Emory’s conversation on opioid addiction reveals divide over response: Prosecute, treat

By David Pendered

Amid all the conversation about the nation’s opioid addiction, there is surprisingly little common ground on how to address it – with treatment or prosecution. That was the starting point of a conversation last week that was part of Emory University’s yearlong series, Conversations With America.

There’s plenty of agreement about the extent of the opioid situation, according to a presentation that series moderator Peter Hart shared before the start of the Jan. 24 conversation. Hart is 30-year veteran pollster for NBC/Wall Street Journal, with more than 50 years of polling experience, who is collaborating with Emory on the series.

Hart’s presentation observed:

• More than three in four Americans rank “prescription drug abuse” as much of a public health problem as cancer, according to a poll conducted in October 2017 by the Pew Research Center;
• More than four in 10 Americans know someone who’s been addicted to prescription painkillers, according to a poll conducted in April 2016 by Kaiser Family Foundation;
• Of this subset of 44 percent, 2 percent reported being addicted or formerly addicted; 20 percent say a close family member is or was addicted; 21 percent say it is or was a close friend ,and 26 percent say an acquaintance is, or was, addicted.
• The rate of opioid use disorder has leapt since 2014, from 2.8 per 1,000 to 8.3 per 1,000, according to June 2017 poll by Blue Cross Blue Shield.

The agreement pretty much stops there.

After the observing on the concensus over the extent of the problems, Hart’s presentation indicated that folks can’t seem to agree on the reason a person has an addiction – whether it be a personal weakness, an illness, or for a reason that’s not certain.

“We’ve become polarized as a society,” Hart said.

White Republicans who didn’t graduate from college are more likely to favor prosecution of those who use heroin and cocaine than are Democrats and independents, according to an August 2017 poll by yougov.com.

The picture isn’t so clear when the respondent knows someone who is or has been addicted. Whereas 47 percent of Republicans favor prosecution, the proportion of all respondents who favor prosecution drops to 31 percent. Nearly two out of three respondents think treatment, not prosecution, is the key when they have had personal experience with the addiction situation.

The numbers shift again among older respondents.

But favorable views toward leniency tend to increase after folks get into their work years. Through age 29 years, 42 percent think addiction is a personal weakness. The proportion drops into the 30-percentile bracket among those age 30 years and older – the cohort of an age when physical injuries take longer to heal.

Jack Killorin was one panelist who said from the outset that his opinion may flaunt expectations. Killorin serves as director of the Atlanta-Carolinas High Intensity Drug Trafficking Area task force.

“American law enforcement doesn’t believe we should lock up drug abusers,” Killorin said. “We want to deal with the ancillary issues.

“I’m from the police and we do not want to lock you up,” Killorin said. “We want to build systems with our partners and the community, that if you are suffering … we want to get you into a treatment program. And we believe in you. You can have a rich life.”

The other panelists were Debra E. Houry, director of the CDC National Center for Injury Prevention and Control, and David Laws, a founding member of Georgia Overdose Prevention who lost his daughter to an overdose after she became addicted to painkillers after suffering an injury in a high school soccer game.

Emory President Claire E. Sterk indicated that one goal of the year long series is to provide a venue where differences of opinions on a range of topics can be raised. Only by listening to a range of views can Emory faculty, staff and students contribute to the resolution of seemingly intractable problems that are at the crossroads of culture and politics.

“Events like this are so important,” Sterk said in her opening remarks. “They push us to think about who we are as people, what we stand for as an institution, that we must stay connected to the world, and how we can stay connected to each other.”