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WARREN -- Some proposals made to President Donald Trump that would expand access to addiction recovery services and overdose reversal drugs nationwide would help alleviate the opioid crisis locally, officials said.
In a 10-page draft report to the president, the Commission on Combating Drug Addiction and the Opioid Crisis makes numerous recommendations to put a stop to the opioid crisis. Drug overdoses kill up to eight people a day in Ohio and 142 people daily nationwide, according to the Ohio Department of Health and the report.
In Trumbull County, the number of people who die from accidental drug overdoses has increased every year since 2013, and in 2016, overdoses claimed 107 lives, according to the Trumbull County Coroner's Office.
The commission, chaired by New Jersey Gov. Chris Christie, makes eight recommendations, including a nationwide end to a Medicaid rule that limits treatment beds at detoxification centers to 16.
Getting rid of the limit, known as the Medicaid Institutions for Mental Diseases (IMD) exclusion, would "immediately open treatment to thousands of Americans in existing facilities in all 50 states," the report states.
April Caraway, executive director of the Trumbull County Mental Health and Recovery Board, said local lawmakers U.S. Rep. Timothy J. Ryan, D-Howland, U.S. Sen. Rob Portman, R-Ohio, and Ohio Sen. Sean O'Brien, D-Bazetta, have been working to remove the limitation in Ohio.
"Pennsylvania has a waiver from the Center of Medicaid Services to lift the 16-bed limit of the IMD exclusion and Ohio needs to ask for that same waiver," Caraway said.
Ryan stated he was "pleased to see that the commission recognizes that the Institutes for Mental Diseases (IMD) exclusion prohibiting Medicaid payments for facilities with more than 16 beds is preventing men and women from getting the treatment they need, and that this outdated policy needs to be repealed. I am proud to have joined with Congresswoman (Marcia) Fudge in introducing the Breaking Addiction Act, which would eliminate the IMD exclusion and increase access to addiction treatment. I call on my colleagues to bring up this legislation immediately so we can help combat this ongoing epidemic."
Cindy Woodford, CEO of First Step Recovery in Warren, agrees.
"An IMD exclusion waiver would change the landscape of substance use disorder treatment in Ohio. It would expand accessibility and decrease wait time, which is key. An hour can literally be the difference between life and death," Woodford said.
The commission also recommends the president mandate that every police officer in the country carry naloxone, an opioid reversal drug.
Caraway said that is a good idea, not just to protect the public, but also police officers on duty.
"I strongly encourage every first responder to carry naloxone. They are most often the first on the scene of an overdose and naloxone can and does save people’s lives," Caraway said.
And, the federal government should offer monetary assistance for the mandate, the report states.
There should be federal assistance because government agencies are already struggling and naloxone kits can be expensive, said Kathy Parrilla, injury prevention coordinator for the Trumbull County Combined Health District.
If the president were to declare a national emergency, the secretary of the U.S. Department of Health and Human Services could negotiate reduced pricing for the departments, the report states.
Declaring an emergency would classify the crisis appropriately, the report states. Declaring a state of emergency will bring much-needed focus, energy and money to the crisis, Woodford said.
"The commission's first and most urgent recommendation is to declare a state of emergency. Those of us on the front line of substance use disorder counseling and treatment can tell you we've been screaming this from the top of our lungs for a year and a half. We've watched our Valley's overdose and death rates continue to rise and every time we tell ourselves it can't get any worse, it does," Woodford said.
Recommendations that the people who prescribe opioids follow more stringent guidelines on when to hand out the drugs -- because four of every five new heroin users begin with nonmedical use of prescription opioids, according to the report -- is something a grant program in Trumbull County is already working on.
The health district received a grant through the Ohio Department of Health last year, which is continuing in 2017 and 2018, to offer area physicians new prescribing guidelines that include instructions on how to wean pateints off the drugs when it is time, Parrilla said.
The commission is expected to come out with a final report in the fall.
rfox@tribtoday.com