States are on the Front Lines of Trying to Control Opioid Abuse, Deaths

All across the country, an influx of prescription and illegal opioids – from Oxycontin to heroin – has created a disaster in small towns and big cities alike.

In Alaska, the disaster is official.

Early in 2017, Alaska Gov. Bill Walker issued a disaster declaration on the state’s opioid epidemic, hoping to help state officials get a handle on suppressing the problem.

“When earthquakes, fires or floods claim lives and property on a large scale, a declaration of disaster is issued to prioritize the state’s response,” Walker said. “This is no different. We must stop this opioid epidemic.”

A key player in helping the state tackle the problem is Dr. Jay Butler, chief medical officer and director of the Alaska Department of Health and Social Services Division of Public Health. Butler has testified to Congress about the issue, and spoke with National Press Foundation fellows about how he and other state officials have attacked the problem.

“Epidemic is not a term I use lightly, but the case I want to make to you is that this really is an epidemic,” he told fellows.

According to the U.S. Centers for Disease Control and Prevention, opioids were involved in 33,091 deaths in 2015 nationwide.

Butler traced the origins of the epidemic back about 10 years, when there was three-fold increase in legal opioid prescriptions. “That was then mirrored by a three- or four-fold increase in opioid deaths,” Butler said.

Soon after came changes in production of heroin, making that illegal drug more available and at a lower price. The drug moved into suburban and rural areas, going from “a pill of known potency, where the user at least knows what they are getting, to a situation where they don’t know what they are injecting themselves with,” he said.

That’s been followed by increases in availability of a much-cheaper opioid, fentanyl, which is working its way across the country.

In Alaska, the governor has introduced a bill to tackle the problem, modeled in part by what has been successful in other states. Among other things, the bill would allow patients to turn down opioids while in medical care; require continuing education in pain management and opioid addiction for medical providers; limit the initial prescriptions for opioids; and boost reporting on opioid prescriptions.

For journalists interested in covering the issue, Butler recommended two books: “Dreamland,” by Sam Quinones (author, publisher, Amazon) and “Drug Dealer, M.D.,” by Anna Lembke (author, publisher, Amazon).


This program is funded by de Beaumont Foundation. NPF is solely responsible for the content.

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