Plan for the Opioid Crisis

Like most states, Alabama has been hit hard with opioid abuse and addiction. Indeed, our state has the highest rate of prescription opioid use in the nation, and it’s well established that legitimate use of opioid medication is a leading cause of illicit opioid abuse. But opioids aren’t our only drug problem. Other prescription medications and illegal drugs like crystal meth and cocaine continue to plague our communities.

As Governor, one of my first steps to fight this crisis will be to separate substance abuse out from under the Department of Mental Health. We need a cabinet level officer who answers directly to the Governor in the battle to save our state from the ravages of illegal drug use while continuing to coordinate drug policy with mental health resources so that underlying causes of addiction are addressed.

As I’ve discussed many times, the expansion of Medicaid is a major first step in overcoming many of Alabama’s problems, including opioid and other drug abuse. The expansion will increase the availability of and access to treatment and counseling that we so desperately need. We also need to improve prescription drug monitoring and make medical treatments more widely available, like Suboxone, which alleviates the pain of opioid withdrawal but is too expensive for most to afford without assistance.

Detox units, residential and outpatient services, consultation among addiction specialists and other providers must be expanded. UAB’s Addiction Recovery Program provides an effective model that can be replicated statewide for a medically supervised approach to early sobriety including intensive therapy, 12-step fellowship, trauma and grief work, and family support. Overdose remedies like Narcan must be widely available to both emergency first responders and the general public. We must implement common sense initiatives like warm handoffs so that people who seek emergency medical treatment for drug overdoses are automatically connected to a treatment program – and, of course, that begins by make sure treatment programs are available.

We have learned that simply teaching children to “just say no” is not enough, but we owe it to them to improve education and information about the devastating effects of drug abuse. As we do this, we must also fund research into effective drug strategies that work, not just implement programs that sound tough and make politicians feel better.

The opioid epidemic is also a time for society to look inward and reflect on how our past reaction to problems, like the crack cocaine scourge of two or three decades ago that disproportionately affected African American communities, was to enhance law enforcement and criminal penalties. The “war on drugs” was never an effective strategy to treat substance abuse. Today we see a more compassionate, treatment-based approach to fighting opioids, which are devastating white and black communities alike. It’s terrible that it takes a growing tragedy in white communities to help us see the truth of what’s been happening in all our communities for many years, but the fact is that substance abuse has always been first and foremost a public health problem that cannot be solved by the criminal justice system alone. We’ve not always treated it that way, and that must change.

Our prisons are troubled on all fronts, but one of the clearest, most consistent mistakes of the past has been to warehouse non-violent prisoners with addiction problems without providing treatment or rehabilitation.

Diversion into drug courts must be expanded with the goal of getting people off drugs instead of punishing them. When those with substance abuse problems do serve prison terms, we must get them clean while they are incarcerated and offer job training so that they have the skills needed to avoid falling back into the trap of addiction.

As we engage in reforms to fight drug scourges like opioids and meth, we should also examine our laws and attitudes toward marijuana. Arrests and convictions for marijuana possession for personal use ruins lives more than does use of marijuana, which is why the City of Tuscaloosa has led efforts to decriminalize marijuana. This allows law enforcement resources to be better utilized and helps avoid ruining lives with arrests for petty offenses.

Medical marijuana obviously should be available for all conditions in which it has been shown to be effective. I find it incomprehensible that bias and prejudice against marijuana continues to deny an available treatment to people with painful and debilitating illnesses. Plant-based medicines account for 40% or more of pharmaceuticals, and there is no reason we should exclude cannabis from our toolbox.

The people of Alabama have not yet indicated a desire for recreational marijuana, so we should simply observe what is happening in the states that have legalized it and move forward based on that evidence.

Moralizing over drug abuse and imprisoning non-violent users haven’t worked in the past and never will work to solve our drug problem. Alabama must move forward with strategies that are effective and efficient in combatting one of our worst public health crises, and under a Walt Maddox administration that’s exactly what will happen.