There’s almost universal agreement more treatment needs to be made available to help Ohio overcome the opioid crisis that killed nearly 11 people a day last year. But a study from Ohio State University says there simply isn’t enough capacity to help the 170,000 Ohioans who are battling opioid addiction. As part of a series on recovery and roadblocks in the opioid crisis, Statehouse correspondent Karen Kasler reports on what experts are saying Ohio needs to focus on now.
“60 percent aren't getting it. That's probably a low estimate.” That’s according to Michael Betz, one of the authors of the study titled “Taking Measure of Ohio’s Opioid Crisis”. In just 22 pages, it starkly lays out the size of the crisis. For instance, Betz says Ohio only has enough treatment capacity to reach 20 to 40% of the addicts who need it. “Even when treatment is available, there's a large part of the population that doesn't seek treatment out themselves, so getting them into treatment,” Betz said. “This has been such a fast moving crisis, especially in the past three or four years when we've seen more illicit drug use like heroin and fentanyl, overdose deaths have really increased very rapidly.”
Betz’s research partner at Ohio State is Mark Partridge, who said: “A lot of our rural areas haven't faced at least the hard drug problem and right now that is where the opiate addiction issue is concentrated – it tends to be concentrated in rural areas. And rural areas have considerably less treatment facilities per person than what you would see in urban areas. So not only are they experience the worst of the addiction they have the least resources to actually treat it.”
The researchers found there are just 377 doctors certified to prescribe the opioid fighting drug suboxone, which also can be abused. And Betz says there are just 26 methadone treatment centers in Ohio – but only two of them are in rural areas. “I think that was one of the things that was really surprising to us is really the dearth of treatment options available particularly like you say for those in rural areas,” Betz said. “If you're thinking of someone who's struggling with addiction and they need daily treatments with this, to drive an hour and a half or two hours to receive treatment – it's just putting up larger barriers for people to get the help that they need.”
Ohio’s two US Senators, Democrat Sherrod Brown and Republican Rob Portman have proposed a bill to raise the cap on beds at residential treatment facilities from 16 to 40. Others have called for Ohio ask for a waiver to allow for treatment in facilities with more than 16 beds, as West Virginia has.
Many of those who get to treatment have it paid for with federal Medicaid expansion money, which brought a huge increase in funding to the state in 2013. But the money has leveled off since then, as overdose deaths have soared. And majority Republicans in the Statehouse are very concerned about sustainability and costs, and have put some restrictions on Medicaid spending in the budget, including a Medicaid expansion enrollment freeze. Gov. John Kasich vetoed that, but that could be overridden anytime before next December.
The Kasich administration has been fighting the crisis on the front end by focusing on prevention – for instance, through his “Start Talking” campaign, which he mentioned in his “State of the State” speech in April: “We've got to love our kids and talk to them about this. The answer is no, I don't want to be cool by taking drugs.”
Prevention may seem like a low-cost way to battle the opioid crisis, but they’re not free. John Corlett is with the Center for Community Solutions in Cleveland has studied the opioid epidemic and its devastating on communities, and the spending that’s being done on it. “I think we were struck by how little state dollars go into prevention efforts – that most of the money that goes into prevention in Ohio is federal funds. And so that may be a place where the state wants to invest more of its own money,” Corlett said.
An analysis provided by the Office of Budget and Management shows that prevention funds have actually decreased nearly 30 percent from last year. But Ohio State researcher Mark Partridge isn’t convinced more money will help with that. “We learned from the war on drugs in the 80s and early 90s, ‘just say no’ is by itself a very ineffective message if you don't have alternatives,” Partridge said. “So, yes, I'm in favor of this. But on the other hand we have to realize that that it's going to have only a small effect. We really have to take some of the much more proactive steps.”
The researchers also found a person whose highest level of education was high school is 14 times more likely to experience an overdose. That’s interesting when compared to another stat – that Ohio spent $8.2 billion on K-12 public education in 2015. That’s less than the $8.8 billion the researchers estimate the opioid crisis is costing the state every year.