Alaskans coming together to address the opioid epidemic

Recent reports from the Alaska Division of Public Health and the Centers for Disease Control and Prevention provide sobering commentary on the current status of the opioid crisis. While increasing numbers of drug overdose deaths grab headlines, a closer look at the data shows areas of progress. The number of deaths caused by prescription painkillers has leveled off as the volume of prescribed opioids has declined. In Alaska, deaths caused by heroin declined in 2017. The amount of drugs seized by law enforcement and taken out of the illicit market has increased. And the number of treatment options for persons with opioid addiction, while still inadequate to address the need, is increasing.

However, we cannot spike the ball on the 50-yard line. We are only starting to make a difference, and new challenges are still emerging. The continued increase in opioid overdose deaths is driven largely by illicit fentanyl and other synthetic opioids. More users appear to be mixing opioids with drugs like methamphetamine — sometimes intentionally. And in New Haven, Connecticut, dozens of recent overdoses from synthetic cannabinoids highlight new health and public safety threats.

How do we change the course for our state and our nation? The foundation of Alaska's success will be pulling together in our cities, villages and tribes, like Alaskans have done in the past. While we may have differences in opinion and ideology, there are three areas where we must agree to make progress:

First, the opioid crisis is not their problem; it is our problem. One in three Americans say their families have been directly affected by the opioid crisis. As long as we claim the problem lies with those people, this opioid crisis will continue to expand. "Otherism" kills. Politically, the opioid crisis is a nonpartisan issue that demands bipartisan solutions.

Second, we do not shoot our wounded, metaphorically speaking. Addiction is a disease of the brain, albeit a disease that directly affects public safety and our criminal justice system. Addiction can be treated. Effective treatments can restore lives, prevent spread of infectious diseases like hepatitis C and HIV, and reduce drug-related crime and prison recidivism. Thousands of Alaskans have made the successful journey from addiction and crime to recovery and productivity.

Third, we need to prevent our young people from being wounded. Childhood trauma can lead to self-treatment with addictive substances. To prevent this from happening, effective mental health treatment and youth-driven drug and alcohol use prevention messages should be available. Ancient and contemporary guidance align on this approach. The book of Proverbs teaches, "Train up a child in the way he should go, even when he is old, he will not depart from it." More recent studies in neuroscience correlate substance use early in life with increased risk of addiction.

Prevention is an investment our state's future. Just as we think of roads, ferries, a gas pipeline, and the electric grid as the infrastructure supporting economic development, investing in healthy youth will produce a healthy adult workforce in the not-so-distant future. U.S. Surgeon General Dr. Jerome Adams has also said that 70 percent of young Americans do not qualify for military service due to not only obesity, but also substance use disorders and criminal records often rooted in unaddressed substance misuse. Addiction is not just an economic threat, it is a national security threat.

What does working together look like? It will be different in every city, village, and tribe. Gov. Bill Walker's February 2017 disaster declaration broke down traditional bureaucratic siloes and improved efficiencies between state agencies addressing Alaska's opioid epidemic. But more efficient government is not the only solution. Solving this epidemic requires working together across all sectors: government, businesses, the faith community, health care, persons in recovery and those still struggling with addiction — in other words, all of us. We are Alaskans, and we are Americans — we have overcome great hurdles by working together before, and if we will agree on what must be done, we can do it again.

Dr. Jay Butler is Alaska's Chief Medical Officer and Director of the Alaska Division of Public Health.

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