Posts Tagged ‘Ohio Opioid Epidemic’

Encore (Non) Performance

April 19, 2017

“Ensuring that we have the basics in place — fiscal strength, lower taxes, proper regulation — opens the door for us to sell our state across the nation and across the world.” (Ohio’s current Governor John Kasich in his 4-4-17 State of the State address). Future Ohio Governor wannabe (but current Ohio Attorney General) Mike DeWine addressed the opioid epidemic in Pickerington recently (DeWine would require opioid education as governor Trista Thurston , Reporter for Gannett’s Lancaster Eagle-Gazette, 4-19-17). The current governor touted his Start Talking initiative as counter acting the opioid drug epidemic in Ohio. The wannabe governor touts a mandatory K through 12 “Just Say No” curriculum to counteract the epidemic (following the trail of tears footsteps of Nancy Reagan and Ohio’s DARE program). “”I don’t know any other way of doing it,” DeWine said. “It can be done without a great burden on the schools.”” Another unfunded mandate on Ohio’s public schools (sans charter/private) embraces the current governor’s three basics (fiscal strength, lower taxes, proper regulation). In addition, Thurston notes “The communities faring the best throughout the epidemic, DeWine said, are the ones where people have watched it get so bad and decided to do something themselves.” (without state involvement, or cost). DeWine sees the state’s role in terms of his recently begun pilot program, “Since about half of the children in foster care throughout the state are there because one or both parents are addicted to drugs”. “The pilot program will provide specialized services, like intensive trauma counseling, to children. It will also offer increased access to drug treatment to parents of children referred to the program.” “So far $5.5 million has been committed to the pilot.” In his State of the State Governor Kasich committed $20 million from the Third Frontier Commission to develop a high tech silver bullet solution [no pun intended]. “The current opioid crisis is different than other drug epidemics, DeWine said, because it’s impacting everyone.” Thurston concludes her report by quoting the wannabe governor: “”We have a crisis,” DeWine said. “If ten people were dying a day of some strange new plague, we would treat is as a health crisis.”” So why don’t you? What’s stopping you? Analysis finds that treatment for a public health crisis of this dimension would be in terms of beds in detox and rehab centers, beds that were immediately accessible. It would be in state budgeted funding for all the children affected by the loss of caregivers produced by this epidemic (essentially Ohio’s new orphans), not just a pilot enterprise. It certainly wouldn’t emphasize nor rely on high tech silver bullet solutions, K-12 curriculum additions, or Start Talking programs.

The State Of The State Of Ohio’s Opioid Epidemic

April 6, 2017

A blizzard of angst filled soul searching follows the presidential election, current administration, continuing to this day with “how did this happen?” Etc. Many are not so surprised, more bemused in that all of this was in plain sight. Intentions as well as actions today are simply a continuance of what was stated, promised, and actively displayed before. ‘Nuff said. Within his recent (4-4-17) State of the State address, Ohio’s Governor John Kasich’s lips pronounced “Ensuring that we have the basics in place — fiscal strength, lower taxes, proper regulation — opens the door for us to sell our state across the nation and across the world.” This mantra was repeated multiple times, even more through fragments. Sounds pretty clear. No mystification of priorities, intent, or course of action here. He also had this to say about Ohio’s Opioid drug epidemic, though he didn’t call it that (Name thing I guess. Been there, done that with the current pres’): “Last year, Highway Patrol troopers had their largest single heroin, meth and prescription pill seizures. Ohio was one of the first states to create prescribing guidelines for doctors. We’ve linked our medical providers into our pharmacy system to slow doctor shopping and for the first time we’re registering pharmacy technicians. We’ve expanded access to the overdose-reversal drug to first responders, pharmacies and families of those addicted. And we created Start Talking! to encourage more adults to talk to children about the dangers of drugs. In all, we’re spending nearly $1 billion a year.” And “That’s why today I’m asking the Third Frontier Commission to provide up to $20 million to help bring new scientific breakthroughs to the battle against drug abuse and addiction. These funds will target existing, proven ideas that simply need an extra push to be brought to the fight — ideas like using a simple device that connects to someone’s ear that can relieve pain and block the effects of opiate withdrawal.” Finally “We love our children and care about our neighbors, so we’ve got to deliver this message to them: “Don’t do drugs or you will destroy your life and you will destroy the purpose for which the good Lord created you.”” Not a word, or dollar, for rehabilitation. Analysis considers the implications of this abdication of leadership, the vacuum formed by Kasich’s overriding priorities, intent, and course of action. Indeed, historically US public health epidemics have been met by an equally public response of sanatoriums, recovery centers, and public health initiatives (all notably absent with the governor’s approach). History has lectured us extensively on what happens in a leadership vacuum (South East Asia, Syria/Iraq, Afghanistan, etc.). Add to that Kasich and the GOP’s historic preference (and reliance) on a religious response to education, social welfare and public health concerns. Here is some of what Kevin Lewis O’Neill writes in an essay entitled “On Hunting” (Critical Inquiry Spring 2017):

