tackle opioid misuse in their communities.
The other report, from U.S. Surgeon General Dr. Vivek Murthy, also attempts to change how Americans regard addiction: Substance abuse is not a moral shortcoming, but instead, a disorder explained by neurobiology, Murthy says in "Facing Addiction in America."
The tone of both reports underscored a sense of optimism from Carole Baxter, who's been working in the field of addiction treatment since 1974.
"I am more optimistic about what is going to happen over the next 10 years about our ability to treat people struggling with addictions than what has happened in the last 30 years," said Baxter, executive director of Recovery Centers of Arkansas, a network of services for substance abuse and similar disorders.
"The ball is kind of rolling."
Baxter also sits on the Behavioral Health Treatment Access Legislative Task Force, which will recommend increased support for addiction services, among other changes, to lawmakers during the 2017 legislative session.
Among the measures, she said: opening more crisis centers that can triage people with substance-abuse and mental-health problems instead of sending them to crowded jails; revising Medicaid to allow additional reimbursement of substance-abuse treatment; put Narcan, a medication that inhibits the effects of overdoses in the brain, into the hands of first responders; and requiring police to undergo training to enhance their ability to detect a potential overdose victim.
Baxter acknowledges that "there are a lot of competing interests for funding," but said "the public is finally recognizing" that the issues must be addressed.
"There is so much that [addiction] costs us," she said.
Dr. Carlos Roman, an Arkansas anesthesiologist and former chairman of the state Pain Management Review Committee, said that, while such initiatives help, they address only symptoms and not the underlying causes of the "opioid epidemic."
"The problem is uniquely American," Roman said, citing CDC statistics that the United States accounts for the use of 80 percent of the world's prescription opioids.
"You have to look at our practice of medicine to see why we have this problem. It comes down to pain-management physicians. We are the problem."
Roman said he will address the Arkansas State Medical Board on Dec. 3 to recommend that the state officially adopt new federal guidelines for prescribing opioids.
The guidelines suggest particular dosage and duration of opioid use and also focus on increasing the use of non-opioid medication and physical therapy to treat chronic pain.
Last month, the governor of West Virginia announced that doctors, beginning in 2017, must follow federal guidelines when prescribing pain pills to those with state insurance and Medicaid.
West Virginia currently has one of the highest per-capita rates of opioid prescriptions in the country, according to the CDC.
Roman said there are too many doctors who "take advantage" of their patients to overprescribe opioids.
Incentives from pharmaceutical companies to doctors also play a role in "trapping patients in this system," he said.
For example, payments from the opioid industry to doctors practicing in Arkansas totaled more than $2 million between 2013 and 2015, the Arkansas Democrat-Gazette found in a review of records from the federal Open Payments database.
"We can raise awareness about this," Roman said. "There's a whole underlying ignored population of patients, physiologically altered by this drug, and we're not doing anything about it."
Metro on 11/20/2016