Tackling the opioid crisis: Candidate proposals highlight coordinated treatment, education

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October 30, 2017

11:38 PM

The Republicans and Democrats vying for victory in Virginia’s key statewide races — governor, lieutenant governor and attorney general — share little common ground on most policy issues, but the state’s ongoing opioid addiction crisis is different.

Although the six candidates offer varying proposals for tackling the epidemic, all recognize its prevalence. Democratic gubernatorial candidate Ralph Northam deemed the crisis “the largest challenge in Virginia” right now, and Republican attorney general candidate John Adams said that if elected, his top priority would be establishing a substance abuse coordination center.

The number of drug overdoses in Virginia has risen dramatically in recent years, and in November 2016, State Health Commissioner Marissa Levine declared the opioid crisis a public health emergency.

Between 2015 and 2016, the percentage of deadly drug overdoses in the Commonwealth rose by 38 percent, and in 2016, individual fatalities numbered an estimated 1,420. Since 2013, drug overdoses have topped Virginia’s list of unnatural causes of death, surpassing both motor vehicle and gun-related deaths.

Opioids are a category of drugs that dull the nervous system’s opioid receptors. Some opioids, including oxycodone and codeine, are commonly prescribed as strong pain relievers. Others, including heroin, fentanyl and carfentanil, are illegal and highly potent. Carfentanil, a synthetic form of fentanyl, is 100 times more powerful than pure fentanyl and is used to tranquilize large animals.

Although prescription opioids used to be the prime culprit in fatal drug overdoses, heroin and fentanyl have become increasingly present in Virginia. Last year, 803 of the state’s overdose deaths stemmed from fentanyl and/or heroin abuse, while 465 were the result of prescription opioid abuse.

A key development in the state’s fight against opioid addiction was the Virginia General Assembly’s passage earlier this year of HB 1750, a bill that allows pharmacies to dispense the life-saving drug naloxone without a prescription. The legislation built on a standing prescription issued by Levine as part of her declaration of a public health emergency and essentially made the drug’s widespread availability a permanent measure.

During emergency situations, naloxone can block or reverse the effects of opioids and prevent a fatal overdose. Increased accessibility to naloxone has helped law enforcement officers and first responders treat addicts, but the drug is only one element of a complex solution.

Republican gubernatorial candidate Ed Gillespie and his opponent, current Lieutenant Governor Ralph Northam, have both released multi-step plans for tackling the opioid epidemic.

Gillespie’s proposal emphasizes coordinated treatment efforts, drug abuse education for middle and high school students and teachers and the designation of a long-term recovery official to provide guidance on recovery systems across Virginia. The plan also outlines five guiding principles for fighting drug abuse: recognize addiction is a disease rather than a moral failing, focus on intervention, realize the state cannot “arrest our way out” of the current crisis, recognize multiple pathways to recovery and offer immediate help.

Comparatively, Northam offers a seven-pronged plan with goals including providing treatment and resources for all Virginians who need them, ensuring transparency and accountability and promoting non-opioid pain treatment. He pledges to fight for the continued availability of substance abuse treatment services provided under the Affordable Care Act, expand Medicaid to increase accessibility to evidence-based addiction treatment services and create a public online dashboard with real-time data about the crisis.

The candidates for lieutenant governor — Republican Jill Vogel and Democrat Justin Fairfax — share many of their gubernatorial counterparts’ views. Vogel, in fact, announced her comprehensive plan alongside running mates Gillespie and Adams.

According to Vogel, the experience of fighting addiction in her own district, which includes the City of Winchester and parts of multiple Northern Virginia countries, showed her that incarceration and other law enforcement solutions were ineffective.

“Why is this a law enforcement issue?” Vogel said. “Why are we not treating this as a public health crisis and trying to get people into treatment and out of jail? I’m providing a path of legislation to provide for a behavioral health approach and essentially a drug court, a docket that would get people out of the track of ‘hey, we’re going to send you to a jail and incarcerate you,’ [and explain], ‘We’re now going to treat your illness. You know, it’s not a moral failing that you have here. You’re an addict. And you can’t get well sitting in jail.’”

Fairfax approaches the opioid crisis as both a health care and law enforcement issue thanks to his background in federal prosecution; however, his proposals are largely related to criminal justice reform. Rather than imposing mandatory minimum sentences on nonviolent drug offenders, Fairfax suggests finding the underlying causes of drug abuse and providing support as needed. He also advocates increased resources for at-risk populations, particularly students, and finding alternatives to school systems’ harsh disciplinary measures.

We must adopt practices that encourage positive engagement by law enforcement with the communities they serve,” Fairfax told political website Ballotpedia. “By building and emphasizing relationships in these neighborhoods, trust and communication lines can be strengthened.”

“We must adopt practices that encourage positive engagement by law enforcement with the communities they serve,” Fairfax told political website Ballotpedia. “By building and emphasizing relationships in these neighborhoods, trust and communication lines can be strengthened.”

The third pair of candidates — Adams and current Attorney General Mark Herring — have been quick to criticize each other throughout their campaigns, and the opioid crisis has served as one of many points of contention.

As the incumbent attorney general, Herring has already spent several years tackling the epidemic. His five-point plan focuses on legislation, education, prevention, enforcement and collaboration, and he emphasizes prior successes ranging from the prosecution of more than 75 cases against heroin dealers to the creation of an award-winning educational documentary and donation of more than 80,000 drug disposal kits.

During Herring’s time in office, the General Assembly passed HB 1750, the bill that made naloxone readily accessible without a prescription, and a “Good Samaritan” law designed to encourage individuals who witness an overdose to seek medical aid.

Still, Adams readily pointed out the shortcomings of Herring’s efforts during the final attorney general debate. According to WTOP, Adams alleged that the “opioid crisis that [Herring has] worked so hard to fix is spiraling out of control.” He noted, too, that the number of opioid-related deaths has risen during Herring’s tenure.

Adams’ solution to the opioid crisis centers on prevention and education, treatment and enforcement. He hopes to use the attorney general’s office to leverage resources across the state and proposes the establishment of a substance abuse coordination center where representatives from the law enforcement, rehabilitation and medical communities can connect and share information regarding aid efforts.

 There’s a lot of good people out there trying to help,” Adams said. “But they’re not talking to each other, they’re not communicating, they’re not sharing information in an as efficient way as they could.”

“There’s a lot of good people out there trying to help,” Adams said. “But they’re not talking to each other, they’re not communicating, they’re not sharing information in an as efficient way as they could.”

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About Author

Meilan Solly

Chief Staff Writer Meilan Solly '18 is an English major in the W&M/University of St Andrews Joint Degree Programme. Previously, she served as editor of The Saint, St Andrews' student newspaper, and an editorial intern at Smithsonian and Kiplinger's Personal Finance magazines.

(1) Reader Comment

  1. john stack
    October 31, 2017 at 10:16 AM

    The horse is alred out of the barn. Collapse of families and loss of job opportunitiies is behind all of this. Increased supply and availability also a key part of problem. I agree non-criminal rehab is needed for victims, but problem will not be solved with politcal proposal alone.

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