The sheer scale of America's opioid epidemic cannot be overstated. Deaths related to overdoses of both illicit and illegally prescribed opioids increased nearly five-fold in the United States between 1999 and 2016, surpassing 200,000 during that period. This crisis, which has shown little sign of abating, has produced two straight years of life-expectancy decreases in the U.S.
Given these frightening numbers, it shouldn't be surprising that most Americans think that their governments have responded ineffectively and with an insufficient sense of urgency. Roughly six in ten feel that both federal and state governments have failed to the address the crisis in a timely and sufficient manner.
In an era of profound political gridlock at the federal level and in so many state capitols, local government has a compelling need and opportunity to address this paucity of solutions. Lehigh County, Pa., has stepped forward with several promising initiatives that could serve as a model for regional responses across the country.
The challenges Lehigh County faces are particularly acute. The county's opioid-related fatalities have matched or exceeded state averages for several years, rising by 20 percent between 2016 and 2017 alone. In response, the county has embarked on a multi-faceted approach revolving around rehabilitation, prevention and restitution.
First, the county has joined the hundreds of municipalities, counties and state attorneys general that have gone to court seeking reimbursement from drug manufacturers and distributors for the costs those governments have incurred in dealing with opioid addiction and abuse. That effort, which has been joined by the U.S Justice Department, is patterned on the landmark 1998 tobacco settlement, in which cigarette makers agreed to reimburse states more than $200 billion over 25 years for their smoking-related health-care costs. In Lehigh County, human services subsume roughly 70 percent of the budget, and additional resources are sorely needed after years of unfunded federal and state mandates.
Second, addressing the integrated nature of the epidemic requires law enforcement and medical personnel to work together to address the underlying forces driving substance abuse. Lehigh County recently unveiled a program called Blue Guardian, an innovative rehabilitation model designed to encourage long-term recovery.
Blue Guardian takes advantage of Act 139, a state law that provides limited immunity from charge and prosecution for possession of drugs and drug paraphernalia for individuals who experience a drug overdose or require medical care, as well as for those who seek medical care for the victim in good faith. Within 48 to 72 hours after naloxone has been administered and the victim hospitalized for additional treatment, a uniformed police officer and a certified recovery specialist will conduct a home visit and engage with the family and individual to discuss treatment options and establish a system of support. Similar immunity legislation exists in 40 states and the District of Columbia, providing an opportunity to extend programs like Blue Guardian nationwide.
In the end, preventive measures, and particularly a focus on steering young people away from drug use, are always going to be the most effective means of reducing long-term costs for society. Lehigh County Executive Phillips Armstrong, a retired educator, has proposed extending countywide an initiative called Communities That Care that has experienced considerable success in one of the county's school districts.
Communities That Care, based on a national model in use across the country, is a proven program designed to facilitate discussion among community leaders in the political, business and volunteer sectors and create a community action plan. It's been associated with significant declines in destructive behavior, including drug use and early alcohol consumption, and has demonstrated savings of $7 for every $1 invested.
The initial strategy for Communities That Care calls for convening the multiple school districts within the county, along with prominent community leaders, to expand the model outward. The county stands to save both lives and resources by creating healthy coping mechanisms early in life.
Models like these provide localities with the ability to do more than voice frustration and express concern at the loss of life. They provide substantial and evidence-based means of resolving one of the nation's worst crises.