Kentucky has the money for once. Will the legislature have the vision?
A holiday wish is displayed at the iKids Childhood Enrichment Center, a child care facility in Benton, Nov. 28, 2023. (Kentucky Lantern photo by Abbey Cutrer)
Kentucky’s new Attorney General Russell Coleman is right when he says prevention is the weak link in the long-running war on drugs.
If we’re serious about prevention, we’ll work to help more Kentuckians grow up in secure homes.
Affluence is no protection against addiction or overdose; we’ve proof enough of that. At the same time, economic insecurity is a common thread among those who develop drug use disorders. Multiple studies document this link. A pair of economists coined “deaths of despair” to describe the rising overdoses and suicides that had eroded Americans’ life expectancy even before COVID-19 struck.
Coleman is right on another point. The term “opioid epidemic” is too narrow.
The drug trade is nothing if not fungible; supply and demand have an uncanny ability to align.
Consider the last 25 years: The manufacturer of highly-addictive OxyContin targeted an economically depressed region already dependent on “nerve pills” and prescription painkillers. In response, Kentucky regulated the over-prescribing of opioids, drying up the supply. Enter heroin, followed by fentanyl, which is cheaper than heroin to produce and transport. It’s also extra deadly and hard to recognize when masquerading as a prescription pill or mixed with other drugs.
Kentucky also tightened the sale of over-the-counter medicines used to make methamphetamine, which is why you sometimes hear grousing that it’s easier to buy firearms than Sudafed. As toxic makeshift meth labs disappeared, Mexican cartels filled the void, as Coleman observed in an interview with the Lexington Herald-Leader.
Politicians and law enforcement will keep pushing policing and prison. They’ll talk about tightening the southern border through which almost a trillion dollars of legal trade passes each year.
But there’s no reason these approaches will work any better now than they have in the past. If they do succeed in constricting the flow of drugs, supply will just morph again to meet demand.
Reducing demand — prevention, as Coleman says — is the way to make a long-term dent in Kentuckians’ yen for illicit drugs.
Naloxone, buprenorphine and methadone are part of the solution now.
What’s also needed is a dose of hope.
While the pharmaceutical industry and Mexican cartels cannot supply hope, there are some things Kentucky’s legislature could do.
I keep thinking of tiny Warfield on the West Virginia border in Martin County. The Mountain Citizen reported last fall that the elected commissioners were trying to figure out how to respond to homeless people living in tents on a creek behind the IGA. One idea was to ban encampments in the city limits. Columnist Bugs Dixon subsequently called for more comprehensive solutions and noted that many of the tent-dwellers were former patients of a nearby addiction treatment center.
Can you imagine trying to stay sober holed up in a tent under suspicious eyes? Who wouldn’t want a numbing hit of something?
Kentucky, rural and urban, has a shortage of housing for all kinds of people. It was a crisis for low-income working families even before disasters destroyed thousands of homes.
The legislature put a dab of money towards affordable housing last year. Gov. Andy Beshear is proposing another dab in the upcoming two-year budget. But the need is so much greater. And the benefits are so broad, not least of which are construction jobs.
After a long budgetary drought, Kentucky, like other states, is sitting on a big surplus — $3.7 billion in the “rainy day fund” — dollars that can make a difference.
Republican lawmakers often speak of putting money into Kentuckians’ pockets via tax policy. The Republican supermajority has enacted two income tax cuts in the last two years. People who need help the least benefit the most from income tax cuts.
This would be a good time for tax policy that puts money in the pockets of Kentuckians who need it the most — tax policy that will help prevent costly future problems like addiction and crime.
And we have a recent example of it working: Congress’ temporary expansion of the child tax credit during the pandemic cut child poverty by a third nationwide and lifted 69,000 Kentucky children out of poverty.
Kentucky could join the 14 states that have some form of child tax credit.
Poverty puts children through traumas that manifest in ways that society later punishes at a high cost to itself. A few hundred dollars a month — to cover rent, keep the fridge stocked and the heat on — could protect a lot of kids from a lot of trauma.
Kids and their families also are at risk if the legislature or Congress fail to shore up child care. Parents can’t work without it.
And, as you can read elsewhere in today’s Lantern, grandparents and other kin caring for kids whose parents are lost to the drug epidemic need help.
Coleman, a former FBI agent, and Christopher Evans, the former DEA agent he’s appointed to head the state’s Opioid Abatement Advisory Commission, will play key roles in distributing hundreds of millions of dollars from legal settlements with drug companies. As they search for ways to strengthen prevention, they should think about housing for people who are trying to recover.
There’s plenty of need and, for once, plenty of money. What’s unknown is if our elected leaders have the vision and courage to change the things they can.
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