Iowa Gov. Kim Reynolds blames immigrants for opioid overdose increase. But what about bureaucrats?

Government leaders in Iowa and elsewhere are trying to determine causes for the rise in drug overdoses deaths. They’re overlooking an important one.

Gov. Kim Reynolds has repeatedly suggested pandemic-related restrictions are to blame for overdoses and other deaths of despair. Recently, she’s also blamed the uptick on illegal immigrants bringing drugs across the U.S.-Mexico border.

Both could be factors but they don’t address the full scope of the problem. Coincidentally, blaming lockdowns and immigrants happens to align with the governor’s preexisting political values — she favors lax COVID restrictions and strict immigration restrictions.

Asked at a recent news conference what the state is doing, Reynolds mentioned two laws she signed in 2018.

A study published last week in a major journal points yet again to the factor politicians usually ignore — the crackdown on prescription painkillers within the health care system.

Long-term opioid patients whose doses are tapered are significantly more likely to have an overdose or mental health crisis compared to patients whose doses were sustained, according to the study led by California researchers and published this month in the Journal of the American Medical Association.

Previous studies have shown outright discontinuing opioid prescriptions might be associated with risks such as suicidal ideation and transition to illicit opioids. The new paper is one of the first large sample studies examining those risks for simply tapering opioids, which involves a 15 percent or more reduction in daily dose.

Federal and state governments have spent several years pressuring health care providers to limit prescriptions of opioids under the rationale that pain pills are driving the opioid overdose crisis. Increasingly, it appears those restrictive policies and guidelines are backfiring.

Iowa reported 419 drug overdose deaths in 2020, a 20 percent increase from the year before. Relatively few overdose deaths in Iowa and the nation are blamed on commonly prescribed prescriptions. Instead, illicitly manufactured synthetic opioids such as fentanyl are by far the most common in overdoses.

The American Medical Association in July issued a statement urging the federal government to overhaul the “arbitrary” 2016 guidelines that were part of a double-digit decrease in opioid prescriptions.

Besides shunning coronavirus restrictions and sending police to the southern border (where they confiscated more marijuana than hard drugs, by the way), Iowa does not seem to have a strategy to confront the recent rise in drug deaths.

Asked at a recent news conference what the state is doing, Reynolds mentioned two laws she signed in 2018.

“Over the last couple legislative sessions we took some significant steps in addressing the opioid concerns — the drug monitoring program, electronic prescriptions, to name a few, the good Samaritan law we put in place. We’re continually reevaluating what we need to do to address addiction in general,” Reynolds said.

The good Samaritan law — providing limited legal protection to people who report overdoses — is worthwhile, though Iowa’s is much weaker than harm reductionists advocated for. The prescription monitoring program — requiring providers to document opioid prescriptions — might actually be part of the problem, potentially discouraging doctors from authorizing medicine patients need to manage pain.

It’s easy in this political climate in Iowa to blame migrants and lockdowns for overdose deaths. The truth is more complicated.

(319) 339-3156; adam.sullivan@thegazette.com