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NPR's podcasts, In 2016, States Expected To Ramp Up Ideas To Solve Opiate Abuse

In 2016, States Expected To Ramp Up Ideas To Solve Opiate Abuse

STEVE INSKEEP, HOST:

This new year offers a new chance for many states to head off drug addiction. Americans are dying from overdoses of prescription opioids and heroin at levels never seen before. NPR's Arun Rath reports on what many states are trying now. ARUN RATH, BYLINE: First, let's start with something we know is going to happen in 2016 - more diversion. As an approach to solving the opioid problem, diversion means diverting addicts from the criminal justice system to the health care system. For Leonard Noisette, the increasing acceptance of diversion signals a final reframing of the war on drugs.

LEONARD NOISETTE: I think that the country has gotten to a place where there's widespread recognition that the war on drugs and the attempt to use the justice system, and particularly incarceration, as a response to drug use and drug misuse was a mistake. RATH: Noisette is the program director of the Justice Fund at Open Society Foundations. They've been supporting law enforcement-assisted diversion programs across the country. And in 2016, they'll be funding programs in seven new cities. NOISETTE: Law enforcement-assisted diversion is an attempt to get law enforcement officials and the public at large to think that a law enforcement person who's encountering such a situation might have other alternatives instead of arresting the person, putting that person into the court system. RATH: Whether it's shifting a burden from the criminal justice system to the health care system or public institutions like police forces working with private foundations like Open Society, the blurring of institutional lines seems to be a sign of the times when it comes to the opioid crisis. Karmen Hanson is a program manager with the National Conference of State Legislatures.

KARMEN HANSON: I've been working on health policy for about 15 years, and I honestly can't think of anything other than the Affordable Care Act that has touched so many other aspects of policy in state legislation. RATH: And she doesn't expect it to calm down in 2016. HANSON: My guess is there's going be some type of bill to address prescription drug abuse and opiate abuse at some level for every state. RATH: In the criminal justice system, in addition to diversion, increasing numbers of states are revising mandatory sentencing policies and criminal penalties for some drug offenses. Other measures include good Samaritan laws that let people seek medical attention for overdoses without fear of arrest and making anti-overdose drug naloxone easier to obtain.

Many places in many states have adopted these practices, and in 2016, many more are poised to do so. Karmen Hanson says states are looking at what other states are doing and copying the best ideas.

HANSON: And if you are looking for ideas and sharing what works, that's what they're interested in right now. RATH: Meanwhile in Massachusetts, where many of the ideas laid out here are already policy, for 2016, Governor Charlie Baker has proposed a couple of alternative approaches that have not been tried before and are generating some controversy. One would limit a first-time prescription for opiate painkillers to a 72-hour supply. The Massachusetts Medical Society put out a statement raising concert the limit could undermine a doctor's clinical judgment. Here's Governor Baker. (SOUNDBITE OF ARCHIVED RECORDING)

CHARLIE BAKER: But they came back a couple weeks later and said, well, for first prescriptions for opioids, given everything that's going on, maybe seven days would be fine. So my proposal's three days. There's is seven. We're clearly heading, I think, to some sort of agreement on that. RATH: The other controversial proposal actually gives some doctors more power. It would allow emergency doctors to hospitalize addicts against their will for up to 72 hours. That doesn't sit well with many civil liberties advocates, but Baker points out the proposal has been endorsed by the Massachusetts Association of Community Hospitals. (SOUNDBITE OF ARCHIVED RECORDING)

BAKER: I think a lot of folks in the health care community know that not taking some controversial steps here and doing some things to disrupt the status quo, we're not going to disrupt the status quo, and we need to disrupt the status quo. RATH: If these proposals become law in Massachusetts this year, one thing is certain. Other states will be watching closely to see if they work.

Arun Rath, NPR News, Boston.


In 2016, States Expected To Ramp Up Ideas To Solve Opiate Abuse

STEVE INSKEEP, HOST:

This new year offers a new chance for many states to head off drug addiction. Americans are dying from overdoses of prescription opioids and heroin at levels never seen before. NPR's Arun Rath reports on what many states are trying now. ARUN RATH, BYLINE: First, let's start with something we know is going to happen in 2016 - more diversion. As an approach to solving the opioid problem, diversion means diverting addicts from the criminal justice system to the health care system. For Leonard Noisette, the increasing acceptance of diversion signals a final reframing of the war on drugs.

LEONARD NOISETTE: I think that the country has gotten to a place where there's widespread recognition that the war on drugs and the attempt to use the justice system, and particularly incarceration, as a response to drug use and drug misuse was a mistake. RATH: Noisette is the program director of the Justice Fund at Open Society Foundations. They've been supporting law enforcement-assisted diversion programs across the country. And in 2016, they'll be funding programs in seven new cities. NOISETTE: Law enforcement-assisted diversion is an attempt to get law enforcement officials and the public at large to think that a law enforcement person who's encountering such a situation might have other alternatives instead of arresting the person, putting that person into the court system. RATH: Whether it's shifting a burden from the criminal justice system to the health care system or public institutions like police forces working with private foundations like Open Society, the blurring of institutional lines seems to be a sign of the times when it comes to the opioid crisis. Karmen Hanson is a program manager with the National Conference of State Legislatures.

KARMEN HANSON: I've been working on health policy for about 15 years, and I honestly can't think of anything other than the Affordable Care Act that has touched so many other aspects of policy in state legislation. RATH: And she doesn't expect it to calm down in 2016. HANSON: My guess is there's going be some type of bill to address prescription drug abuse and opiate abuse at some level for every state. RATH: In the criminal justice system, in addition to diversion, increasing numbers of states are revising mandatory sentencing policies and criminal penalties for some drug offenses. Other measures include good Samaritan laws that let people seek medical attention for overdoses without fear of arrest and making anti-overdose drug naloxone easier to obtain.

Many places in many states have adopted these practices, and in 2016, many more are poised to do so. Karmen Hanson says states are looking at what other states are doing and copying the best ideas.

HANSON: And if you are looking for ideas and sharing what works, that's what they're interested in right now. RATH: Meanwhile in Massachusetts, where many of the ideas laid out here are already policy, for 2016, Governor Charlie Baker has proposed a couple of alternative approaches that have not been tried before and are generating some controversy. One would limit a first-time prescription for opiate painkillers to a 72-hour supply. The Massachusetts Medical Society put out a statement raising concert the limit could undermine a doctor's clinical judgment. Here's Governor Baker. (SOUNDBITE OF ARCHIVED RECORDING)

CHARLIE BAKER: But they came back a couple weeks later and said, well, for first prescriptions for opioids, given everything that's going on, maybe seven days would be fine. So my proposal's three days. There's is seven. We're clearly heading, I think, to some sort of agreement on that. RATH: The other controversial proposal actually gives some doctors more power. It would allow emergency doctors to hospitalize addicts against their will for up to 72 hours. That doesn't sit well with many civil liberties advocates, but Baker points out the proposal has been endorsed by the Massachusetts Association of Community Hospitals. (SOUNDBITE OF ARCHIVED RECORDING)

BAKER: I think a lot of folks in the health care community know that not taking some controversial steps here and doing some things to disrupt the status quo, we're not going to disrupt the status quo, and we need to disrupt the status quo. RATH: If these proposals become law in Massachusetts this year, one thing is certain. Other states will be watching closely to see if they work.

Arun Rath, NPR News, Boston.