State, feds must work to stop opioid crisis

The widespread devastation of the opioid crisis becomes clearer with each new report. Nationwide, opioids have helped increase mortality rates for the first time this century, and drug overdoses are now the leading cause of death for Americans under 50.

Led by Attorney General Pam Bondi, Florida aggressively cracked down on the pill mill crisis that peaked in 2010. Tougher penalties for pill mill operators and better oversight of prescription drugs were effective measures that helped reverse the trend. But cracking down on one area of drug abuse created unintended consequences, as addicts who relied on pill mills turned to stronger opioids available on the streets, such as heroin and fentanyl.

In 2010, eight people in Florida were dying every day on average from opioids. For the first half of 2016, that average nearly doubled, according to the Centers for Disease Control and Prevention.

State officials are on the case. Gov. Rick Scott extended his declaration of a public health emergency to distribute $27 million in federal money for various treatment and prevention programs, including $17.8 million for medication-assisted treatment and related counseling. A three-year minimum sentence for people caught with 4 grams of fentanyl or carfentanyl approved by the Legislature this spring and signed into law by Scott should be another deterrent to dealers. The $10.5 million in state money allocated by Tallahassee to reduce opioid dependency will help as well. But it’s not enough. The scale of this effort remains too small.

Florida still does not have enough treatment centers, workers and beds to meet the needs of addicts. Emergency rooms have been overwhelmed with treating people for overdoses and rely on a revive-and-release strategy, with no legal requirements to do more. That leaves plenty of room to exploit the situation. Politico reported recently about so-called “sober homes” in Palm Beach County that attract thousands of addicts and charge outrageous prices for screening to soak up insurance money. They are largely unregulated, provide no treatment, and generate dozens of emergency calls for overdoses.

Strong federal support is the essential element in making massive changes, and President Trump promised in March “to help those who have become so badly addicted.” Yet Washington has failed to deliver. The Republican legislation to repeal and replace the Affordable Care Act would weaken efforts to fight opioid abuse, particularly by reducing federal money that would be spent for Medicaid. A proposal to add $45 billion in the next decade to fight opioids in the Senate bill pales in comparison to the $772 billion in overall Medicaid reductions it would make by 2026. Grant money has to complement health coverage, not substitute it.

To effectively combat this crisis will require a more aggressive and holistic response — and not just on the punishment side. The critical step is greatly expanding treatment and prevention resources to help addicts. That requires long-term care, counseling, and oversight that hospitals and treatment centers across the state simply do not have the capacity or financial resources to provide now. Florida and other states cannot reverse the tide by themselves, and the president and Congress need to step up with a real commitment of money and resources.

This editorial first appeared in the Tampa Bay Times.

This story was originally published July 10, 2017 at 8:20 PM with the headline "State, feds must work to stop opioid crisis."