Harm reduction done right

In case you missed it, there was an interesting NY Times article about how Dayton Ohio and its county of Montgomery dramatically reduced opioid overdose deaths from last year to this.

Lots of things seemed to come together to make this possible. The most obvious of these was Gov. Kasich's decision to expand Medicaid under the Affordable Care Act. Dayton mayor Nan Whaley claimed it was the basis for everything they've been able to accomplish, saying

“If you’re a state that does not have Medicaid expansion, you can’t build a system for addressing this disease.”

That's sad but really true. Some of the states that need it most haven't done it year, although that number is fortunately diminishing.

Other factors were harm reduction programs, support groups, a strong program to distribute Naloxone to reverse the effects of overdoses, and, importantly, the growing cooperation between Dayton police and public health workers.

Unfortunately, Charleston WV has been going in the opposite direction, as this WV Public Broadcasting story relates. 

The Times article quotes Sam Quinones, author of “Dreamland: The True Tale of America’s Opiate Epidemic,”who told a congressional hearing that "the more cops and public health nurses go out for a beer, bridge that cultural chasm between them," the better the US will be able to deal with the problem.

Full point

In another lifetime, I used to referee karate tournaments. That was before I became convinced that karate should never have been turned into a sport and way before my trip to the Holy Land, aka Okinawa.

When I did ref though, I tried to be fair and watch as closely as possible regardless of what I thought of a competitor, his/her teacher or style and call em like I saw em.

In that spirit, I hereby call "Ippon!" (that's full point in Japanese) for Ohio Governor John Kasich, who pushed through, perhaps a bit roughly, Medicaid expansion for his state despite his firm Republican credentials.

And, once again, shame and nothing but shame on the rulers of the states that refuse this basic act of humanity. As Krugman argued today, the arguments against Medicaid expansion are just plain lousy.

The shadows of life

As West Virginia's Democratic governor mulls over expanding Medicaid to over 100,000 working West Virginians, I hope he might give some thought to some things his Republican counterpart in Ohio had to say:

...in this case, extending Medicaid benefits will help us on many levels, including the positive impact this decision can have on the mentally ill and the addicted. Some of them live under bridges, some of them live on streets, some of them are in our jails tonight. One of the sheriffs that I was with the other day told a story of a man whose life had gone really perfectly. He got sick, started living in the woods. He's now in jail. He wraps scriptures around his fingers to ward off evil. The sheriff told me, he doesn't belong in our jails. It's a chance to rebuild the safety net that we've all wanted to since we have released people from, from these mental hospitals. 

My personal faith in the lessons I learned from the good book, they're like, run my life. I mean, I'm serious they're very important to me. Not just on Sunday, but just about every day. I gotta tell you, I can't look at the disabled, I can't look at the poor, I can't look at the mentally ill, I can't look at the addicted and think we ought to ignore them.

For those that live in the shadows of life, those who are the least among us, I will not accept the fact that the most vulnerable in our state should be ignored. We can  help them. And I want all of you to think about this.