Gov. Wolf's opioid triage a start, but keep costs and effectiveness in view | Editorial

A heroin user holds a needle after injecting himself along the railroad track in Kensington in Philadelphia, PA on October 25, 2017. DAVID MAIALETTI / Staff Photographer

Gov. Wolf wasn’t just stating the obvious when he declared the opioid epidemic a disaster last week. It’s a war, and so far, we’re losing. Last year, 5,260 died in the state and thousands more came close to death when they overdosed. Even more saw their lives unravel as they or their loved ones fell into addiction. This year’s casualties are expected to be higher.

Wolf’s disaster declaration is the legal basis for bureaucratic triage. He’s cutting red tape so addicts can get admitted into treatment more quickly, which is good. But he’s also cutting some of the red tape that could keep those programs honest and effective.

The governor would allow treatment centers with high success rates to skip some reviews. In theory, that may save administrative time, but in reality, even the best institutions can fall prey to incompetence or worse. Since helping addicts recover is the goal, the government should ensure that treatment meets the highest possible standards. Wolf would be wise to reconsider giving treatment facilities a break on reviews and installing an independent inspector general to continually hold treatment centers accountable.

It’s not just lives that depend on effective treatment. A staggering amount of public money is spent. According to a New York Times report called “Addiction, Inc.,” nationally, addiction treatment is “one of the most lucrative health-care industries to emerge in a generation, a massive business fed by a national addiction crisis that is out of control.” But as the series points out, there is little agreement on how to most effectively treat patients.

According to the governor’s office, Pennsylvania spent $164 million on opioid treatment in 2016, the latest year figures are available. But there isn’t a clear picture of where the money went and, most important, who got it. Even more money comes from private insurance companies, which spent $721 million nationally on treatment in 2015.

Still, the larger societal costs of this crisis are even more staggering:  impacting productivity,  as well as costs of health care, crime, incarceration, and broken families.

The governor is right to call this a disaster. But not fixing this would be an even bigger calamity.

This crisis started with Big Pharma overselling opioids to physicians who overprescribed these highly addictive drugs to patients. So many of the addicts’ stories start with doctors prescribing opioids after minor surgery or for simple back pain. Too many of those stories end with patients turning into addicts who run through prescriptions, buy drugs on the street, lose jobs, ruin families, become homeless, and die.

The governor’s declaration is an important step because it calls the opioid epidemic what it is – a disaster – and backs it up with action that in most instances helps the victims. The cost and the effectiveness of  treatment programs, though, are not incidental, and we need to demand that those trying to save lives have reasonable oversight. Wolf’s announcement is positive, but we need to remain vigilant on how well programs are working.