Business shutdowns, job losses, school closures, and increased isolation due to quarantine during the COVID-19 pandemic have added fuel to the opioid fire in Ohio and around the nation, creating an alarming spike in the number of opioid-induced deaths.
“The coronavirus and the racial conflict we’re having are obscuring what in my mind is the No. 1 crisis issue in Ohio and in the rest of the United States, and that is the ongoing opioid crisis,” Ohio State Rep. Adam Holmes (R-Nashport) told Health Crisis Alert.
In fact, drug deaths in America, which decreased in 2018 for the first time in a quarter-century, hit record numbers in 2019 with almost 72,000 Americans dead from drug overdoses, an increase of 5 percent from 2018 with the majority of the deaths involving the use of opioids, according to data released July 15 by the Centers for Disease Control and Prevention (CDC).
The CDC released its data separately from Ohio, and reported the state’s increase in drug deaths at 6.9 percent in 2019, ranking it 25th in the nation.
Meanwhile, preliminary data from the Ohio Department of Health, which plans to finalize its numbers this fall, shows that fatal drug overdoses in the state rose 5 percent in 2019 compared to 2018.
“Opioid addiction corrodes any endeavor we are trying to do to help Ohioans and we have to solve that right away,” Holmes said. “It’s a threat to any good idea that we have coming for the state.”
While the current COVID-19 pandemic is “certainly a tragedy” that continues to require massive amounts of attention and resources, Holmes said the number of opioid fatalities far exceed those caused by the coronavirus.
“I think the oncoming economic crisis, along with this health crisis, is only going to exacerbate the problem,” he added. “And we’re not appropriately putting resources on it now. We’re focused on the emerging crisis, but the enduring crisis still remains.”
In response, Holmes and his colleague Ohio State Rep. Jeffrey Crossman in June introduced five separate bills in the Ohio Legislature to comprehensively address the state’s opioid abuse problem.
- House Bill (H.B.) 698 would appropriate funds to establish addiction treatment facilities; increase penalties for drug trafficking violations; modify penalties for drug possession; and create restitution work programs, among other provisions.
- HB 699 would reduce the abuse of prescription opiates. For instance, a prescriber who issues an initial prescription for a drug that is an opioid analgesic for the treatment of acute pain shall limit the prescription to a period of not more than three days. Before prescribing additional opioid analgesics after the initial three-day period, the patient must be reexamined and a new prescription issued, according to the text of the bill.
- HB 700 would make addiction treatment widely available, among other provisions, by permitting a health insuring corporation to provide payment or reimbursement to a pharmacist for providing a healthcare service to a patient if both of the following are the case: (A) The pharmacist provided the healthcare service to the patient in accordance with state code; and the patient’s individual or group health insuring corporation policy, contract or agreement provides for payment or reimbursement of the service, according to the text of the bill.
- HB 701 would establish the Social Impact Bond Fund (SIBF) and program. At the beginning of each fiscal year, the director of the Ohio Department of Rehabilitation and Correction could transfer funds totaling up to 5 percent of the total of all funds appropriated to the department to the SIBF and could seek and apply for additional federal funding for the SIBF. Under the related program, the director also could enter into multi-year contracts with individuals or entities to achieve certain social impact goals in the state, such as lowering the recidivism rate of offenders released from state correctional institutions, among other provisions, according to the bill’s text.
- HB 702 would create the Reentry Ohio Program for employees of the Department of Rehabilitation and Correction who suffer an injury or contract an occupational disease in the course of and arising out of participation in the program. The participants would be entitled to compensation and benefits, among other provisions, according to the bill’s text. “These grants would augment the payroll and benefit costs associated with hiring released offenders,” said Holmes. “It would also provide housing for ex-offenders who take such jobs.”
Holmes explained that the five bills have been put separately in an effort to get some of their overall Comprehensive Ohio Drug Addiction Solution plan in place more quickly, rather than waiting for an agreement on one large comprehensive bill.
“Realistically, I don’t think we’re going to get anything signed this year, but the very first thing next year we will get it signed into law,” he said. “From what I’ve seen, thus far, it’s got wide support. It’s a very well-thought out approach to solving this situation.”
In Holmes’ new role as vice-chair of the Ohio House Health Committee, he’s also working on two bills that he said will get signed this year: one on surprise medical billing and the other on telehealth. “The cost of healthcare is expensive and I only see that rising, which is why we’ve come up with some really dedicated strategies,” said Holmes referring to the proposals.
The opioid crisis is an expensive medical issue for Ohio.
“We think if you extrapolate the data, there were 1,900 overdose deaths in 2012 that totaled $2 billion in medical costs for Ohio,” Holmes told Health Crisis Alert. “This year we expect well over 4,200 deaths, realistically pushing those costs for the state to over $4 billion to $6 billion.”
State lawmakers, he added, also have redirected some of the resources that are being poured into opioid prevention toward related drug challenges exacerbated by the COVID-19 pandemic.
In fact, Ohio already has spent millions to fight drug addiction by expanding Medicaid, for example, while also limiting and monitoring prescription opioids and naloxone — which can reverse opioid overdoses — by adding local pop-up, walk-in clinics for naloxone and treatment services during the pandemic.
For instance, Columbus Public Health and Franklin County Public Health in Ohio issued an advisory notifying the public of an increase in drug overdose deaths and encouraging residents affected by substance use to seek local resources to protect their health. The advisory noted that public health and community partners are out in the community providing education and prevention services, such as access to free naloxone and free community naloxone training.
Rep. Holmes supports non-opioid-based treatments, saying that to substitute opioids with opioid replicators “aren’t really solving the addiction problem correctly. What we’re trying to do is eliminate the addiction to opioids in any form. I don’t want to be hostile about it, but we’re trying to get to the root cause of being addicted to any substance.”
Holmes thinks that so many good things are getting done legislatively in Ohio, but “if we don’t solve the opioid crisis, it corrodes all of it, from childcare to wrap-around services to education, to mental health and healthcare issues, to business and workforce development — all of it is negatively impacted by opioid addiction,” he said. “We have got to get to that one first.”
There’s also a federal effort to tackle the rise in substance abuse during the COVID-19 pandemic in Ohio and across the nation in Congress.
Most recently, U.S. Rep. Troy Balderson (R-OH) and a bipartisan group of more than 30 lawmakers on July 13 introduced the Drug-Free Communities Pandemic Relief Act, H.R. 7595. The proposal calls for providing temporary flexibility for the Drug-Free Communities Support Program by enabling the Office of National Drug Control Policy to waive the community match requirement for grantees to receive federal dollars if the community partners are unable to raise the funds due to the ongoing pandemic.
“As the coronavirus pandemic has devastated Ohio, we cannot forget the other ongoing public health crisis we face: the opioid epidemic,” Rep. Balderson said. “Flexibility and relief are necessary for our communities to continue combating youth substance abuse, provide behavioral health support, and protect the well-being of young Ohioans.”
Balderson said communities are less equipped to deal with the added strain on local resources, which have been redirected toward the pandemic. This cycle of a rise in substance abuse and decline in resources to fight it is unsustainable, he said.