Either through prevention efforts or triage, Iowans will pay for the ongoing opioid public health crisis.
State policies will decide if taxpayers pick up the tab for education, treatment and prevention or the ever-increasing toll of emergency response, prison and foster care.
Indirect costs are rising, too. Prevalence of domestic violence, property crimes, unemployment, infants with withdrawal syndrome, anxiety disorders, depression, episodes of childhood trauma, academic dropouts and other social and cultural issues travel alongside opioid misuse, although it often can be difficult to determine what among this litany manifested first.
Needle reuse and non-sterilized injection sites lead to potentially lethal infections such as cellulitis and endocarditis.
And it must never be forgotten that there also is the ultimate cost to this tragedy: lives forever altered or lost.
Sadly, shrinking state revenues, special-interest tax waivers and promised tax cuts leave scant crumbs; far short of the level of investment this crisis demands.
So, this week, we were gratified to see members of the Iowa House unanimously pass House File 2377, which significantly expands the Prescription Monitoring Program and provides additional legal protections to Iowans who report or experience an overdose. As many lawmakers noted, this isn’t a comprehensive battle plan, but a small first step.
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The bill now is before a Senate Human Resources subcommittee, and we urge that body to include more budget-neutral strategies.
The state should legalize needle exchange programs that allow nonprofit groups and the private sector to fight disease through the distribution of clean syringes.
Although admittedly more controversial, injection monitoring sites would save lives and reduce some of the burden now on first responders. Testing of street drugs can prevent accidental injection of deadly fentanyl, which is 50 times more potent than heroin, can be absorbed by touch, and often requires multiple doses of reversal drugs.
As access to legal opioids dries up, people too often turn to dangerous illicit replacements. More Iowa monitoring, while necessary, sets the stage for a greater public health crisis that can’t be answered by criminalization alone.
In a 12-month period, opioids claimed the lives of 335 Iowans and harmed thousands more. The Iowa rate of newborn in utero substance exposure increased by 126 percent from 2009 to 2014. Addiction treatment admissions in our state have more than tripled, and the number of opioid-related deaths is about 10 times higher than it was in 2000 — and still climbing.
Lawmakers must provide the investment and tools, however unconventional, that can stem this expensive and bloody tide.
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