DUBUQUE — Iowa’s opioid crisis right now is bad. And it is quite possible it will get worse, according to at least one panelist at a conference called to discuss the situation.
“Often, in government, I’m amazed that the right hand does not know what the left hand is doing,” U.S. Rep. Rod Blum said Monday during the conference the 1st District Republican hosted in Dubuque to discuss federal, state and local efforts to address the opioid epidemic in Iowa.
“Part of the purpose (of this conference) is that we can share what the federal government is doing, what the state government is doing and what local government is doing with the people that make it happen and the people who are addicted and affected by this so they can seek help.”
In a panel during the conference, local law enforcement, health care professionals and elected leaders talked about specific challenges and the barriers to addressing those problems.
Dubuque County saw 28 overdoses in 2016, which included nine deaths, noted Sheriff Joseph Kennedy said. So far in 2018, there have been 17 overdoses that included three deaths.
But Kennedy was optimistic on the rate of successful deployments of overdose-reversal drugs. He also pointed to other states to the east that were experiencing an even more debilitating overdose rate, such as Ohio, which saw 39.1 deaths per 100,000 people in 2016.
“Although we have problems here and we feel that the tide is moving this way, we can feel fortunate we don’t have their problems yet,” Kennedy said. “But it’s likely they’re coming.”
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Blum emphasized the importance of sharing information across agencies and governments. He urged going further by instituting a database tracking opioid prescriptions that would be shared across state lines to limit doctor shopping.
He also touted the legislative actions the U.S. House of Representatives have moved to the Senate to address the opioid epidemic.
About 70 people attended the event.
Throughout the event, several individuals in attendance mentioned their concerns for patients who use opioid medication for legitimate pain — oftentimes, chronic — but still struggle to find physicians willing to write a prescription due to pressure from officials to reduce the number of opioids in the country.
Joan West, 58, of Cedar Rapids, who suffers from chronic pain caused by a rare form of Muckle-Wells syndrome, an autoinflammatory disease, told The Gazette the conference topic was “very poignant to what I’m going through right now.” West’s Cedar Rapids-based physician recently limited her five-pill-a-day opioid prescription to four — a move that has caused her to experience up to six more hours of pain during her day.
That means she is unable to perform tasks such as driving a car or washing the dishes.
“You have to think each pill represents a certain number of hours that I’m able to function,” West said. And if she doesn’t take a pill, “you have to subtract a certain number of hours that you’re not able to function and you spend in suffering.”
“We don’t want people in pain, but conversely we don’t want to be giving them more than they need, and that’s kind of an art form,” Blum said in remarks to the media before the conference. “Maybe we need to leave it up to the physician, but monitor the physicians — and whoever is overprescribing insistently, there needs to be penalties.”
Blum also encouraged alternative therapies for chronic pain, such as steroid injections or ketamine infusions.
However, Randy Cornelius, a nurse anesthetist with Mercy Medical Center-Dubuque and a panelist, said the challenge health care providers face is that insurance companies often require patients to try the pills first. Only when that doesn’t work will they approve coverage for other therapies.
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Progress Iowa, an advocacy group, pointed out that Blum owns stocks in opioid-connected companies. According to his 2016 House financial disclosure report, he has between $100,001 and $250,000 worth of stock in Allegran PLC and Cardinal Health Inc., with earnings of more than $1,001, but no more than $2,500 from each.
Previous disclosures showed ownership on more opioid-related companies, the group said.
However, until there’s a better alternative, Blum said, there is a place for legal opioids.
Blum said he believes the scientific community can find something that will alleviate pain that lacks an addictive nature. But until then, “we need to treat people’s pain.”
“I wouldn’t encourage anyone not to invest in these companies, they’re not doing it to make people addicted,” he said. “They’re doing it to make people pain-free — it just happens to be a side effect.”
The conference’s keynote speaker, Jeffery Stamm, pointed to a larger drug-use rate among Americans as an element within the opioid crisis.
Stamm is executive director of the Midwest High Intensity Drug Trafficking Area, a program under the Office of National Drug Control Policy that offers assistance to law enforcement agencies in specific drug-trafficking regions. The Midwest region oversees Iowa, as well as Kansas, Missouri, Nebraska, North Dakota and South Dakota.
“The larger opioid issue is actually not Uncle Joe who becomes addicted to OxyContin after shoulder surgery. Its international drug trafficking,” he said.
Stamm also emphasized opioids were not the only concern for law enforcement. In Iowa, he said the drug with the highest rate of use is methamphetamine.
“I think the opioid crisis is an emergency,” he said. “However, I think the attention given to opioids has taken away from the principle drug threat here in the Midwest, which is methamphetamine.”
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