State Leaders Navigate The Politics Of The Opioid Crisis

Jan 31, 2018

It’s a cold January morning in High Point as Governor Roy Cooper climbs into a white SUV. Guilford County EMS worker Chris Wilson drives through the city’s south side. On one side of the road there are two dingy motels. On the other a large cross and the message “God is love” on the ground.

“Do you happen to know about how many calls for overdoses to these two hotels [the county received] in the last few months?” Cooper asked Wilson.

“Right here, at this particular location... about 13,” said Wilson, referring to a recent 90-day stretch.

It knows no socio-economic [status], no race, no religion... No profession, no family is immune. - Guilford County EMS worker Chris Wilson

Just 20 minutes before the Governor’s arrival in this city of about 110,000 people, there was another overdose. High Point, in Guilford County, is one of the pockets of North Carolina where this epidemic goes from terrible, to even worse. Wilson said in the first few weeks of 2018, EMS workers responded to three overdoses every day.

“It knows no socio-economic [status], no race, no religion,” Wilson said. “One of the cases I remember early in this opioid epidemic, we went out and did a reversal and he was an orthodontist from Charlotte. No profession, no family is immune.”

From the bright lights of presidential campaign trails, to sparsely attended County Commissioner meetings, opioids have become a political issue in North Carolina and across the country. In this partisan era of divisive rhetoric, nearly all elected officials agree: the opioid epidemic is a big problem. But among the challenges to solving the crisis is how to determine the best policy solutions, and then navigate the public’s perceptions.

North Carolina Governor Roy Cooper sits for an interview with WUNC in the Executive Mansion in Raleigh, N.C., Tuesday, Jan. 30, 2018. Cooper addressed the opiod crisis affecting the state.
Credit Ben McKeown / For WUNC

Governor Cooper has made a half dozen stops across the state in recent months as part of an effort to listen to addicts, first responders and medical professionals on the front lines of the epidemic.

But some experts like Western Carolina political science professor Chris Cooper say the politics of the opioid epidemic are a dicey political issue.

“We agree it’s a problem, we don’t agree who should solve it, and we don’t even agree about what the means of solving the problem should be,” said Chris Cooper, who is not related to the governor. “So unfortunately, that’s the type of policy problem that is very difficult to solve.”

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Can Policy Help Curb The Epidemic?

The policy discussions include a range of questions: What funding is needed? Who should pay for it? What to do about the strain this crisis has placed on the foster care system? How should health providers and the state prepare for a looming issue with hepatitis C stemming from shared needles? Advocates, for one, say bolstering needle exchange programs across the state is an important step.

“It’s also been effective in providing continued human contact with the person who has substance use disorder to get  that person into treatment,” said Gov. Cooper. “Many of the people who are on the ground out there say that that matters, so that is a proven effective method.”

But what some see as a solution, like a syringe program, others might see as a political problem.

“It’s a difficult move and it’s an easy one to use against somebody when they’re running for office next time,” Chris Cooper said. “If there’s an ad that goes out that says legislator X voted for syringes for your children, that doesn’t really sound like somebody I might necessarily want to vote for,” added professor Cooper.

State lawmaker Greg Murphy (R-Pitt) agrees – there are positive outcomes associated with needle exchange programs. However, he does not expect state funds to be used for such an initiative.

Medical marijuana is another strategy with known positive outcomes, but it’s also politically combustible. And while North Carolina isn’t cannabis crazed Colorado, Murphy notes there is data to consider.

“It has actually been shown in states where medical marijuana is allowed that there’s a 25 to 35 percent decrease in the percentage of opioid deaths,” said Murphy, a surgeon and the only medical doctor in the General Assembly. “Politically speaking, that has been a tough one to navigate.”

Last spring, Murphy was a lead author of the STOP Act, a new law that changed the prescribing guidelines for opioids in North Carolina. It’s a measure Governor Cooper signed into law and is widely credited as an early success, which then served as a blueprint for several other states pursuing opioid legislation.

But Murphy and others leaders acknowledge there are still many political challenges that come with addressing the opioid epidemic.