A city councilman in Middletown, Ohio, Dan Picard, has proposed a “three strike” policy for people who overdose on opioids, under which those reported to have overdosed on more than two occasions would be denied emergency treatment the third time. He made the proposal at a City Council meeting on June 20.
In what would amount to state-sanctioned murder, emergency responders would not be dispatched and the opioid user would be left to die. As Picard told the Washington Post on Wednesday: “When we get a call, the [emergency services] dispatcher will ask who is the person who has overdosed. And if it’s someone who has already been provided services twice, we’ll advise them that we’re not going to provide further services—and we will not send out an ambulance.”
Like hundreds of cities and towns across the US, Middletown, located in southwestern Ohio, has been wracked by the opioid epidemic. The town, which has a population of 48,791, has already seen nearly 600 overdoses this year, which is more than it saw in all of 2016.
Defending his proposal, Picard told the press, “It’s not a proposal to solve the drug problem. My proposal is in regard to the financial survivability of our city.” He continued, “If we’re spending $2 million this year and $4 million next year and $6 million after that, we’re in trouble. We’re going to have to start laying off. We’re going to have to raise taxes.”
Picard states openly the widespread sentiment in the American ruling class and among its political flunkeys—that the life of a working class person has a price tag, which is dropping every day.
The giant pharmaceutical companies played a central role in creating the opioid epidemic. They made billions of dollars in profits by systematically and knowingly pushing highly addictive opioid medications on the population throughout the 1990’s and early 2000’s.
Now the epidemic has become a concern for the ruling class, not out of any compassion for those who suffer, but because it is creating a financial burden for the state. The proposals currently working their way through Congress to drastically reduce the availability of medical care for the working class, particularly by gutting Medicaid, the primary source of funding for the treatment of drug addiction, are calculated to accomplish on a national scale what Picard is proposing for Middletown.
Meanwhile, the pharmaceutical companies continue to profit from the crisis. Part of the reason emergency care for those who overdose on opioids is so expensive is that the price of the “miracle drug” Naloxone (trade name Narcan), used to revive users from overdoses, has skyrocketed over the past decade. The popular injectable version of the drug has gone from $0.92 a dose to more than $15 since 2007. An auto-injector version is now up to more than $2,000 a dose.
The pharmaceutical companies’ price-gouging, combined with the increase in demand, has caused revenues from the sale of Naloxone to jump from $21.3 million in 2011 to $81.9 million last year, according to data from the prescription-tracking company IMS Health. It is now costing state and local governments much more money to save lives.
Picard pointed to this in a statement defending his proposal, saying, “I want to send a message to the world that you don’t want to come to Middletown to overdose because someone might not come with Narcan and save your life. We need to put a fear about overdosing in Middletown.” He continued, “John Smith obviously doesn’t care much about his life, but he’s expending a lot of resources and we can’t afford it.”
As with all social problems, the opioid epidemic is treated by the political establishment as the result of the personal failings of individuals. In fact, it, and drug abuse more generally, are the result of the increasingly dire social conditions facing broad masses of the people, under conditions of unprecedented and growing levels of social inequality. These conditions are themselves rooted in the rapacious drive of the pharmaceutical corporations and the corporate-financial elite in general for profit, intensified by the worsening crisis of the capitalist system.
Picard’s homicidal proposal has evoked an angry response from the public. Middletown City Manager Douglas Adkins wrote in a blog post Wednesday about the overwhelming backlash. “We’ve received hate mail, national news coverage and overloaded voice mail and email in-boxes,” he said.
Many health care organizations, recovery centers and advocacy groups have spoken out against Picard’s plan. Truth Pharm, a nonprofit organization that seeks to raise awareness of the issues surrounding substance abuse, released an open letter to Picard denouncing his proposal.
Alexis Pleus, the founder of Truth Pharm, wrote in the letter: “In short, our goal is to save lives, so, needless to say, we were more than appalled by your recent proposition to refuse medical treatment to overdose patients. It pains and infuriates us to see how easily you have turned human lives into dollar signs and an impact on your budget… To suggest that you withhold emergency medical response to overdose patients is manslaughter at best and premeditated murder at worst.”
Pleus spoke to the World Socialist Web Site about the issues raised by Picard’s proposal. On the use of Naloxone as a solution, Pleus explained: “At first, Naloxone and Narcan seemed like a pretty fast and cheap solution to save lives. And that was true to a point. It is still a very important tool we have to help people.
“The problem is that they have never dedicated the follow-up... There is no governmental body that has given the proper resources necessary to complement the use of Naloxone. It is not a fix in itself, is not a cure to the epidemic. We set ourselves up for frustration because we keep using this life-saving device but don’t ever get to the root causes of addiction. I think ultimately the fault goes right back to each state government and the federal government as a whole.”
Pleus told reporters she wasn’t surprised that lawmakers would propose a measure not aimed at addressing the epidemic but rather at saving money. “Look at how easy it is to get legislation to pass when there is money to be made,” she said. “But try and get something through that simply helps people--it just won’t happen…this problem does not have a quick cheap fix. But still, all the while, the pharmaceutical companies are profiting, profiting, profiting.”
When asked how President Trump’s new health care plan might affect the opioid problem, Pleus said, “It will be absolutely devastating.” She continued: “At our organization we try and help people find treatment. About 80 percent of those we help have Medicaid. If they repeal it, I cannot even fathom what we will do. The new plan also will not mandate addiction treatment as part of insurance coverage. I can’t imagine turning away eight of ten people and telling them there is nothing we can do.”