Simply restricting pills won’t solve epidemic

Published 2:54 pm Friday, July 28, 2017

By Jim Paxton

The Paducah Sun

The Centers for Disease Control has found that the number of prescriptions for opioid pain pills has declined in Kentucky since 2010. But as an article appearing in The Paducah Sun last Sunday observes, the number of overdose deaths from opioids in the state continues to rise.

The article was penned by the Lexington Herald-Leader. We were struck by a line in the story that said prescriptions for pain pills “inflamed drug abuse in Kentucky for years.” It is a theme one sees a lot in the media these days. It is partly true. But we also think it oversimplifies the addiction problem.

There is little question that overprescribing pain medicines — doling out more pills than needed to more people than needed them — contributed to abuse and many pills making their way to the streets. But we don’t think it follows that cavalier prescribing practices resulted in wholesale, accidental addiction of the masses. That narrative has become common, but we think it misstates reality.

The truth is that millions of Americans who have taken opioids as prescribed have not become addicted and were never in danger of such. Most who become addicted make conscious, bad decisions. Prescribers don’t advise patients to grind up their pills and snort them. They don’t advise them to take too many in search of euphoria.

Victimhood this is not, not in most cases, despite a tendency to portray it that way. Such oversimplification is part of the reason government efforts to cope with this tragedy keep coming up short.

What we are seeing and what the CDC report pretty much confirms is that once established, dealing with widespread addiction is like pushing in on a balloon. Press in on one spot and the bulge emerges elsewhere.

This is what happened when Kentucky and many other states made pain pills more difficult to get. The efforts reduced availability and abuse of pills declined accordingly. But this did nothing to reduce addiction itself. Rather, addicts turned en masse to cheaper, far more dangerous street drugs.

Last Sunday’s story spells it out. Deaths involving oxycodone declined 4 percent last year from 2015, and deaths from a sister opioid pill, hydrocodone, dropped 5 percent. But opioid overdose deaths overall continued their dramatic upward trajectory, driven by street drugs like heroin and fentanyl.

Policy approaches are coming up short in part because of the oversimplified view that overprescribing “caused” the epidemic. It did not. It was a means to an end. The root of addiction lies elsewhere.

We cannot help but note that in Kentucky the addiction epidemic began in eastern Kentucky and coincided with the economic collapse of the coal industry. More generally the addiction plague has spread across the nation as the march of technology vaporizes once-reliable work opportunities in communities large and small.

This dislocation, fear and loss of sense of purpose has been as much a commonality in the national wave of addiction as the overabundance of pills. It is an area policymakers cannot attack quickly enough. The cure to this growing problem has to include aggressively retraining and providing new opportunity to displaced American workers.

Making pills harder to get has been the preferred path of lawmakers seeking to “do something” about addiction simply because it is easier. But it will never be the cure. Our leaders need to face up to that.