OPINION - Guest writer

A path forward

Fighting the opioid epidemic

Recently, President Trump recognized the opioid crisis as a national emergency. He confirmed what local officials have known for some time: Every day that we fail to work together to put an end to the crisis, the human costs grow enormously.

America's opioid epidemic is now the worst drug crisis in our country's history--with no realistic end in sight.

To put this in perspective: Overdose and addiction deaths now claim 143 American lives every day. In 2012, doctors in Arkansas wrote 116 painkiller prescriptions for every 100 people, according to the IMS Health National Prescription Audit. This ranked Arkansas as the eighth highest rate in the nation. In 2015, doctors prescribed enough hydrocodone to supply every Arkansan with 37 pills for the year, as reported by an Arkansas Prescription Monitoring Program report. Arkansas ranks first in the nation for ages 12 to 17 in misuse of painkillers.

In 2014, the latest year for which custodial data is available, nearly 30,000 individuals died from opioid overdose in the United States. In 12 states the number of prescriptions written for painkillers exceeded the number of residents of the state. On an average day in the U.S., according to the Department of Health and Human Services, health-care professionals dispense more than 650,000 opioid prescriptions. Here in Arkansas, the rate of opioid overdoses is up at least 28 percent from last year, and overall drug-overdose deaths have risen from 287 in 2015 to 335 in 2016. Emergency calls for overdoses have skyrocketed, and the lifesaving drug naloxone has become an increasingly vital tool for our first responders--police, fire and EMS.

But while the president is correct that we need more funding and resources to combat the opioid crisis, those efforts must focus on medical treatment to addiction rather than simply on criminal punishment and stigmatization. The federal government must grant cities and towns the necessary tools and resources to effectively fight addiction. It must ensure full funding for its already-authorized opioid legislation, and local authorities must be given the freedom and support to pursue innovative approaches like drug courts. Most importantly, Congress must assure local health organizations that Medicaid expansion and its opioid treatment provisions will remain the law of the land.

Last year, I served as co-chair of the National City-County Task Force on the Opioid Epidemic, a joint effort of the National League of Cities and the National Association of Counties. After a year-long study of best practices, tools and needs of local communities, we published a final report, A Prescription for Action: Local Leadership in Ending the Opioid Crisis, which contained 29 distinct recommendations directed at local, state and federal levels of government. You can view and share the report at www.opioidaction.org.

I was pleased to see the White House take up the epidemic at the federal level by establishing the Commission on Combating Heroin and the Opioid Crisis earlier this year. The commission put forward its interim report, which largely mirrored the recommendations put forth last November by city and county elected officials.

The City-County Task Force and the White House Commission agree on several necessary approaches, like increasing public awareness and prescriber education, providing states with flexibility within Medicaid, and helping states increase access to naloxone while making prescription-drug monitoring programs more robust.

Unfortunately, aside from the matter of fenta-nyl interdiction, the White House Commission report largely ignores the role of public safety personnel. With the expansion of diversion programs, drug courts and jail-based treatment programs, mayors and police chiefs have the opportunity to reshape the landscape of substance-use treatment. It is vital that these efforts be recognized--by the commission, and by the president himself.

The current administration has yet to outline the specifics around this declaration of a state of emergency. As they do, I hope they take this opportunity to open a dialogue with local leaders who have been tackling these challenges on the ground.

Based on my own work with city and county officials, I think it fair to say that the commission is on the right track. My hope is that their vision will encompass a broad range of recommendations--including leadership, education and prevention, treatment and public safety reforms.

Meanwhile, I hope the president continues to listen to his commission's recommendations--and the wisdom of local leaders in general--and stays an active partner in local efforts to address, contain and end this tragic epidemic.


Mark Stodola is mayor of the city of Little Rock and currently serves as the first vice president of the National League of Cities, which he represented last year as co-chair of the National City-County Task Force on the Opioid Epidemic.

Editorial on 08/25/2017