The day after nearly 30 patients were treated for a heroin overdose at Louisville hospitals, local, state and federal officials addressed the opioid epidemic affecting the region, calling for increased funding for addiction treatment.
Lexington mayor and Democratic candidate for U.S. Senate Jim Gray held a press conference at The Healing Place recovery center along with U.S. Rep. John Yarmuth on Wednesday, calling the previous day’s spike in overdoses part of a growing health crisis for Kentucky, which had over 1,200 fatal drug overdoses in 2015. Though Congress recently passed a wide-ranging bipartisan bill to address the national opioid crisis, Gray said there were not enough appropriations devoted to its initiatives to have a real impact, and he criticized Sen. Rand Paul — his opponent in the upcoming election — for not pushing Senate Republicans enough to spend that money.
“Next week, as Congress reconvenes, I call on Sen. Paul and Senate Republicans who oppose emergency funding for the opioid crisis to fully fund the Comprehensive Addiction and Recovery Act,” said Gray. “While CARA includes important treatment and recovery efforts, it does not include the means and resources to implement them. With skyrocketing overdose rates reported throughout the state, Sen. Paul should be taking every step to provide the resources our communities and facilities like (The Healing Place) desperately need to save lives. We really can’t afford not to.”
While Yarmuth praised CARA, he added that “good policy without good resources and adequate resources is a failure,” noting that the Obama administration had requested roughly $1 billion to implement the provisions of the bill expanding access to medication-assisted treatment and the overdose antidote naloxone. Though commending Paul for pushing his bill to allow doctors to prescribe the addiction medication Suboxone to more patients — which the Obama administration implemented this summer — he added that Paul and Senate Republicans voted against an amendment that would have appropriated $600 million toward CARA initiatives.
“How much are 1,200 lives worth in Kentucky, and hundreds of thousands of lives nationally?” asked Yarmuth. “Certainly they’re worth $600 million. And when senators like Rand Paul and Mitch McConnell run around taking credit for legislation when they’re not willing to put up the resources to make that legislation effective, it’s kind of a hollow boast.”
Responding to Gray’s criticism, Paul’s spokeswoman Kelsey Cooper sent IL a statement touting the senator’s Suboxone legislation that pushed the Obama administration to lift patient caps, adding “It’s disappointing that rather than focusing on the bipartisan work of Congress in addressing the opioid epidemic, Mayor Gray is once again politicizing a crisis. The heroin epidemic facing our Commonwealth is too important to be left to partisan bickering.”
As for congressional appropriations, Cooper said Paul voted for legislation earlier this year that devoted $1.5 billion to addiction prevention and treatment efforts, but it was vetoed by President Obama; she added that Paul “has led on this issue and will continue standing for Kentucky families as we fight back against this epidemic and help people find a path to recovery.”
The legislation cited by Cooper was HR 3672, which did appropriate that amount, but also repealed most of the Affordable Care Act and completely defunded Planned Parenthood, with Obama justifying his veto by saying it would increase the number of uninsured Americans by 22 million next year. Gray campaign spokeswoman Cathy Lindsey responded to this defense by saying Paul should “do his job” next week by pushing for emergency funding for CARA and “stop the games.”
‘It’s time to get busy saving lives in this country’
Later that morning in downtown Louisville, a rally that was planned months ago to address the opioid crisis now had increased urgency and relevance due to the city’s alarming spike in overdoses. It was organized by Fed Up!, a national coalition that is co-chaired by Louisville resident Emily Walden, whose son died of an opioid overdose four years ago; she has been fighting to raise awareness about opioid addiction ever since.
Before the rally, Walden told IL that Congress included no funding within CARA, and this was one of 50 Fed Up! rallies being held around the country in which they would ask Congress to correct that error as soon as possible.
“The president is asking for $1.1 billion, and we want Congress to act and put that money in place,” said Walden. “I’m hoping with these rallies going on that Congress will see the need and go ahead and get the funding that’s needed for treatment.”
Metro Council President David Yates told the crowd that the council resisted “negative political pushback” when it created the syringe exchange program last year to prevent the spread of disease caused by shared needles and educate users about treatment options. Referring to the health department’s many trainings over the past year on naloxone — through which the family of addicts can obtain kits to use in case of an overdose — he noted that a mother told him she was able to save her son shortly after one of those trainings.
“We tell people to say no to drugs, we tell people to get clean, but it’s up to us as a community to demand that they have the ability to do that,” said Yates. “That when someone wants to get better that we support that effort, that we shed the stigma of being an addict and we add hope. Because that’s what we miss a lot of times in this community. When someone loses hope, there’s little chance of recovery.”
