Op-Ed

Fighting addiction tough in heavily medicated Kentucky

Starting in 2012, Kentucky’s heroin overdose deaths, per 100,000 residents, became higher than the national average.
Starting in 2012, Kentucky’s heroin overdose deaths, per 100,000 residents, became higher than the national average. cware@herald-leader.com

In Kentucky, we must work harder, smarter and more collaboratively to save our communities from the ravages of the opioid epidemic.

More than 1,200 Kentuckians died last year from drug overdoses. Although staggering, that number fails to fully capture the truly devastating effect of this epidemic.

Thousands of Kentuckians are enslaved by addiction. The worsening opioid problem burdens our health-care system, social-services network, criminal-justice system and our education system. It drains state and local budgets and hampers our economic development efforts.

We will never build the commonwealth we want for our children and grandchildren without reversing the current opioid abuse trends.

None of us have all of the answers; Kentuckians must come together with an unbridled determination to beat this scourge. Much more must be done in the areas of prevention, enforcement and treatment.

The best victories in this fight are found in prevention efforts. We must engage our children at a younger age as well as educate ourselves about the nature of this threat. We must also understand that our children are exposed to much more at a much younger age than was true a generation ago.

We must confront the obvious pathway to heroin and fentanyl use. Eighty percent of heroin users first misuse opioid analgesics or pain pills. The United States makes up five percent of the world’s population, yet we consume more than 80 percent of the world’s supply of oxycodone and almost all of the world’s supply of hydrocodone.

Kentucky remains one of the most heavily medicated states in an overmedicated nation. These drugs have a place in the treatment of acute and chronic pain, but the oversupply of prescription opioids has become a factory that manufactures addicts, who in increasing numbers turn to heroin.

We must convene the best minds in our health-care community to define and implement best prescribing practices for our physicians. The plain truth is that our society has dealt with prescription opioids over the last generation in a manner that has caused unintended, but nevertheless disastrous, consequences.

The law-enforcement community understands that we will never arrest our way out of this problem. We also know that effective enforcement, while not sufficient, is a necessary component of any successful strategy. Wholesale incarceration of those who suffer from addiction is ineffective. Addicts must be given every opportunity to access effective treatment.

On the other hand, we cannot blind ourselves to the fact that there are those in our midst who profit from the misery of others, without regard to the pain they cause. State, local and federal law enforcement must work collaboratively to remove these individuals from our streets. We must constantly seek to reach as high up the distribution chain as possible and we must target those who sell drugs that kill.

“Smart on crime” does not mean “soft on crime.” In short, we must approach those suffering from addiction with compassion and those who seek only to profit from addiction with a firm resolve to do justice.

While we do not condone poor choices, we must accept the fact that opioid addiction is a chronic, often fatal, disease of the brain. We need to identify treatment programs and make them more available. The cost of treating addiction is less than the cost of ignoring addiction.

Finally, we must effect the attitudinal changes that are so necessary to winning this fight. Opiate addiction knows no racial, ethnic, gender or socioeconomic boundaries. Heroin is found in all segments of our community and its use is rapidly growing among suburban middle-class young people. It is no longer a back alley drug.

The smug comfort that addiction only happens in other neighborhoods, in other communities and to other families is both false and destructive. Families suffering under the weight of addiction — and to be sure it is not just the addict who suffers — deserve our support and compassion.

While the challenge we face is daunting, there are reasons to be encouraged. Leaders from all levels of government, as well as the private sector are coming together to forge effective community solutions. More resources are being devoted to prevention and treatment. Enforcement efforts are targeting the “worst of the worst” drug dealers.

There is a growing recognition that opioid addiction is an urgent public-health issue. Perhaps most importantly, the good citizens of the commonwealth are talking to each other about this threat and they are increasingly aware that we must band together to win the fight.

Our future demands no less.

Kerry B. Harvey is the United States attorney for the Eastern District of Kentucky.

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