Feds’ role in fighting drug abuse is debatable

Bravo for Sen. Heidi Heitkamp for her appearance in Minot last week to discuss with concerned residents and professionals the critical challenge of opioid abuse. In the past, denial might have hindered efforts to have discussions like these so it was good to see the dialogue happening.

Whether the opioid threat is greater in Minot than in other parts of North Dakota is hard to ascertain. Regardless, though, it is clearly having a tremendous negative impact on social services, crime an d the healthcare system. State and local authorities face a considerable challenge in coming up with a strategy to address this issue.

What the federal government’s role is in this process is debatable.

Sen. Heitkamp is championing legislation called LifeBOAT, which proposes to tax opioid prescriptions at a penny a milligram, raising about $1 billion nationally for addiction services. She explained to Minot Daily News in a meeting last week that funds raised would then be assigned via a grant process.

Clearly, it will take resources to combat opioid addiction and quite likely it will take a pool of resources only the federal government can create. Still, there are problems of principle with the proposed legislation. One, however it is pitched, this is a tax on patients and insurance companies, not on pharmaceutical companies. Big pharma isn’t going to just eat the price of the tax any more than any business just pays out taxes from its profits. No, the tax will be passed on in the price of opioid painkillers.

Two, given that opioid prescriptions are a gateway to illegal opioid use, is it really a good idea to hand the federal government incentive for there to be as many prescription opioids sold as possible? Isn’t it preferable for the government – and its massive, all-powerful regulatory legions – to have motivation to try to see fewer prescription opioids flushing out into communities?

Lastly, history shows us that government can succeed when it tries to prevent evil; but it is a mixed bag when it comes to efforts of government to do good. They are two different things. Have a look at our “wars” on poverty and drugs. Has anyone benefited except public sector/union workforces? Billions, trillions even, invested in combating poverty and the rich are richer and a permanent underclass is swelling. The war on drugs? Take a look around and you can see today’s drugs of choice are far more dangerous, their use far more widespread and prisons are one of the nation’s growth industries. Let’s not even get into the discussion of how regulation meant to help people has contributed to the explosion of diabetes, the environmental disaster of over-packaged household goods, etc.

Besides concerns on principle, there are concerns about practical application as well. Yes, we may need resources to wage this war locally. But would a grant program administered in D.C. end up benefiting North Dakotans? Federal grant money has a tendency to flow where the power flows and the politics of horse trading often influences grant processes. Does our delegation have the clout to carve out some of the proposed new pool of money, or will it go to places whose representatives have more political capital to utilize? And what would the attached strings be? Oh, there will be strings. There are always strings. How much would compliance cost?

There are ample questions about the role of the federal government in our community’s, in any community’s, response to opioid addiction. Local solutions to problems work best. Just how we coalesce federal dollars (whatever the finding stream) and local control of finding solutions remains to be seen. To be fair, this may require the wisdom if Solomon. We aren’t there yet.

But at least we are talking about it.