““We hunt men,” Alejandro said, “to save them.” Locked up inside a Pentecostal drug rehabilitation center for his use of crack cocaine, Alejandro participates in his pastor’s hunting parties or grupos de caceria. At the outer edges of today’s war on drugs, Christian vigilante groups scour the streets of Guatemala City with singular intent: to pull users out of sin by dragging them into rehab. And so, in the middle of the night, when the capital is an absolute ghost town, three or four recovering users drive with their pastor to the house of an active user.” “As a part of economic restructuring – which has included the privatization of state enterprises, the liberalization of trade, and the relaxation of government regulation [sound familiar?]– less than 2 percent of Guatemala’s total health budget addresses issues of mental health, with its hospitals flatly denying medical service to those patients seeking support for substance abuse.” “Pentecostal drug rehabilitation centers, when taken in the aggregate, have six thousand beds.” “Guatemala’s prisons sit at 250 percent capacity; the hospitals do not accept users; and Guatemala’s only mental institution understands drug use to be well outside the scope of its mission.” “More important than numbers, however, are the visceral truths that Pentecostal Christianity promises its people: Salvation is real; hell is eternal; and Jesus loves you. Another imperative also follows. Often stamped onto Pentecostal print media, with an allusion to sin as well as the hunt, it announces: escape for your life. One effect of this faith is a growing network of informal and largely unregulated Pentecostal drug rehabilitation centers. These sites warehouse users against their will inside of onetime garages, factories, and apartment buildings. Each has been repurposed for rehabilitation with razor wire, steel bars, and iron gates. Inside, pastors practice teoterapia, or theological therapy. This is a mix of Pentecostal theology, twelve-step programming, and self-help psychology. Its working assumption is that captivity will give way to conversion. It does not. Yet this bald fact has not slowed down the growth of these centers, and for good reason. Again, these centers provide a practical solution to a concrete problem. Drug use is up. State resources are down. And Pentecostalism is the discourse of change. [Sound familiar?] The net result is a shadow carceral system infused with Pentecostal imperatives about not just sin and salvation but also about who can be hunted and why. It is a theological construction that carries concrete consequences. Today more Guatemalans find themselves literally tied up in Pentecostal drug rehabilitation centers than locked up in maximum-security prisons.” Lest the reader think that, not being Pentecostal or Guatemalan, Ohio’s Governor along with the current US Attorney General are not in the hunt. Au contraire, “there are some thirty thousand men in Philadelphia alone with warrants out for their arrest.” (O’Neill)

