The Oberlin Review

Opioid Epidemic Cannot Be Fought Through War on Drugs

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Almost exactly a year ago, I wrote a piece for The Oberlin Review about the opioid epidemic, specifically in Ohio, and what could be done about it. Since then, there has been no significant reduction in opioid-related deaths in the state or in the nation. According to The Columbus Dispatch, Ohio’s drug overdose rate increased to 39 percent from mid-2016 to mid-2017; the national average is 13.3 percent.

Ohio’s 2017 opioid-related data looks bleak. The state had the third most opioid-related overdoses and the third highest overdose rate increase out of any other state in 2017, totaling 5,200 deaths. Montgomery County in southern Ohio reached 800 overdose deaths in 2017 and had to expand its morgue to accommodate the drastic increase. Out of the 4,329 overdose-related deaths in Ohio in 2017, 83 percent were due to opioid overdoses.

Thus far, attempts to mitigate the damage have led to unintended side effects, both in the state and nationally. The higher prices and heightened difficulty of obtaining prescription opioids, though successful in decreasing the overdose rate of prescriptions, have only led to the substitution of other types of opioids that are cheaper and easier to obtain illegally than prescription opioids — namely heroin and, more recently, the synthetic opioid fentanyl. The overdose rate from fentanyl has doubled since 2015. A major reason why fentanyl usage has made a huge jump in recent years is that individuals need much less of the substance than heroin or prescription drugs to achieve the same high, making it cheaper for users and easier to smuggle for the cartels. It is also easier to produce — it does not require a specific plant like heroin does to manufacture — and is 40 to 100 times stronger than morphine and 10 times stronger than heroin. This makes fentanyl users more likely to overdose than users of heroin and other opioids. Furthermore, individuals seeking heroin often mistakenly buy fentanyl, and end up taking too much because they think they are using a weaker drug.

Despite well-intended efforts, we continue to fail in dealing with this epidemic. If anything, this failure proves that we, as a country, cannot continue to fight this opioid abuse by simply proceeding with the War on Drugs. When we make policies that attempt to suppress the smuggling of prescription opioids and punish those with substance abuse disorders, the overdose rate of prescription opioids may go down, but that is counteracted by a spike in heroin. This same phenomenon takes place with policies regarding heroin, only with the backlash being a jump in the even stronger fentanyl. Each time we single out a drug to eradicate, producers and cartels develop and cater a new one that is even stronger, cheaper, and easier to smuggle than the last. If we continue to fight the opioid epidemic in the same way, we will get the same results as always — even bigger spikes in opioid-related deaths than the year before.

For my 2016 Winter Term project, I had the privilege of interning with Judge Denise Bradley, who presides over a criminal courthouse of Harris County in Houston, Texas. During my time there, I was introduced to a nationwide program that Judge Bradley volunteered to helm — the Drug Court system. Nonviolent drug offenders can apply to Drug Courts when available, where they are required to complete a rehabilitation program under the supervision of a judge. Although the program is lengthy, individuals who enter the Drug Court system receive substance abuse and other mental health treatments, social services, and employment assistance. However, they are also held accountable for being productive members of society and staying clean. Failure to do so results in a mandated sentence from the judge.

The Drug Court system is successful in several ways. The program’s supervision is close enough that its participants are six times more likely than those in unsupervised programs to be in treatment long enough to actually produce results, and they have a lower rate of relapse after graduation. Out of 2,000 graduates, only 16 percent of individuals were arrested for drug-related crimes after the first year and 27 percent after the second year, compared to 60–80 percent of those who were arrested but not a part of Drug Court.

The system also saves taxpayers a substantial amount of money and could help in lowering the national incarceration rate in America. One study showed that the average savings per individual in Drug Court ranged between $4,000 and $12,000. Furthermore, studies consistently show that Drug Courts play a direct part in lowering the national crime rate. Thus, individuals who complete the program are very likely to stay out of jail long-term — inevitably leading to less spending — unlike those who receive jail time or unsupervised rehab and probation.

Finally, though there have been no studies on the relationship between opioids and Drug Courts, a study conducted on methamphetamines showed that compared to eight other treatment programs, Drug Courts produced the highest and longest rates of abstinence for methamphetamine users. These facts provide strong evidence that Drug Courts could be a successful, long-term approach in battling the opioid epidemic in this country.

Action must be taken, and soon. The collateral damage of opioid abuse is beginning to pile up.

Our incarceration rate is out of control; one in 115 U.S. citizens is confined. Labor force participation has fallen drastically in states with higher opioid usage. People suffering from addiction who want help are forced to wait weeks or even months for admittance to treatment centers. The number of children who have been removed from a home involving substance abuse has quadrupled since 2010, leaving the foster care system overcrowded. Those forced into treatment by criminal courts receive unsubstantial, short-term treatment and relapse 95 percent of the time. Something must change. Not only are we failing to lower the crime rate and rehabilitate offenders, but we are also failing to protect individuals and families from the threat and consequences of the opioid epidemic.

It is our government’s duty to protect its citizens. It is therefore also its duty to take quick and thorough action in fighting this epidemic, especially as its effects are spreading to so many aspects of American life. Drug Courts are proven to be highly successful, but there are simply not enough in existence. This system must be expanded so that individuals seeking rehabilitation treatment will not be forced to wait more than a couple days to be placed into a program. So long as we continue the War on Drugs, stronger drugs will continue to surface, and the direct effects and side effects of the opioid epidemic will continue to take lives, families will continue to be torn apart, and death and imprisonment rates will continue to skyrocket.

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