Despite the crisis we are in, 85.1 percent of people with a substance use disorder didn’t receive any addiction treatment in the past year. Meanwhile, only 43 percent of local jails provide medications for opioid use disorder — basic health care required by federal law. As a result, individuals returning from incarceration are up to 129 times more likely than the general population to die of an overdose. As a civil rights attorney who has worked on cases that required carceral institutions to provide medications for opioid use disorder, I have seen firsthand the pain these denials cause my clients.
Our country is not without solutions to dramatically reduce these record-breaking overdose deaths. Increasing access to treatment — both in the community and carceral settings — is obvious, low-hanging fruit for state legislatures aiming to save lives from this pernicious scourge. These interventions are proven to dramatically reduce rates of overdose.
However, most state legislatures have not implemented proven solutions that would loosen the vise grip this crisis has on our nation’s health. We need state and local leaders of all political stripes to solve these problems with evidence-based solutions. Unfortunately, some state legislatures have focused instead on “tough-on-crime” bills that may be good for sound bites but do nothing to slow overdose deaths.
This legislative session, for example, at least three states — Georgia, Idaho and South Dakota — have enacted laws that make providing a deadly dose of fentanyl a homicide, despite evidence showing this does nothing to decrease overdose deaths. Arizona is among states that increased mandatory minimum sentences for drug trafficking, despite the evidence that mandatory minimums do not deter crime.
It is not too late to reverse course. Increasing access to treatment will save lives. Saving lives is not just good policy; it is good politics. While legislators may be tempted by the political sugar rush of passing tough-on-crime legislation, actually ameliorating this crisis requires patience, persistence and funding. With record federal funding and $50 billion in opioid settlement funds hitting state and local coffers, states and local jurisdictions can absolutely afford to make robust, game-changing investments in the entire continuum of care for substance use disorder: prevention, harm reduction, treatment and recovery services.
Take treatment, for example. States that have not ensured access to medications for opioid use disorder in carceral settings should follow the lead of the red and blue states alike that have made that a reality in their prisons, their jails or both — from California to Ohio to Rhode Island. We are starting to see results in these states. In Rhode Island, for instance, overdose deaths decreased by 60.5 percent among recently incarcerated people and by 12.3 percent statewide. Yet to date only 16 states require access to these medications in correctional settings.
States must also ensure that treatment is readily available in the community. Only seven states require emergency departments to refer individuals who are being treated for substance use disorder or an overdose to treatment upon release, rather than merely treating their symptoms and releasing them without connection to proper care. States should likewise take action to lower unnecessary state and local regulatory barriers to medications for opioid use disorder by ensuring they comport with new federal regulations and take steps to increase the treatment workforce.
This is just the beginning of the good work that state legislatures can do across the continuum of care — including investing in evidence-based prevention; harm reduction services like naloxone and syringe service programs; and recovery support services, like peer support specialists, as well as adopting recovery-ready workplace policies.
Every five minutes, someone is losing their life to overdose. The clock is ticking, and lives are at stake. We need state legislative action to address this crisis now.
Joseph Longley is a civil rights and prisoners’ rights attorney who works with the Addiction and Public Policy Initiative at the O’Neill Institute for National and Global Health Law at Georgetown University Law Center.
Governing’s opinion columns reflect the views of their authors and not necessarily those of Governing’s editors or management.
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