Licking County Prosecutor Race

October 11, 2016

In a previous posting (Unbearable 9-2-16) Analysis covered the FED UP rally in Newark on 8-31-16. At that event the recent desired change in disposition of the municipal police department was promulgated. Newark police would attempt to consider drug addiction as a disease if the afflicted turned themselves in at headquarters and requested help to overcome their problem. Otherwise, out on the streets, it would still be handled as a criminal offense. This was heralded as a good first step. At the Newark Think Tank prosecutor race candidate forum (10-8-16) the matter again came up as a topic of difference between Bill Hayes and Chris Shook. Mr. Hayes is not keen on the Newark PD program in that, as prosecutor, he stresses following the letter of the law. He would like to see any drug protocol changes across the board so that one municipality is not arresting a suspect that another municipality would be referring for treatment. Chris Shook would like to see a distinction made within the judicial proceedings for offenders where the court recognizes this as a disease (and mediates treatment), and cases where the treatment option would not be appropriate and possession remains criminal. Mr. Hayes is the current legislative representative for southeastern Licking County in the Ohio House (and has been) while Mr. Shook is active with the court in Franklin County (where there is a drug court for those vetted as better off in rehab than jail). As mentioned in Unbearable, at the rally the Ohio legislature was lambasted for caving to the lobbying of the pharmaceutical industry in failing to mandate prescription opioid pills be only available in a form that cannot be reconstituted for injection or inhalation, but can only be ingested as prescribed. “Too expensive” was the industry position. Mr. Hayes’ background making law, as opposed to “following” it, was not questioned at the forum, nor was his legislative record considered in light of his candidacy. Governor (and former presidential wannabe) John Kasich and Attorney General Mike DeWine have championed the elimination of pill mills (one stop prescription and dispensaries) in southern Ohio. Unfortunately the trail goes cold there with the business friendly governor and representative Hayes not wanting to ask who profits from all this. Analysis indicated that opioid addiction was “good for the bottom line” of the private prison industry (Unbearable). It is also good for the bottom line of the industry manufacturing and distributing the prescription pills. On the same day of the forum (10-8-16) Eric Eyre , Staff Writer for the Charleston Gazette-Mail reported on the ongoing prosecutorial action of the West Virginia attorney general with Cardinal Health of Dublin Ohio (a major source of “Jobs!” in the central Ohio region for those of you keeping score at home). From the article headlined “Drug firm shipped 241M pain pills to WV over five years, suit alleges”: “Oxycodone (sold commercially as OxyContin and Percocet) and hydrocodone (Vicodin and Lortab) are the most widely abused prescription painkillers, and contribute to more overdose deaths in West Virginia than any other drug. West Virginia has the highest drug overdose death rate in the nation, and the number of deaths climbed last year.” “Former West Virginia Attorney General Darrell McGraw filed suit against Cardinal Health in 2012, alleging the company helped fuel the state’s prescription drug problem by shipping massive quantities of pain pills to rogue