Jefferson County Attorney Mike O’Connell talked about losing his son to a heroin overdose in 2014, saying law enforcement must aggressively break up the business of heroin traffickers on the front end, while saving lives on the back end by expanding access to addiction treatment — passionately calling out Congress for not putting up the funding to do the latter.
“To those that are in Congress of the United States, I say get some guts and get some courage and stand up here and help save the lives of the people that you say on a daily basis you represent,” shouted O’Connell. “It’s time to quit talking and it’s time to open the pocket books, and it’s time to get busy saving lives in this country.”
‘Let’s put down the partisan bickering’
Kentucky Justice and Public Safety Cabinet Secretary John Tilley touted the state’s bipartisan efforts to combat the opioid epidemic in recent years, including last year’s legislation he pushed as a Democratic legislator at the time to allow local health departments to create their own needle exchanges. He said he joined the Bevin administration in his current position to expand those efforts — highlighting $12 million in additional state funds passed this year — but added that the problem is continuing to evolve, citing the increased presence of heroin being cut with fentanyl, a more potent opioid suspected to have played a role in Louisville’s overdoses on Tuesday.
While saying law enforcement needs to aggressively pursue the cartels and traffickers of such drugs, he added that many low-level drug offenders deal drugs to support their own addiction, and the state’s focus should be on expanding treatment for addicts instead of incarceration.
“A prison cell is no place for an addict,” said Tilley. “But sadly, we still have many addicts in our prison cells in Kentucky – our county jails and our state prisons and our federal prisons; 24,000 of them in Kentucky right now. If we were a country, we’d have the seventh-highest per capita incarceration in the world.”
Tilley said that CARA was a long-overdue step by Congress to address the opioid crisis, but added that they need to follow through with “as much as we can get” in appropriations to make it work, as “money doesn’t solve every problem, but it does provide treatment, it does provide solutions.”
“Let’s put down the partisan bickering,” said Tilley, “and let’s all get together as a community and a nation to give some relief.”
Kentucky Attorney General Andy Beshear said drug abuse will be “the greatest challenge that this generation will face,” and that Kentucky “will either face it, defeat it and move forward, or we will fall back.” He said fentanyl dealers should be targeted with stricter penalties, as “these folks have no morals, they have no decency, and they must be stopped.”
Beshear gave some rare praise to the Bevin administration, thanking Tilley’s Justice Cabinet for devoting more funds to the state’s “rocket docket” program, which expedites low-level drug crimes in the court system and moves such offenders toward treatment. However, he added that there still is insufficient funding from the state to address the opioid epidemic, saying that legislators preparing the next state biennium budget in 2018 “must be ready to put hundreds of millions of dollars of our taxpayers where it needs to go, addressing this problem and providing for recovery.”
Referring to several county school districts that have been slow to accept free supplies of the overdose antidote naloxone, Beshear said that “Every single school system in this commonwealth should accept and stock naloxone. Jefferson County Schools should stock naloxone. Because the only child we can’t treat, the only child that no longer has hope, is a dead child. And our school system should be on the front lines of doing everything we can to help that overdosed child.”
While the Obama administration, Congress and national expects in the field of opioid addiction are pushing for expanded access to medication-assisted treatment that includes Suboxone, Beshear warned that he would go after cash-based clinics offering such services, comparing some to the prescription painkiller “pill mills” the state has cracked down on in recent years.
“My office is focused on rogue Suboxone clinics that are popping up around our state, that as opposed to providing good treatment that some other clinics and groups provide in this state, are instead trying to profit off the addiction that is out there and to flood our commonwealth with a new form of legal drugs,” said Beshear. “I will not tolerate anyone who would profit from our addiction community. The concept of cash only clinics we have seen in the past, and we’ve seen what they do.”
While many in law enforcement are concerned about the diversion and abuse of Suboxone — as are some in the recovery field who view it as just another addictive drug — physicians operating private clinics prescribing the medication say the are providing a vital and underutilized treatment option to combat the opioid crisis. Many of those providers would rather accept Medicaid than deal in cash, but say managed care organizations are notorious for delaying or denying reimbursements, which when accepted are so meager that it is impossible to stay in business. They also cite state regulations enacted under the administration of former Gov. Steve Beshear that discourage physicians from opening private clinics, as doctors requiring cash for office visits may not be a Medicaid provider.