Editorial: Fighting the opioid crisis on many fronts

When it comes to opiate addiction, a new study finds drug-assisted treatment is more effective than standard detoxification procedure. (Karen Foley/Dreamstime/TNS) 1216523
When it comes to opiate addiction, a new study finds drug-assisted treatment is more effective than standard detoxification procedure. (Karen Foley/Dreamstime/TNS) 1216523
Published November 17 2017
Updated November 21 2017

From birth to death, opioid addiction is ravaging the lives of thousands of Floridians. Drugmakers, doctors, state lawmakers and insurance companies all have a role to play in slowing the epidemic. Lately some more responsible answers, including millions pledged in state and federal money, have begun to emerge, offering hope to families afflicted by this especially pernicious addiction.

The toll opioids are taking in Florida is evident in the numbers:

• A 35 percent increase in opioid-related deaths from 2015 to 2016.

• 5,725 people dead from opioid use in 2016.

• More than 4,000 babies born addicted to opioids last year.

• A 38 percent increase in the number of children under 5 removed from homes because of substance abuse in the past four years.

The effect on children belies the myth that the opioid epidemic hurts only the adults making their own poor choices. Kids are a front-line casualty of this scourge, which is now so widespread that no age, racial or socio-economic group is spared. The problem got its start in doctors’ offices. Over two decades, pharmaceutical companies flooded the U.S. market with highly addictive opioid painkillers, and thanks to successful marketing campaigns doctors began prescribing them to treat all kinds of pain. That gave rise to pill mills, many in Florida, that churned out prescriptions for hundreds of pills at a time with little scrutiny, often for cash. The state embarked on an effective crackdown, but as prescription opioids such as oxycodone became harder to get and more expensive, street drugs such as heroin and fentanyl surged in popularity. Now, addiction to all kinds of opioids is soaring, and the potential for overdose, and death, is acute.

Gov. Rick Scott, after resisting for several years, declared the opioid epidemic a public health emergency in May, fast-tracking millions in federal money for prevention and treatment. His proposed 2018 budget devotes $53 million to combat the crisis, mostly for recovery services. Scott has also proposed a three-day limit on opioid prescriptions, with exceptions to allow a seven-day supply; requiring doctors and other providers to participate in the Florida Prescription Drug Monitoring Program; and new crackdowns on unlicensed prescribers. The governor’s proposal to invest more and commit to the monitoring program are a good start, but the availability of treatment still lags far behind the need in Florida. Containing this problem over time will require hundreds of millions of dollars in public investment.

As more resources are marshaled to fight the deadly abuse of opioids, patients who need them for legitimate pain must not become victims of overzealous crackdowns. Limiting all prescriptions to three days or even seven days would create real hardship for people who rely on daily pain management. Cigna and Florida Blue, two of the largest health insurers in Florida, recently announced they will stop covering the opioid OxyContin because of the potential for abuse. Instead, the companies said they will cover a similar opioid called Xtampza ER that cannot be crushed for snorting or injecting. That’s a sensible marketplace solution as long as it is not cost-prohibitive for patients.

Around the country, police and fire departments have been stocking up on Naloxone, a fast-acting drug that can save someone who is in the midst of an overdose. Clearwater police just acquired 50 kits of the drug. The opioid crisis is not some far-off problem but is here in Tampa Bay, and from first responders to state lawmakers, it will take a collective effort and a serious commitment of resources to stop thousands more Floridians from dying.