pharmacies. Attorney General Patrick Morrisey, who lobbied for two drug trade groups that represented Cardinal Health before he ousted McGraw, inherited the lawsuit when he took office in 2013. He later stepped aside from the case after the Gazette-Mail reported on his ties to the drug wholesaler. His wife, Denise Henry, is a lobbyist for Cardinal Health in Washington, D.C.” (“Cardinal Health has paid Morrisey’s wife’s lobbying firm, Capitol Counsel, $1.4 million since Morrisey became attorney general, according to lobbying disclosure reports. His wife has lobbied for Cardinal Health on Capitol Hill since 1999. Cardinal Health also contributed $2,500 to Morrisey’s inauguration party in 2013.”). Back on track again, the public disclosures (something representative Hayes eschews and attorney Shook favors) show clearly that the opioid addiction epidemic is certainly good for the bottom line of more than just the private prison industry. Some items to note from the Gazette-Mail article : “Between 2007 and 2012, Cardinal Health shipped 85.5 million oxycodone pills and 155.6 million hydrocodone pills to West Virginia. That’s 154 doses of hydrocodone for every man, woman and child in the state over five years, and 85 oxycodone pills for every person.” “Over five years, Dublin, Ohio-based Cardinal shipped 8.8 million hydrocodone tablets and 1.8 million oxycodone pills to Logan County. Pharmacies in McDowell County, one of the poorest counties in the nation, received 3 million hydrocodone pills and 1.5 million oxycodone pills. “Cardinal distributed much of the fuel for the prescription drug problem in this state,” the lawsuit alleges.” Like with Wells Fargo’s recent massive credit service sales initiative (deemed marginally as well as outright fraudulent), there are similar reports of pharmaceutical industry giants employing like tactics in boosting sales. And the numbers show it. An American Journal of Public Health report from Feb. 2009 (The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy, Art Van Zee, MD author) gives: “When Purdue Pharma introduced OxyContin in 1996, it was aggressively marketed and highly promoted. Sales grew from $48 million in 1996 to almost $1.1 billion in 2000.” “OxyContin’s commercial success did not depend on the merits of the drug compared with other available opioid preparations. The Medical Letter on Drugs and Therapeutics concluded in 2001 that oxycodone offered no advantage over appropriate doses of other potent opioids.” “Purdue pursued an “aggressive” campaign to promote the use of opioids in general and OxyContin in particular. In 2001 alone, the company spent $200 million in an array of approaches to market and promote OxyContin.” Cardinal health is only one of a dozen prescription drug wholesalers operating in West Virginia. More recent statistics on sales and aggressive marketing strategy are available. Analysis indicates that separating making the law from enforcing it is not the same as being on this or that side of a curtain, as Bill Hayes would like voters to believe. Promoting a business friendly agenda (as Governor Kasich would put it) while solving a devastating social epidemic that implicates business, requires prosecuting all involved with the crime. ““This is not like you sold a broken toaster,” [WV Delegate Don] Perdue said. “You’re selling stuff that can break people. Drug wholesalers have not ever taken responsibility for this, but they’re part of the [drug] supply chain, and as part of that chain, they should be cognizant of that responsibility.” (Gazette-Mail)

