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During his 40 years of working with people with addictions, David Crowe has seen various drugs become popular in Crawford County, Pennsylvania.
The use and distribution of methamphetamine is a major challenge for rural areas, said Crowe, executive director of the Crawford County Executive Board on Drugs and Alcohol. But overdoses related to opioids have killed at least 83 people in the county since 2015, he said.
Crowe said his organization had received just over $ 327,300 in key federal grants to fight the opioid epidemic. While money was a boon to the county – south of Lake Erie, on the border of the state of Ohio – he said, methamphetamine is still a major problem .
But he can not use federal opioid subsidies to deal with methamphetamine addiction.
"Now I'm looking for something different," he says. "I do not need more opiate money – I need money that will not be used exclusively for opioids."
The federal government has distributed at least $ 2.4 billion in state subsidies since 2017 to fight the opioid epidemic, which claimed 47,600 lives in the United States that year alone . However, state officials noted that drug abuse problems rarely concerned a single substance. And while local officials are thankful for the funding, the grants can only be used to create opioid-fighting solutions, such as prescription OxyContin, heroin, and fentanyl.
According to the latest data from the Centers for Disease Control and Prevention, 11 states reported that less than half of all drug overdose deaths reported in 2017 were opioid-related, including California, Pennsylvania, and Texas.
Money is also guaranteed only for a few years, which calls into question the sustainability of state efforts. Drug policy experts said the money might not be enough to improve the mental health care system. There is also a need to focus on answering the underlying question of why many Americans are fighting addiction, they said.
"Even the nickname, like" the opioid epidemic, "is problematic and incorrect," said Leo Beletsky, an badociate professor of law and health sciences at Northeastern University in Boston. "There has never been any talk of opioids."
States received federal funding for opioids primarily through two grants: Targeted State Response and Opioid Response by State. The first grant, authorized by the law of the 21st century, totaled $ 1 billion. The second reserve, $ 1.4 billion – approved in last year's generalized spending bill – provides for a portion of the funding for those states with the highest number of deaths from poisoning from the United States. drug.
For states like Ohio and Pennsylvania, the need was shouting. Nearly 4,300 and 2,550 residents, respectively, died from opioid-related overdoses in 2017. State officials said the money had allowed them to invest significantly in drug-related overdoses. programs such as training of medical providers for addiction, more treatment access points and interventions for special populations, such as pregnant women. Ohio received $ 137 million in grants; Pennsylvania, $ 138.1 million.
Grants also provide for a minimum amount for each state. Thus, even in regions where the rate of opioid-related overdose deaths is low, now has considerable funds to fight the crisis. Arkansas, for example, reported 188 opioid-related deaths in 2017 and received $ 15.7 million from the federal government.
While 2,199 people in California died of opioid-related causes in 2017, its opioid death rate was one of the 10 lowest in the country. The Golden State received $ 195.8 million more than any other state.
"This funding is dedicated to opioids," said Marlies Perez, division chief at the California Department of Health Care, "but we are not blindly building a system dedicated to opioids."
More and more evidence indicates a worrying increase in the use of methamphetamine nationwide. The presence of cheaper and cleaner forms of methamphetamine on the drug market, coupled with a decrease in the availability of opioids, has fueled the popularity of the stimulant. The number of drug overdose deaths involving methamphetamine has tripled from 2011 to 2016, the CDC reported. Amphetamine-related hospitalizations – the clbad of stimulants that includes methamphetamine – are increasing. And it's more difficult to tackle. The treatment options for this addiction are narrower than the table available for opioids. Given the increasing number of deaths from other substances, are these subsidies the best way to fund the opioid response of states?
Bertha Madras, a professor of psychobiology at Harvard Medical School and a former member of the federal opioid and addiction commission, said the federal government responded well by adapting its response to opioids, as these drugs continue to kill tens of thousands of Americans every year. . But, she added, as more and more people living with an addiction are identified and the popularity of other drugs increases, the country's interest will have to change.
Beletsky pointed out that the subsidies are insufficient to allow to make corrections to the mental health care system, which must meet the needs of patients living with an addiction.
People dependent on a substance usually consume other drugs. Controlling a person's lifelong dependency can seem like a "thunderclap," said Dr. Paul Earley, president of the American Society of Addiction Medicine, because They may stop using one substance to abuse another. But specific addictions may also require specific treatments that can not be treated with molded tools for opioids, and the appropriate treatment may not be as available.
"I think we really need to start self-examination to find out why this country has so much addiction," Madras said.
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