*Originally published in the Appalachian News-Express*
By Buddy Forbes
The House of Representatives held a hearing last Wednesday to address the opioid crisis that is currently flooding the United States. Representatives from Maryland, Virginia, Kentucky and Rhode Island joined together on Capitol Hill to “combat the opioid crisis.”
“With this hearing, we will focus on the actions of our state governments to find out what efforts are working, what is not working and how we can work together to save lives,” said Chairman Rep. Tim Murphy (R-Penn.). “We want to know the problems, and please be candid with us.”
Kentucky Secretary of the Justice and Public Safety Cabinet John Tilley represented Kentucky during the hearing to illustrate what he says is Kentucky’s commitment and shared understanding of the opioid issue.
“The problem really has its origins in Kentucky and Ohio. We’ve lost 1,404 Kentuckians. Fentanyl is now the driving force behind these overdoses,” said Tilley. “We lose, in this country, nearly a commercial airplane (of opioid overdose victims) a day. If this were a communicable disease, we’d be wearing hazmat suits to combat it.”
The hearing mostly mentioned the drug Fentanyl, but the conversation targeted the opioid epidemic as a whole.
“This devastates communities. As soon as we got our arms around heroin, we began to see Fentanyl,” said Tilley. “I think all of us know the devastation it has had on our criminal justice community. Our jails and prisons are at capacity … the public health crisis is on full display in Kentucky.”
According to Tilley, the prevalence of hepatitis C in the Commonwealth is at a rate which is seven times the national average. This heightened presence of the disease brought forth a state-wide needle-exchange program.
“We passed one of the first comprehensive syringe exchange programs. Now, in Kentucky, we have 30 programs all passed by local option,” said Tilley. “When someone walks over the doorstep in one of those programs, it battles back these diseases like hepatitis C and HIV. Sadly, Kentucky, as the CDC reports, has 54 of the 220 counties most susceptible to a rapid outbreak of HIV.”
Tilley broke down the steps Kentucky is taking in its efforts to combat these diseases as they relate to use of opioid drug use.
“So, what has our response been in Kentucky to battle this? Taking a bold step as a southern state with the needle syringe program; passing comprehensive legislation, in consecutive years, on prescription pills and pill mills; second state in the country to battle back synthetics; the first state in the country to mandate usage of what we call KASPER and being the first state in the country to limit prescriptions for acute pain to three days,” said Tilley.
Tilley said the state’s efforts are becoming more expansive.
“We’ve doubled down on things like ‘rocket dockets’ and alternative-sentencing worker programs. We’ve put it in our jails and prisons, we’ve increased treatment at the Department of Corrections. We use naltrexone in our jails,” said Tilley. “We give an injection prior to release and another upon release, then we try to link that returning individual to the services in the community to see if they’re Medicaid eligible and to see what kind of resources they have to continue that kind of treatment … I think we have the most comprehensive effort I’ve seen in my 25 years of criminal justice with something we call KORE (Kentucky Opioid Response Effort).”
While he said Medicaid is helpful for those recovering offenders, Tilley would not directly comment on the role Medicaid plays in the efforts of Kentuckians to combat the issue. When asked by Rep. Diana DeGette (D-Colo.) if Medicaid expansion, which accounted for more than 60% of the total Medicaid spending on substance abuse treatment in Kentucky, has been particularly helpful in its efforts to combat the opioid epidemic, Tilley pointed back to the “commitment” of Gov. Matt Bevin to expand Kentucky’s treatment options, but did not comment on the role of Medicaid in the efforts.
“I would agree that, through a number of sources of funding, we have increased treatment,” said Tilley.
Following testimony from the state representatives, Murphy said that the only way to truly battle this epidemic is by being bluntly honest about what is and isn’t working.
“I think we have to be honest and say, ‘We have a long way to go in this war.’ It’s still quite a crisis. This committee will continue to take this up. We have an awful mess in this country and the outcome is a death rate that is mortifying,” said Murphy. “Thank you for your honest approaches. Keep fighting the good fight.”