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    Sunday, May 05, 2024

    'Better than nothing' is too little to fight opioid epidemic

    It would be bad, really bad, for an elected official up for re-election to appear callous toward victims, first responders and doctors embroiled in the opioid abuse crisis that is claiming a skyrocketing number of lives in many states, including Connecticut.

    With that in mind, Congressional Republicans and Democrats voted overwhelmingly last week in favor of legislation known as CARA, the Comprehensive Addiction and Recovery Act.

    But there remains another bad, really bad, problem: Congress authorized slightly more than one-tenth of the proposed $1.1 billion funding to expand education about opioid use, identify and treat addicted prison inmates and supply first responders with naloxone, or Narcan, the drug that reverses acute overdose symptoms. The authorization would also have helped fund states' efforts to track opioid prescription activity and allow nurse practitioners to prescribe buprenorphine, a drug that helps recovering addicts avoid relapse. With $181 million as the total funding until after the election, it's not clear which aspects of CARA won't go forward, only that many will not. 

    President Obama tried to nudge Congress toward funding the provisions by increasing the federal cap on the number of addiction patients for whom a primary care provider can prescribe buprenorphine, from 100 to 275. After the vote he delayed saying whether he would sign the legislation, because of its potentially empty promises.

    However, like fellow Democrats Chris Murphy and Richard Blumenthal, the Connecticut senators, and Joe Courtney, the second district congressman, the president has decided that CARA is at least a first step and he will sign it into law. 

    But like a medieval plague, the epidemic of abuse of heroin and prescription drugs spreads faster than it can be contained, and now even imperils police who respond to a potential crime scene where drugs are present.

    Groton Town Police Chief Louis J. Fusaro Jr. announced that officers will no longer test at the scene for the presence of fentanyl, an extremely potent additive to heroin and cocaine, after a video from the U.S. Drug Enforcement Agency warned about the dangers of inhaling even minute traces while handling contraband.

    In Connecticut, where Chief Medical Examiner Dr. James Gill is predicting a jump in fentanyl-abuse deaths from 188 last year to 332 by the end of 2016, the Malloy administration and public health officials are staking some of their hopes on a three-year strategic plan being developed in cooperation with Yale School of Medicine and insurance carriers.

    In May the governor signed a new law that limits initial opioid prescriptions to less than seven days and more strictly regulates prescriptions to minors; requires local emergency plans to equip the likely first responder on the scene of an overdose with the antidote naloxone; updates the state's prescription monitoring rules; and requires an official goal for reducing opioid-induced deaths by Jan. 1, 2017. The law also addresses some of the insurance issues that have cropped up with the increased use of naloxone by police and EMS personnel.

    Last week Malloy announced $30,000 apiece in funding for each of the next three years for six local health departments including Ledge Light Health District, which covers East Lyme, Groton, Ledyard, New London and Waterford. The money comes from the Centers for Disease Control and Prevention and will be used locally to fight the epidemic. 

    If it's not clear how bad, really bad, this plague has become, here are four headlines from a single week in June in The Day:

    June 24: 3 dead as nearly 20 overdose on tainted heroin or cocaine in New Haven, surrounding towns

    June 25: Clergy 'cry out for the children of this town' amid opioid crisis (in Preston, in the aftermath of of the death of Olivia Roark, 17)

    June 27: East Lyme police respond to 3 opioid-related overdoses in 1 week.

    June 28: Norwich battling spike in fatal overdoses. 

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