Simply because safe injection sites are not the answer, does not mean that there are not meaningful things we can do on the local level to combat the opiate epidemic.
The best way to combat the opiate crisis is to prevent people from ever becoming addicted. One of the most crucial areas to prevent addiction from occurring is revamping our school drug education. Traditional school drug education is not working, and Philadelphia needs to revamp it to adjust to present circumstances.
Schools need to educate our children on the fatal side effects of heroin, and make sure they understand that abusing pain medication can, and many times does, result in heroin use. It is also important for children to understand that even when pain medication is legitimately prescribed, the risks are the same. They need to learn to be very careful not to abuse those drugs.
Further, we need to ensure that the drug education students receive in school addresses misinformation surrounding opiates and the stigma of addiction. For example, many overdose deaths involving opiates involve a mixture of drugs. Students need education on the increased dangers when opiates are used in combination with other illegal substances.
However, educating children is not enough. We also need to educate the parents and the community about the dangers of opiates. Indeed, the community will be at the forefront of combating this issue. Parents and others in the community need to understand that opiates pose a much bigger risk than they did in the past as well as training on how to communicate that message to their children. The local community is also the best place for the government to learn what the causes of opiate addiction are in their community, and what preventative and treatment options have been successful.
Stopping Pill Mills and Other Bad Actors
The amount of pain medication sold illegally on the streets in our communities is astounding, and this is the result of physician “pill mills.” These are doctors who prescribe unreasonably large amounts of pain medication solely for profit and without any legitimate medical justification. These drugs are then sold in our communities. The fact is that in many cases these prescriptions are ultimately paid for by insurance providers (government and private) and dispensed from a pharmacy.
We need to get better access to this prescription data to determine which physicians are running “pill mills.” In fact, we already have a large amount of such data. Nationwide, 25% of Medicaid beneficiaries are prescribed opiates, and Medicaid patients are twice as likely to be prescribed opiates as privately insured patients. For Pennsylvania Medicaid recipients, we already have information on which physicians are prescribing these drugs. Philadelphia should work with private and public insurance providers and pharmacies to share additional opiate prescribing data with the commonwealth. With this information, we can look for trends and investigate, and ultimately prosecute, physicians operating pill mills.
There are other bad actors in the opiate epidemic such as those who “pimp out” addicts. This is a practice where people run overcrowded, slum boarding houses, filled with filth and bed bug infestations, where addicts can live and in exchange, the house owner tells the addicts which treatment facility to attend, when to attend and for how long. In exchange for this, the treatment facility pays the boarding house owner a kickback for each patient, ranging from $100 to $400 per person, per month. The treatment facilities then charge Medicaid – state funds – for this treatment. It is an abuse of taxpayer dollars and the system is based around keeping addicts in treatment, not treating the addicts. We will not allow those who are most vulnerable to be exploited for money, especially when it is our tax dollars.
We also must help treat those currently addicted so the can beat their addiction and become productive members of society. Philadelphia should devote resources to ensure that every person suffering from substance abuse and wants help, has the resources to combat their addiction.
For treatment, we need to rely heavily on local communities. That is where treatment will start and recovery will begin. One way to do this is to request that local hospitals work with their local community and refer the names of non-fatal overdose victims to treatment centers so they can reach out and try to arrange for services.
The Philadelphia veteran population is also at high risk for heroin use. Many veterans, due to the struggles of war, abused opiates and other substances upon returning to civilian life. In 2008, a study found that 11% of veterans abused prescription drugs and about 1-in-5 were homeless when they sought treatment. Philadelphia needs to make sure it is taking care of its veterans struggling with addiction.
Many people battling addiction are not bad people. They have found themselves unable to shed their addiction, but with the right treatment can become productive members of our society. Their addiction, however, can put them in jail. In fact, approximately 68% of inmates suffer from substance abuse.
For a heroin addict jail is not necessarily a bad thing, and in fact going to jail might very well save their lives. Jail can provide heroin addicts with an opportunity to get clean, clear their heads, and reflect on their lives. We need to build upon this, and provide effective drug treatment to inmates battling addiction. By doing this, people battling addiction will have the tools they need to remain clean upon release, thereby lowering the chances of recidivism and improving the chances they integrate back into the community. Incarceration, however, is certainly not always the best way to treat addiction so we must also have community based treatment available.
In addition to the above, Philadelphia should also expand its drug courts and other diversionary programs for people who have committed drug related offenses to help them achieve sustained recovery. We should also expand drug courts to juvenile courts. Drug dealers belong in prison, but incarcerating merely the drug user is costly to the city and does not further the goals of our justice system. One primary goal of our justice system is rehabilitation, and many people who are addicted to drugs end up committing crimes, and rather than send them to jail where they may not get the treatment they need, we should expand these programs to make sure they have the proper resources to get treatment and reenter society.
Treatment in Schools
Children still in high school also suffer from addiction. Philadelphia should expand on the Recovery School Bill passed in 2016. The Recovery School Bill established a four-year pilot recovery high school program for students recovering from substance abuse. We need to expand this bill so every child in Philadelphia recovering from substance abuse can continue their studies in an environment conducive to their recovery.
Pathway in Life After Recovery
After someone has successfully recovered from treatment, we need to make sure they can reenter society as a productive member. This goal can be furthered by lowering the stigma associated with substance abuse. Further, as part of expanding access to treatment, we should have counseling that will prepare those in recovery to reenter society and maintain a job while staying sober. This is not always an easy task as the stresses of life can result in someone in recovery using again to cope with these stresses. We need to make sure that these people have the resources to develop a plan to deal with stress differently, as well as resources they can utilize if they have the urge to use.
Securing our Port
Most of the heroin sold on the streets in Philadelphia, and Pennsylvania, was brought here through our port. Philadelphia needs to add extra security at the Port of Philadelphia to seize large heroin shipments before they hit our streets. In addition, as heroin imported in Philadelphia’s Port is shipped all over the Commonwealth, City Council should lobby the state government for additional resources to secure our port.