State and federal health officials in Georgia were heartened to hear President Donald Trump’s determination to put more resources into fighting the opioid epidemic. They cautioned it’s just a start, however, and enthusiasm was scarce for Trump’s most startling proposal, urging the death penalty for some opioid distributors.
"We're in the middle of a fast-moving, tragic epidemic," said Dr. Anne Schuchat, the acting director of the U.S. Centers for Disease Control and Prevention. "We didn't get into this overnight and we're not going to get out out of it overnight, but bold goals were announced."
Schuchat works in perhaps the world’s premier public health agency, but she also sees the opioid epidemic roll out from the CDC’s offices in the Decatur area. When health workers here got a warning about the appearance in Georgia of a type of fentanyl that could be fatal if touched, she got it, too.
According to the office of state Attorney General Chris Carr, Georgia is among the top 11 states in opioid overdose deaths, and 55 Georgia counties have an overdose rate higher than the national average.
The CDC two weeks ago reported that emergency room visits from opioid overdoses rose 30 percent from July 2016 through this past September. That was no surprise to Dr. Matthew Keadey, the chief of emergency medicine at Emory University Hospital, who joined with Schuchat to speak about the opioid plan. “We see it on a daily basis,” he said.
The proposal to impose the death penalty on some drug dealers has grabbed headlines, and it elicited strong applause when Trump spoke of it Monday in New Hampshire, according to a White House pool report. “We can have all the blue-ribbon committees we want,” the president said, “but if we don’t get tough on the drug dealers we’re wasting our time.”
It’s unclear, however, whether that would actually help fight the epidemic. Schuchat said the government’s response must indeed be multipronged; but pressed on whether there was epidemiological evidence that the death penalty would have a public health impact, she said, “I’m not aware of any.”
Another goal advanced by the administration is to reduce opioid prescriptions by one-third over three years.
Technology could help. Schuchat and Keadey want to see a national database showing the opioid prescriptions that patients get and doctors give in order to help doctors and regulators spot high usage and state-hopping. The CDC is already helping states that have their own databases to link them; some experts favor a new and more seamless database that could be implemented nationally.
There is controversy over doctors and pharmacists who don't use the databases. But for the moment, even those who make the effort in states such as Georgia and Florida won't see whether abusive patients or overprescribing doctors are spreading problems across the state line, the health officials said.
Neil Campbell, the executive director of the Georgia Council on Substance Abuse, said Georgia has spent all of its $11.7 million allocated by the Obama administration toward the opioid crisis. Her organization has funded a hotline and put addiction coaches in emergency rooms in Braselton, Gainesville and Winder. She cheers the push to increase those resources perhaps sixfold.
But both on the state and federal level, she said, it’s not enough. More Americans died of opioid abuse last year than died in the Vietnam War, and yet 9 out of 10 can’t get access to treatment, she said. Georgia cut prevention funds in the 2009 economic crisis and never put the money back.
“I think there’s a mistunderstanding of how the epidemic is really impacting us,” she said. “Our hair should be on fire.”
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