The Opioid Epidemic

Over 30,000 people will die from opioid-related overdoses this year in the United States.
 
The United States has less than 5% of the world’s population but uses 80% of the world’s prescription opioid painkillers. 
 
People who abuse prescription painkillers often turn to street heroin, at a rate of about 600 per day, because of its lower cost. 
 
One tragic consequence of the opioid epidemic is babies who are born addicted to opioids like OxyContin or Vicodin.  This alone costs over $300 million in hospital care, not to mention the human toll.
 
I have joined with a number of other Attorneys General in an investigation into the potential legal culpability of pharmaceutical manufacturers in the marketing and sale of opioid prescription painkillers. I hope that any money recovered from this effort could help fund treatment, which is desperately needed to curb this epidemic.
 
Investigations and lawsuits alone, however, will not stop the addiction crisis.  Nor can Minnesota arrest or prosecute its way out of this problem.
 
Before the legislative session, I issued a white paper on the opioid epidemic.  The paper made a number of legislative proposals which, if enacted, would hopefully help save lives.  The white paper was recently recognized as a 2017 Notable Document by the National Conference of State Legislatures (the only white paper to address the opioid crisis).  Unfortunately, most of the proposals in the paper failed to be enacted into law this year.  Lobbyists whose clients wanted to duck responsibility on the issue turned out against the legislation.
 
The proposals include the following:

• Minnesota should require prescribers and dispensers to review a patient’s history in Minnesota’s prescription drug monitoring database before prescribing or dispensing controlled substances. Research indicates that required use of a drug monitoring program is effective in reducing prescription painkiller abuse and doctor-shopping. This proposal failed to be enacted.

• Opioid prescribers and dispensers should be required to receive periodic continuing education on pain management, substance abuse disorder, and painkiller risks.  This proposal failed to be enacted.

• Patients should be given plain-language information about the risks of opioid abuse and the proper disposal of these medications when they fill a painkiller prescription. This proposal failed to be enacted.

• To limit diversion of drugs, there should be a collection receptacle in each county to dispose of unwanted opioid painkillers. This proposal was enacted.

• To stop painkillers from falling into the wrong hands, the time period for a painkiller prescription to become void if not filled should be shortened.  This proposal was not enacted.

• Occupational health licensing boards and law enforcement agencies should be given access to data to shut down “pill mills” that use professional licenses to sell inappropriate drugs to addicted patients.   This proposal was not enacted.

• Drug treatment should be substantially expanded. Every $1 spent on substance abuse treatment saves $4 in health care costs and $7 in criminal justice costs. Only modest new treatment funding was appropriated.

• Drug courts should be expanded to give judges options in getting people who are addicted to drugs help with their addiction.  Some additional funds were appropriated to the courts.

Another proposal—which I support—would have charged a one-penny fee on each painkiller dispensed (measured in morphine milligram equivalents).  The fee would have generated an estimated $20 million per year for drug treatment.  This proposal was not enacted.

This epidemic affects people from all parts of Minnesota and all walks of life.  The victims include people who are addicted to drugs, their families and friends, their employers, and those who fall prey to crimes like theft, assault, and intoxicated driving caused by drug abuse.

I hope that you will review the white paper and contact your legislators with your thoughts on this crisis.  Despite the lobbying, legislators will respond to these proposals if they hear from enough constituents who make it clear that the epidemic affects their communities.