Over 400,000 Americans have died from opioid abuse, be it heroin or synthetic prescriptions, since 1999. To put this death toll into perspective, roughly the same number of Americans perished in World War II.
No state has been left untouched by the opioid epidemic, and that includes Georgia. Indeed, in 2017 alone, there were over 1,000 opioid overdose-related deaths in the Peach State. But for considerable time, Georgia, like much of the rest of the country, didn’t adequately address the crisis. Rather, policymakers declared war on the problem and adopted a prohibition-only approach, but unsurprisingly, this ended unsatisfactorily.
As with all failing wars, Georgia needed to either surrender or adjust its strategy. So, beginning under former Gov. Nathan Deal’s administration and now into Gov. Brian Kemp’s, Georgia promulgated some innovative responses to the opioid crisis. And while Georgia is off to a promising start, there is still much more work to do
Not long ago, lawmakers in Georgia realized that several problems were contributing to the opioid crisis. Georgians suffering from addiction oftentimes found themselves languishing in prison rather than receiving effective drug treatment; naloxone, the drug that reverses opioid overdoses, was difficult to acquire; and intravenous opioid use frequently led to the proliferation of blood-borne illnesses. In response, Georgia policymakers spearheaded efforts to address these issues.
Beginning in 2012 under Gov. Deal’s administration, the Legislature established the Georgia Accountability Court Program, which led to the creation of drug courts. Thanks to this effort, defendants charged with nonviolent drug-related crimes can now enter these highly specialized courts, where they are more likely to receive drug treatment than jail time. The objective of this strategy is clear: To get people the help they need and to keep them out of prison. And there is a good reason behind this approach — former inmates are at a high risk of resuming drug use and recidivating once they are released from prison.
This solution was helpful but not nearly enough. Opioid users were still dying from overdoses in droves, in part because naloxone was so difficult to obtain. The medication was even on the state’s dangerous drugs list, and a doctor’s prescription was required to acquire it. This meant that by the time naloxone could be acquired, the user was either in critical condition or already dead. As a result, in 2016, Gov. Deal removed naloxone from the dangerous drugs list and signed a bill allowing pharmacists to prescribe it over the counter. This gave Georgians easier access to the medication and a better chance at saving lives.
This measure will certainly help stem the tide of sudden opioid-related deaths, but it does little to address some of the slow destruction associated with intravenous opioid use. That’s because, until earlier this year, needle exchanges weren’t legal across the state of Georgia, meaning that addicts sometimes had to reuse and/or share needles with those already afflicted with blood-borne illnesses. Thankfully, Gov. Kemp recognized the conundrum and signed a bill into law permitting Georgians to exchange used needles for new needles to slow the proliferation of diseases.
These reforms will undoubtedly benefit the state, but access to these services is still a major problem. To date, there are only a handful of needle exchanges in operation, in part because it is a new concept, and drug courts aren’t consistently found across the Peach State. In order to continue combating the opioid problem, state and local governments should invest in more accountability courts and encourage the establishment of additional needle exchanges.
These efforts will go a long way toward reducing the opioid crisis’ effects. Still, so long as opioids exist in some form, they will be abused, and overdoses will inevitably occur. To that end, some locales outside of Georgia have tinkered with the idea of permitting safe injection sites. These are facilities where individuals can use opioids under the supervision of medical professionals — not with the goal of condoning illicit drug use, but to provide oversight in the event of an overdose. Data show that these injection sites are effective at reducing both drug-related deaths and the spread of disease.
There aren’t many easy answers to the opioid crisis, but so long as the prohibition approach seems destined to fail, we ought to consider new ways to mitigate the severity of the epidemic and reduce overall harm. Georgia has already taken great strides, but more needs to be done. If lawmakers are serious about curbing overdoses, inhibiting the spread of disease, and helping addicts become productive members of society, then policymakers must continue fighting the crisis with creative solutions.
Marc Hyden is the Director of State Government Affairs for the R Street Institute, and he is a longtime Georgia resident. You can follow him on Twitter at @marc_hyden.