By Jordyn Grzelewski
State officials say Ohio’s response to the opioid crisis is among the most comprehensive and aggressive in the country.
Members of Gov. John Kasich’s cabinet, Ohio State Highway Patrol representatives, and Mahoning County officials met Wednesday to discuss the crisis with The Vindicator’s editorial board.
By all accounts, the situation is a crisis – and Ohio’s is the worst in the country. In 2015, the most recent year for which data is available, 3,050 Ohioans died of accidental drug overdoses.
“We do not anticipate that the numbers will be decreasing,” said Tracy Plouck, director of Ohio Mental Health & Addiction Services.
Plouck explained that two factors – excess prescribing of painkillers and heroin becoming more widely available – converged a decade or so ago to create Ohio’s opioid-addiction problem.
“The timing of these two circumstances contributed to Ohio having a more robust challenge than other states,” she said.
Plouck and other officials were in the Mahoning Valley on Wednesday to talk to Trumbull County law-enforcement and drug-treatment officials. Kasich has tasked his Cabinet Opiate Action Team with traveling around the state to talk to local leaders.
Plouck noted that she is a Trumbull County native, having grown up in Mesopotamia Township. She experienced Trumbull County’s drug problem first-hand this week when she returned home to attend a memorial service for a childhood friend who died from a drug overdose.
“So while this is a state level problem, I recognize personally that this is a challenge here in Trumbull County,” she said, acknowledging that Trumbull County has had death rates among the highest in the state.
Although overdose deaths continue to rise, Kasich’s team said the state has made progress on several fronts.
Cameron McNamee, director of policy and communications for the state pharmacy board, said a newly released American Medical Association study found that Ohio has the most-used prescription drug monitoring program in the country.
“We beat out every single state in 2016 – by far,” he said.
Pharmacists are required to run prescriptions for controlled substances through the Ohio Automated Rx Reporting System to track dispensation of those drugs. McNamee said his agency has been working to better integrate that process into pharmacists’ workflow.
The state also has implemented stricter guidelines for prescribing controlled substances, an effort that has reduced by 20 percent the doses being prescribed, officials said. The state pharmacy board recently released guidelines aimed at curbing prescription of painkillers for acute conditions.
The new restrictions allow up to five days of prescribed pain medication for minors and seven days for adults, and also cap the strength of the doses.
“We’re in the process of trying to right the ship,” said McNamee, explaining that medical professional in the 1990s were trained to more-aggressively treat pain as a condition in and of itself.
Ohio spends approximately $1 billion per year on its efforts to address the opioid epidemic, an investment that the Kasich administration has pledged to continue.
For example, Kasich has proposed increasing from $500,000 to $750,000 per year what the state allocates to purchase naloxone, a medication that reverses the effects of an opioid overdose.
While state officials said they are “hopeful” that the Ohio Legislature will support that spending, the federal government’s actions are less certain. Kasich is a supporter of Medicaid expansion, but President Donald Trump and some congressional Republicans support cuts to the program.
“We are very concerned about Medicaid expansion, and we absolutely want to maintain that for” Ohioans, said Plouck. “That is a huge priority for us.”
Calls for the state to declare a state of emergency or for Kasich to dedicate some of Ohio’s rainy-day funds to the crisis wouldn’t help, officials said.
“We don’t see that making a proclamation would add any teeth or any actionable items that we’re not already doing,” Plouck said. “You could rain down all the money that exists in the world,” but it wouldn’t change anything without a workforce to tackle it.
One of the challenges that officials identified is a shortage of professionals to provide treatment services.
To that end, Kasich has proposed $3 million in grants for mental-health and recovery providers to train their existing staff members to fill higher-level positions.
To address shortages of treatment opportunities, U.S. Sens. Sherrod Brown, a Cleveland Democrat, and Rob Portman, a Cincinnati-area Republican, have introduced a bill that would change a law that limits Medicaid funding to treatment facilities with 16 beds or fewer.
Perhaps the ultimate challenge is that no matter how effective a strategy is in dealing with opioids in particular, addiction likely will always exist.
Col. Paul A. Pride, superintendent of the Ohio State Highway Patrol, is already anticipating what he believes is Ohio’s next big crisis: powder cocaine and crystal methamphetamine.
“The key to this whole thing is on the demand side,” he said. “We are very good at the interdiction part of this.”
Pride said he believes that law enforcement has an important role to play with addicts: “Creating a significant emotional event in someone’s life,” such as getting arrested.
But ultimately, he said, “To get them out of the cycle, we’ve got to get them into care.”
Contributor: Staff writer Ed Runyan