Opioid addiction threatens more than health, it threatens safety

Opioid abuse in many areas of the nation has risen to epidemic proportions. The issue sprang to the forefront of the national consciousness during the past presidential election cycle when both candidates Trump and Clinton vowed to tackle the matter head-on.

But the issue hasn’t just been met with strong campaign rhetoric. The recently passed, bipartisan 21st Century Cures Act — a $6.3 billion piece of legislation designed to address myriad public health issues — included $500 million a year toward the treatment of opioid abuse and to help addicts obtain better treatment.

Secretary of Agriculture Tom Vilsack said that the additional resources were “particularly critical in rural areas” where access to effective treatment is limited.

{mosads}While most observers are aware of the problem, fewer are aware of just how significant it has become. According to the American Society of Addiction Medicine, of the 55,403 deadly accidental drug overdoses in 2015, over 20,000 were related to the abuse of pain medication and an additional 12,990 were related to heroin.

Sadly, the link between the abuse of prescription painkillers and heroin is stronger than most people realize. 

Four out of five new heroin users reported to have begun abusing prescription painkillers before switching to heroin and a stunning 94 percent of heroin users being treated for opioid addiction stated that they switched to the street drug because it was cheaper than buying prescription pills.

Not only is abuse or misuse of opioids of significant concern, the apparent ease with which individuals have been able to obtain the drugs is equally troubling.

ASAM noted that in 2012, 259 million opioid prescriptions were written, a number that would allow every adult in the United States to have his or her own bottle.

While opioid abuse has clearly become a significant public health issue, it’s damaging effects have also become a significant public safety issue for not only the general public but also our nation’s incarcerated population as well as the men and women tasked with securing our federal, state, and local correctional facilities.

The smuggling of contraband into and within correctional facilities is not a new phenomenon. Drugs, weapons, or other illicit material has made it’s way through our jail and prison populations and inspired violence since the beginning of systematic and formalized incarceration.

The reasons are varied and often idiosyncratic but drugs and violence have long been connected due to myriad phenomena. Goldstein (1985) described a three-dimensional analysis of drugs influencing violent behavior in the 1) distribution and trafficking of drugs; 2) the “economic compulsive” aspect, i.e. needing to commit crime to acquire money to purchase drugs; and 3) the “psychopharmacological” reaction, i.e. acute drug use causing violent behavior in the user.

But violence associated to the presence of drugs within prisons don’t just affect the dealers and users within the incarcerated population. It also impacts the safety and well-being of our nation’s correctional officers, who find themselves the victims of more non-fatal violent encounters than any other profession, outside of police officers.

This reality, in turn, contributes to higher stress rates and related injuries experienced by correctional officers, no doubt exacerbating tenuous recruiting and retention shortages already affecting the profession.

One state, however, recently made headway in its fight against the illegal smuggling of at least one form of opioids into its prison system.

The state of Maryland — having removed the opioid-dependence drug Suboxone Film from it’s Medicaid Preferred Drug List (PDL) effective July 1, 2016 — saw a dramatic decline in illegal prison seizures of that drug between July-October, 2016 (853 compared to 1,268 seizures during the same time-frame in 2015).

The combination of Suboxone Film’s unique delivery method — it comes in the form of a thin, dissolvable strip — and it’s presence on the state’s Medicaid PDL made it an easily obtainable and concealable form of valuable contraband within the prison system.

Obviously, any decision that inhibits the ease with which contraband can be smuggled into a jail or prison facility is a smart one, and it is reasonable to conclude that less contraband of any kind — drugs, weapons, etc. — makes for safer and more secure correctional facilities.

Policy makers need to recognize and understand the gravity of the opioid crisis in our nation and take proactive measures to effectively serve the needs of those addicted to these drugs while also considering the public safety consequences of their decisions.

Opioid abuse will continue to be a significant public health and safety issue for the foreseeable future. Mitigating it’s damaging effects should be a high priority for public policy leaders at the federal, state, and local level but in order to craft the most effective policy prescriptions to deal with this crisis, a more holistic understanding of its wide-ranging impact must also be recognized.

Scott Erickson is president of Americans in Support of Law Enforcement, a pro-law enforcement nonprofit. Follow him on Twitter @SGErickson

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