SALT LAKE CITY — A handful of the state's foremost leaders in the fight against opioid addiction met Tuesday at the University of Utah for a panel discussion focusing on how to overcome that scourge in Utah.
The discussion, held at the U.'s Hinckley Institute of Politics, was moderated by Lt. Gov. Spencer Cox, who told reporters afterward that opioid addiction has "become a public health crisis, a policy crisis, a political crisis."
"You shouldn't be a knee surgery away from (being) homeless" thanks to addiction, Cox lamented in an interview.
In 2016, 600 Utahns died from a fatal opioid overdose, according to the Kaiser Family Foundation, a prominent health care think tank. U. spokeswoman Brooke Adams said Utah ranks seventh in the country for such deaths, citing public health data indicating overdose fatalities in the state quadrupled between 2000 and 2015.
Cox posed questions about how to reduce opioid overdoses to a panel consisting of Adam Cohen, CEO of the Odyssey House substance abuse and mental illness treatment center; Angela Stander, prescription drug overdose prevention coordinator for the state Department of Health; and Jennifer Plumb, medical director of the Utah Naloxone Association and assistant pediatrics professor at the U.
Plumb described the efforts of both her organization and the state to distribute numerous kits of an overdose reversal medication called naloxone, leading to thousands of rescues in the last few years. It's an undertaking she called "tremendously successful."
"We've gotten naloxone into thousands of homes across the state … everywhere we can possibly get it to people," she said.
Plumb also said that in terms of addiction recovery, naloxone ought to be seen as merely a small piece — a last resort "fire extinguisher" — in preventing opioid overdose deaths.
"(But) you can't get better if you're dead. We have to get these people better (with naloxone) so they can get to those next best steps" in addiction recovery, she said.
Stander praised legislation passed this year that requires pharmacists to affix a warning label to opioid containers stating the drugs carry a risk for addiction and overdose.
"We know the last piece of education a patient can receive is from that pharmacist," prior to the opioids being taken home, Stander said.
Cox told the group, "It's this concept of the ambulance at the bottom of the cliff versus the fence at the top of the cliff. ... How do we do a better job of putting (up) that fence?"
Cohen suggested that one way to prevent addiction upstream is to zero in on more rigorous mental health treatment. Mental illness remains a pervasive cause for a person developing an addiction, he said.
"Most of the time there's a mental health (problem) underlying when we're treating an addiction. So they're self-medicating, numbing themselves," Cohen said. "We need to be addressing that."
Plumb said children need to be taught from a young age not to make sweeping assumptions about prescription drugs being inherently safe.
"We've got to educate our kids and it isn't a 'just say no' campaign — it's 'here is reality, here is what is out there,'" she said. "(People always tell me) 'I just never would've believed that brown bottle would've got me here.' We've got to change the way that is."
Cox talks medical marijuana
The panel was also asked to share their thoughts about research into medical cannabis as it related to opioid addiction, to which Cox responded that the drug "is at least a piece of dealing with the opioid epidemic."
"I think it is a hugely important issue (regarding) the safety of marijuana and its effectiveness in dealing with pain in a way that does not cause the same addiction, the same — all of the problems we've been talking about (with opioids). I think there's general consensus around that it's better than opioids, at least we're getting there.
"The question is what does that marijuana policy look like. We're having this debate right now," Cox said.
Cox said he would have liked the state Legislature to have already passed comprehensive medical cannabis legislation — "two years ago would have been great," he said — but that he doesn't support legalization as outlined in the ballot initiative currently being sought.
"The problem is I can tell you if this gets on the ballot and the details of this policy really start getting out ... a lot of that support is going to go away, because it makes it look a little too much like the potential for recreational marijuana down the road," Cox said.
He said that while Gov. Gary Herbert opposes the ballot initiative, "he told me today ... (if) they ask about marijuana, please tell them I support medical marijuana but I don't support the details of this (initiative) — there's some problems with it."
His comments come almost a week after Herbert issued a release promising to "actively oppose the medical cannabis initiative," saying it "lacks important safeguards" on marijuana production, among other things, and "would do more harm than good."
The Utah Patients Coalition at the time criticized Herbert's claim that the initiative could lead to recreational use, calling it "a scare tactic that has no basis in truth." The group contends the language in their initiative is the "most conservatively drafted" in the United States and presents no such path to non-medical use.