Pills spilling out of bottle

In Alabama, Reform is the Only Way to Fight the Opioid Crisis

The opioid crisis in America is still very real. In 2016, an astonishing 65,000 Americans died from drug overdoses. In Alabama, combatting the opioid epidemic has proved a difficult task. There were 343 opioid related deaths in Alabama in 2016, and the state has one of the highest opioid prescribing rates in the country.  In 2015, there were more opioid prescriptions issued in Alabama than people in the state—5.8 million.

Two of the state’s Congressional districts rank in the top five nationally for number of opioid prescriptions. Alabama’s 4thCongressional district has the highest prescription rate in the nation; 166 prescriptions per 100 people, more than twice the national average. The 1st Congressional district has the 5thhighest rate.

Opioid abuse is not just an issue for Alabama. Other districts rounding out the top 5 are Kentucky’s 5thCongressional district, and the 1st and 3rddistricts in Tennessee. Experts believe that the areas where opioid use runs rampant correlate with places where people have felt neglected by the government; many of Trump’s blue-collar supporters who have lost their jobs and opportunities.

The problem has not been lost on Congress; last month, the House passed a legislative package meant to combat the nationwide opioid crisis. The plan focuses on treatment and recovery, prevention, protecting communities, and fighting fentanyl. In March, Congress passed a funding bill that delegated $4 billion to directly fighting the opioid epidemic, with $130 million set aside specifically for rural communities.

Federal intervention is helpful, but it’s important that Alabama politicians actively combat the opioid crisis in their own state. As statewide elections loom, candidates’ stances on opioid regulation should be scrutinized. It’s a bipartisan issue; Congress crossed party lines to fight it, and Alabama politicians should work together as well.

Incumbent governor Kay Ivey expressed her intent in January to work with the Alabama Opioid Overdose and Addiction Council to find a solution to the state’s opioid crisis, a team that she herself created in 2017. However, she has offered very little in terms of a specific plan to keep opioid abuse in check. Ivey is the 3rdmost popular governor in America, with an approval rating of 67%, and will likely prove victorious in November. If Ivey does stay in office, it would be refreshing to see her adopt a clearer strategy to take on the opioid epidemic.

Ivey’s challenger is Democrat Walt Maddox, mayor of Tuscaloosa. In April, Maddox unveiled a clear plan to combat the opioid crisis. His plan includes expanding Medicaid to address the crisis, creating a cabinet-level official to oversee substance abuse issues, and increasing the availability of treatment and counseling. Regardless of whether Maddox wins the election, aspects of his plan may prove helpful in fighting the opioid epidemic, and Alabama politicians should take notice.

The Alabama Attorney General is a co-chairman on the Opioid Overdose and Addiction Council, so the outcome of that election could also prove integral to the battle against opioids. Steve Marshall, the current AG, has emphasized fighting the opioid crisis in his campaign. Marshall’s plan of attack includes establishing better data sharing among multiple agencies so that problem areas are clear.

The opioid epidemic is not the only area of drug policy in which Alabama could improve. Drugs like heroin, cocaine and meth also pose a problem. The Sinaloa drug cartel, active in the U.S. in general, uses Alabama ports to bring in shipments of up to 100 pounds of meth and 50 kilos of cocaine that are then transported north. The cartel has been linked to a number of grisly killings in the state; the point being that the drug trade is active in Alabama and illegal drugs are widely available, and availability links directly to addiction.

An obvious elephant in the room for Alabama and other more conservative states is marijuana. Legalization of the drug is supported by more than 60% of Americans. The medical benefits of marijuana are proven; not only can it treat pain, but it can be effective in treating mental illnesses like clinical anxiety and depression. Those against marijuana legalization argue that it is a gateway drug, and that legalizing it would increase not only addiction to marijuana but other drugs, including opioids.

However, some speculate that loosening marijuana laws could actually help solve the opioid crisis. Marijuana could provide health benefits for people who would otherwise be prescribed opioids, thus lowering Alabama’s opioid prescription rate. The state could also use money from taxation of recreational marijuana to help fight the opioid crisis and improve public education and awareness about drugs. Additionally, less strict marijuana regulations would lessen strain on the courts and the prison system, which is currently operating at 173% capacity.

At the moment, legalization of recreational marijuana in Alabama is a pipe dream. But, the state has shown some progress in other areas of marijuana law. CBD, a naturally occurring cannabis compound, became legal in Alabama in 2014. Studies show that CBD may help people trying to stay away from prescription medication. The substance has been met with positive feedback so far in Alabama, and medical research shows great promise.

Alabama penalties for marijuana possession may also soon be reduced. A proposal to make possession of an ounce or less of marijuana punishable by a fine instead of jail time cleared its first hurdle in the Alabama legislature in February. Marijuana legislation faces a tough road in Alabama, but it being on the minds of politicians may be a promising sign.

Alabamians will have to keep an eye on the November elections to see if their results affect drug reform in the state. Issues like the opioid crisis and marijuana regulation will be difficult to tackle, but candidates with hardened resolve could make a difference.

This article was written by Chris Reid and Katie Pickle. Katie is Reid Law’s clerk and is in her third year at Emory School of Law.