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Better Public Policy is the First Step in the Fight Against the Opioid Epidemic

According to the policy brief prepared by Andrew Barnes, PhD, and Katherine Neuhausen, MD, MPH for the Senate of Virginia earlier this year, opioid abuse is rising in the state of Virginia due to limited availability of specialized treatment, lack of understanding of this crisis among the general public and providers, as well as high levels of prescription opiate painkiller supply. The Virginia Department of Health reported a devastating 38% increase in deaths from heroin and prescription opiates between 2012 and 2014.

In 2014 alone, 986 Virginians died of drug overdoses and almost 80% involved illicit opioids such as heroin or prescription opiate pain relievers. Deaths from heroin are mostly concentrated in Metro Richmond, Hampton Roads, Northern Virginia and the Shenandoah Valley, while deaths from prescription opioids are occurring statewide. At least 2 people die from heroin or prescription opiates in Virginia every day. JLARC estimates that untreated opioid abuse costs the state $613 million in public safety and health care services per year, primarily driven by health care costs for expensive diseases associated with drug abuse (i.e. hepatitis B and C, HIV/AIDS, cancer, cirrhosis, kidney and liver failure) as well as public safety expenses ( police and jail costs).

For more than five decades, the most reputable and respected drug addiction specialists have unanimously agreed that the ideal time to help a drug user is when they reach out for help. In most cases, this short window of opportunity to turn their life around closes within hours. Best practices and history have shown that the moment when an opiate addict voluntarily seeks treatment corresponds to the greatest chance for the most favorable long-term recovery outcome.

John Shinholster, a recovering addict and the president of the McShin Foundation, a peer-to-peer Recovery Resource Center based in Richmond, VA argues that one of the main challenges facing the Richmond community is that there is a significant group of opiate addicts desperately seeking "a fix" , more specifically in the form of buprenorphine ( Suboxone) 5-day step-down detox that eliminates the physical pain associated with withdrawal from opiates. Adding that most addicts have no resources and no financial support but from charities or tax-funded treatment agencies, Shinholster emphasizes the importance of providing same-day access to medication-assisted treatment that includes Suboxone. Otherwise, the criminal justice system will most likely serve that same opiate addict seeking help (same-day service) and arrest them for a drug-seeking crime. These unnecessary arrests would be totally avoidable if the community had same-day detox available for anyone seeking treatment.

John Shinholster also criticizes the fact that the systems and society have no problem spending over $7,000 of taxpayers' money per opioid-related arrest but somehow fail to execute a opioid recovery system that costs only $625 for a 5-day buprenorphine detox. And adding insult to injury, the incarceration system increases the risk of criminal recidivism, whereas the 5-day detox system increases public safety and reduces recidivism. This inconceivable situation has led the McShin Foundation president to believe that Virginia's policymakers are downright addicted to bad policies.

Shinholster, who has been clean and in successful long-term recovery since August 1982, suggests that same-day detox should be readily available for any opiate detox who reaches out. Those who cannot cover the $625 should be able to walk in a Behavioral Health Authority (BHA) or Community Service Board (CSB) and receive same-day, 5-day Suboxone detox, complete with wrap around peer support; as little as 10% of the state's Department of Corrections budget would provide the funding. This approach could result in cost savings of 30% or more within the department due to the reduction of inmate-related costs. Combined with some dialing back of a couple irresponsible drug laws, this action would create a criminal recidivism reduction trend that could reach 50% in 10 years or less.

The McShin Foundation president also highlights the fact that an increase in recovery community organizations coupled with a more humane approach to detox will give way to a new era of much-needed pride in recovery from drug addiction, as both stigma and lack of appropriate services prevent many opiate users from seeking treatment. Drug addiction does not discriminate - an estimated 56 million Americans are currently in recovery or need to be in recovery, and this means we all have a loved one who is struggling with this deadly disease.


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