Let’s fight this epidemic without heroin hysteria

Ohio must avoid Draconian drug laws and a witch-hunt against prescription painkillers

7/13/2014

Gerritt

Sweeping though Ohio’s small towns, countryside, and suburbs, Ohio’s opioid epidemic has galvanized politicians and policy makers. This spring, Gov. John Kasich signed four of the 13 opioid bills introduced in the state House, mostly by Republicans who represent suburban and rural districts.

Fatal heroin-related overdoses in Ohio have tripled over the past three years and continue to rise. Elected officials who generally ignore the urban poor have been unable to neglect a public-health crisis in their own backyard. An estimated 200,000 Ohioans are addicted to opioids.

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State Rep. Robert Sprague (R., Findlay) emerged last year as the General Assembly’s leader on the opioid issue, after one of his constituents, a mother of two heroin-addicted daughters, pleaded with him to act.

Triggered largely by prescription painkillers, Ohio’s opioid and heroin epidemic today is far whiter — and younger — than the heroin epidemic of the 1970s. The new demographics of addiction are driving a new kind of politics, as heroin-related overdoses killed more than 1,000 people last year.

Most of the resulting legislation and policy changes are constructive. This time around, lawmakers are more interested in treating and preventing this disease than they are in locking people up.

Still, nothing evokes hysteria like a drug problem. For starters, Ohio should avoid a witch-hunt against prescription painkillers that would make it difficult, even impossible, for people with chronic pain to lead a normal life.

The state’s opioid epidemic started, in the late 1990s, with the overprescribing of opioids such as Vicodin, Percocet, and OxyContin. From the late 1990s to 2010, the distribution rates of prescription opioids in Ohio increased ninefold. So did the rates of fatal overdoses from those drugs.

Last year, Governor Kasich’s Opiate Action Team released guidelines for prescribers that have reduced prescriptions with dangerously high doses of opioids. The State Medical Board of Ohio clamped down on physicians who overprescribe, suspending or revoking more licenses. To prevent doctor shopping, a new law requires medical providers to check the state’s online patient database — OARRS — before they write prescriptions for opioids.

These steps and others are generally good, but the risks of overreach are still real. Two bills debated in the legislature this year went too far in regulating how physicians could prescribe.

The proposals and changes may have a chilling effect. Several patients with legitimate needs for opioids have told me that their medical providers are almost afraid to dispense prescription painkillers.

The other danger posed by heroin hysteria comes from law enforcement. With fatal overdoses rising, prosecutors, cops, and politicians propose charging drug dealers in such cases with murder or manslaughter.

A crazy bill before the General Assembly would authorize murder charges and lifetime prison sentences for sellers of illicit drugs that result in fatal overdoses. Ed FitzGerald, the Democratic nominee for governor, among many others, is suggesting support for the practice in certain cases.

Such talk threatens to take us back to the 1980s and 1990s, when Draconian drug laws and sentences quadrupled the U.S. prison population and made the United States the world’s leading incarcerator. Mr. FitzGerald told me he’s aware of those risks and would take steps to avoid similar discriminatory practices.

Murder prosecutions must make a strong case for what the accused intended, or at least believed would happen. People can overdose on heroin for many reasons, none of which may be known to the seller or the user.

Taking NyQuil, for instance, after injecting heroin could become lethal, depending on how the medication’s antihistamines reacted with the heroin. More commonly, an addict could overdose if his or her tolerance for the drug had dropped during a period of abstinence. The person who provided the heroin could have been a friend.

Mr. FitzGerald, also a strong advocate of effective treatment, told me that heroin is different from other drugs and should therefore be treated differently under the law. No doubt, heroin is more dangerous than, say, marijuana, which is probably less harmful than alcohol.

But heroin is “different” chiefly because it’s now an epidemic. Many drugs, including alcohol, can be fatal.

Politicians made the same special-case arguments when they enacted unreasonable sentencing schemes for crack cocaine in the 1980s — penalties that in some cases were 100 times harsher than those for powder cocaine, a drug used largely by the white middle class.

Researchers acknowledged later that the dangers of crack were exaggerated, including by overblown media coverage. No medical facts justified the disparities in sentencing between crack and powder cocaine.

Ohio’s heroin and opioid epidemic has brought untold suffering. It has killed people, ruined lives, and ripped apart families. But as the state moves forward to treat addicted people, dry up demand, manage prescriptions, prevent drug abuse, and take illicit drugs and traffickers off the street, it should avoid the hype and hysteria that too often accompany drug epidemics.

Preventing people with chronic pain from getting relief, or building even more prisons to incarcerate small-time drug dealers for decades, won’t fix the problems. It will only create more of them.

Jeff Gerritt is deputy editorial page editor of The Blade.

Contact him at: jgerritt@theblade.com, 419-724-6467, or follow him on Twitter @jeffgerritt.