Last month the Wisconsin State Senate heard bills that would help stem the burgeoning problem of heroin and prescription drug abuse.  The sponsor of the new legislation, Rep. John Nygren (R-Marinette), has used the story of his daughter Cassie’s struggle with heroin addiction as the basis for action.  His specific target is the abuse of prescription opioids, which many feel are the ‘gateway’ to heroin use and addiction:  when persons addicted to opioids can no longer obtain the prescription drug, they turn to the street-drug heroin, a cheaper and more accessible substance.  Some believe that if opioids are not available, the person will not start down the path to addiction.  And while this might be true in some cases, many suspect that another drug would then fill the role of gateway drug.   Back at the beginning of the war on drugs, many people asserted that marijuana was a gateway drug to heroin.  The assumption that because some people who used marijuana went on to heroin, all people who used marijuana would use heroin.

The following chart shows the growth in opioid addiction since 2001.  Indeed it is a growing problem that should be addressed.  The gut and heart-wrenching agony of families affected by addiction should not be understated.  But, sadly, the problem has existed for a while, and only when the scourge of addiction moved from the city to the suburbs and non-urban areas has it seemingly become worthy of action. 

The components of the new legislation have the following features:

• Assembly Bill 364 would require doctors to check a state database whenever they write or refill a prescription for drugs that have a potential for abuse. The requirement would not go into place until the state Department of Safety and Professional Services determines the system is capable of electronically transmitting records to doctors.
• Another proposal, Assembly Bill 365, would require law enforcement officials to provide information to the database when they find evidence of prescription drugs being abused or stolen.
• A third measure, Assembly Bill 366, would require pain clinics to get certified by the state Department of Health Services.
• Assembly Bill 367 would require methadone clinics to provide the state with more information on key issues such as relapse rates.

The measures all passed the Senate on voice votes and were sent to Gov. Scott Walker, so there is probably nothing to be done at this point.  These measures do not appear to take the kind of action that is needed to face the problem of addiction head-on.  They resemble so many other steps taken as part of the war on drugs that, due to focusing on the wrong aspects of the problem, were doomed to fail.  Some points:

1. Having doctors check a database to determine if the patient for whom they are about to write a prescription is fraught with one very basic challenge:  using names as the key for a search.  To be effective the doctor will have to search on the many variations of a person’s name.  And it goes without saying that most physicians do not welcome another bureaucratic thou shalt that impacts patient care.  What ever happened to keeping the dialog between doctor and patient private!
2. The database itself is worrisome.  This seems like a bunch of personal information just waiting to be hacked and used for nefarious purposes.
3. If the premise is that opioid drug addiction is a precursor to abuse of heroin, what does cutting off access to those opioids actually do?  Will it prevent heroin abuse or simply force an addict into it sooner?
4. Assembly Bill 365 says that law enforcement personnel are required to provide evidence to the database if they find evidence of prescription drugs being abused or stolen.  So, based on what an enforcer sees and assumes, they are going to update personal information.  Ha it occurred to anyone that these officers may not have had any training making them knowledgeable enough to make the call.  It is likely that there will be frequent misinterpretations of circumstances, leading to documentation of incorrect information about a person.  Do you really think that database will be updated to expunge erroneous data?  And what ever happened to innocent until proven guilty?

In closing, something to ponder.  The following chart compares rates of firearm deaths to those from  illegal drug overdoses.  

While it is true that the number of overdose deaths appears to be gaining on deaths from firearms, there is still a large gap between the two.  Yes, the chart represents the national picture, but one can safely assume that the picture in Wisconsin does not vary significantly.  Why are our legislators not pressing urgently forward to address death by firearm?