Unbearable

September 2, 2016

There is an old story, whose ethnic origins are irrelevant, about a genetically deformed man at the birth of his first child. The ambivalence of his experience was what pervaded the recent “FED UP!” opioid addiction rally in Newark, 8-31-16. The pain, actual physical gut wrenching pain, of Ohio’s opioid addiction epidemic was to be expected (and was palpable). It only follows considering the contemporary take that this is a disease, and we eschew illness for exactly that reason (never mind that Woody Allen says germs are our friends). The event turned out to be a generic Komen-race-for-the-cure-Pelotonia disease event bringing folks together in a positivity rally (Woody Allen was right?). Even Newark council person Jeremy Blake enthusiastically led the group in a rather extended pep cheer of New-Ark (and spoke all things wonderful about Newark). Many of the speakers admitted they were preaching to the choir, sharing their grief with those who knew, and that those absent, not wishing to experience pain even vicariously, were the ones who needed to hear. The deaf to the message also passed through the event, rushing to their parked cars after a day’s work, not wishing to experience anything having to do with opioid addiction, even for a minute. The chief of police spoke of the new law enforcement conversion to considering addicts as sick people in need of rehab/recovery. Though he spoke of the financial cost benefits of such an approach (less incarceration, less crime), he was mum on the illegality of illness (is any other disease illegal?). Others were much more specific about the economics involved, lambasting state legislators for caving to Pharma’s lobbying against producing prescription medication that cannot be broken down (to snort or shoot) but only ingested as intended. The argument echoes that of Pharma’s failed resistance to ephedrine regulation: economically unfeasible due to increased costs. Phrased otherwise it would be that contributing to eradicating the opiod addiction epidemic would cut into company profits (opioid addiction is good for the bottom line). The Rob Portman syndrome was present in the form of his spokesperson touting his election year concern and efforts without noting what another speaker pointed out – there are 3-4 week wait times for admission into rehab/recovery facilities in Ohio. Without that, all the Komen race for the opioid addiction cure efforts fail. But if you have insurance, then …(Portman opposes the Affordable Care Act which begins to address the lack of comprehensive health care insurance in this country). The tit-for-tat, do I/don’t I want the child to be like me/not like me of the old story had Analysis looking for cultural/historical insights. That addiction is a disease (albeit an illegal one that winds up with most sufferers in jail) assumes or presupposes health (something the rally insisted about assuming for New-Ark). Are we healthy? Opioid addiction as a disease effectively implies that health is threatened by this malady. In terms of medicine, maladies are treated with medication – drugs. If you are ill, you take a pill, the least painful remedy. Yet the remedy is the malady, all connected by an aversion to pain. Analysis finds the dog chasing its tail, the man not knowing whether to view the newborn or not. Should he wish for it to suffer his disfigurement, or not? One thing is clear. The sparsely attended rally (for a region of well over 50,000) was precisely that because in this day of “brand” emphasis, all things pain are not a big draw. You don’t want your “brand” associated with unpleasantness. And pain is definitely unpleasant. Analysis finds the evolution of cultural disposition to opioid addiction quite relevant. For the greater part of western history, it was associated with a kind of “demon” possession. Odysseus steered clear of the island of lotus eaters knowing full well that once there, he and his crew would be captive to their seduction and never return home. Christians associated it with being in the throes of the devil. Infidel moderns ascribed it as an escape from the brutality of industrialized society (there’s that pain again). In the 80’s it received acceptance as part of Pop culture, with media expose’s of celebrities and icons, and films, music and reading material including drug use with tattoos, piercings, surf boards and advertising art. Of course, celebrities didn’t wind up in jail. Those not in the 1% fueled the profit margin of the prison industrial complex (opioid addiction is good for the bottom line). Today, opioids are as ubiquitous as tobacco once was (an addiction that is NOT illegal). Opioid addiction is seen as a disease, a despoiler of our otherwise happy and healthy society. Like the man in our story, Analysis finds it unbearable to take a look.

Traditional Values, Traditional Responses

August 24, 2016

NPR’s Morning Edition aired an interview with Congressman Garret Graves of Louisiana’s 6th district. Graves, a Republican, describes himself as a fiscal conservative. When it comes to the catastrophe that has befallen his constituents (a “disaster” he calls it), he differentiates it from others that have visited the gulf coast (like the BP oil spill, the Corps of Engineers flooding of New Orleans, and various hurricanes/flooding). He calls these “traditional disasters” accompanied by “traditional responses”. The current “disaster”, according to him, is exceptional warranting exceptional Federal assistance. When reminded that congress has the power of the purse and of the recent fiscal conservative congress’s response to the Sandy disaster (which did not affect his district) he shrugged it off as a “traditional disaster”. Besides, this 6th district’s fiscal conservative advanced a not-so conservative argument for why the Federal government should foot the bill. Graves said it only makes “fiscal sense” as otherwise these folks would become the recipients of various federal poverty programs, costing the taxpayers of the US even more. Indeed, Analysis finds this to be the same line of reasoning used by rabid liberals in their various pleas for universal pre-school, for investment in schools instead of prisons, for addiction related crimes to be reassessed as illness with the emphasis on rehabilitation funding and not anti crime bills, and inclusion of mental health within the nation’s public/private expenditure on medical care. Analysis also finds that Graves must be suffering from an occurrence of “Rob Portman” syndrome. Rob Portman was staunchly anti-same sex marriage until his own son came out. Mr. Graves is a card carrying “fiscal conservative” until catastrophe, “traditional” or not, found its way into his backyard. Then the party of traditional values’ representative decided there was something not very traditional going on here, in the everyday. Analysis finds all this to be very pertinent in light of the current epidemic of opioid addiction devastating Ohio (where all 3 branches of government are dominated by the party of traditional values). Is this a “traditional” epidemic? Is the GOP giving this scourge a “traditional response”?