- Associated Press - Wednesday, June 29, 2016

Recent editorials from Alabama newspapers:


June 23

The Gadsden Times on opioid use data:

Only true masochists enjoy pain, and we imagine no one wakes up in the morning ready to become an addiction statistic.

There simply are a lot of folks in the U.S. who want somebody, somewhere, somehow to stop them from hurting. Doctors, who probably hear the words “stop my pain” so many times the echo never leaves their ear canals, have responded by doling out prescription opioids.

Some providers probably will accuse us of unfairly loading the verb “doling,” but the numbers merit that emphasis.

A report in April by CNBC, citing data also reported in 2014 by pharmaceutical benefit manager Express Scripts, claims the U.S. (which makes up just 5 percent of its population) is using roughly 80 percent of the world’s opioid supply. That’s almost 1 prescription for every adult and child in the country.

Pharmaceutical companies, through investigative reporting, stand accused of fueling that frenzy by touting the drugs for situations they weren’t intended for, and as Boston University health professor David Rosenbloom described it, conditioning doctors to consider pain as a new vital sign.

The result is an addiction crisis, which we’ve addressed on numerous occasions, which caused a record 19,000 or so overdose deaths in 2014, the last year that has been documented. We imagine the upcoming numbers will be worse.

The reaction has been assorted crackdowns on when, how often and at what strength physicians can prescribe opioids to patients (New York has just limited initial prescriptions to 7 days).

The Centers for Disease Control, which estimates opioids are abused by 2 million people annually, released new, voluntary guidelines this year saying they shouldn’t be the first choice for pain relief, but should only be tried in the smallest doses and over the short term after all other pain relief strategies have failed.

There now are some new numbers in the mix. A federal report this week said nearly 12 million Medicare beneficiaries (out of 53.8 million total) were prescribed opioids last year, an average of five times counting initial prescriptions and refills, at a cost of $4.1 billion. One researcher not connected with the study called those figures “astounding.” We agree.

Which state had the highest percentage of elderly opioid users? Alabama at 42 percent, not surprising given the 2012 state-by-state ranking that showed its physicians writing three times as many opioid prescriptions overall as No. 50 Hawaii.

To be fair, we’ll point out that the elderly have unique pain situations - joint replacements, non-replaceable yet worn-out bones, diseases like cancer - that make relief and, especially, management problematic. We don’t know if that justifies hooking them on the most powerful legal weapons in the pain relief arsenal.

Despite the protestations of those who have criticized the crackdowns and new regulations - the sufferers who don’t care about the numbers, new guidelines or the potential for addiction or overdose; they just want the pain to stop so they can function - no one wants to replace opioids with prescribed, biteable bullets.

However, what the numbers show is a textbook out-of-whack situation that arguably isn’t benefiting patients, old or young. We used the metaphor of an arsenal in fighting pain. There needs to be a reassessment on all sides as far as the expectations, the realities - and the rules of engagement for using those weapons.




June 28

The Dothan Eagle on crime in Alabama:

Television shows about cops and crime are among the top programs in their appeal to viewers, but most people realize they demand a suspension of disbelief, regardless of how realistic they may seem.

Within the confines of an hour-long show, they’ll send evidence to the lab, and get the results in time to nail down their cases and get the bad guys.

It’s probably safe to say it never happens that way. In fact, if the crime drama were set in Alabama, evidence sent for forensic analysis in the first season might not come back until the third season.

Alabama lawmakers talk a good game about being tough on crime, but a crippling funding crisis and its effect on the criminal justice system tells another story.

For instance, Montgomery County District Attorney Daryl Bailey told the Montgomery Advertiser recently that the court system there had a backlog of 1,604 drug cases held up because the state Department of Forensic Sciences cannot process the evidence any faster.

It’s not just Montgomery County, either. The bottleneck at the forensic lab affects every jurisdiction in the state.

Bailey theorized that with cases taking years to get to trial, defendants who make bail often return to the drug trade while their cases are in limbo.

It’s not just drug cases; the Department of Forensic Sciences also processes evidence in murder and rape cases.

Like most of Alabama’s service challenges, this is nothing new. The efficiency of the forensic lab services has dwindled over time through budget cuts and staff reductions fueled by the Legislature’s failure to adequately fund vital state services.

State leaders look to a prison construction plan as a panacea for the ills of the state’s judicial and corrections system. However, it’s a complex apparatus with many moving parts, and unless the deficiencies of every component are addressed, little will change.




June 29

Montgomery Advertiser on statistics regarding the overall well-being of Alabama’s children:

Where’s the outrage from Alabama leaders over the abysmal well-being rankings of the state’s children? The Annie E. Casey Foundation’s yearly Kids Count data book was recently released, and the news was depressingly worse.

For 2016, Alabama ranked 46th nationally for overall well-being, down from 45th last year. There are small bright spots in the report - the number of low-birthweight babies dropped a bit and the number of children without health insurance fell significantly, while fewer teens are abusing alcohol or drugs.

But on most other measures things have worsened or remained stagnant, thus the drop in the already dreadful ranking.

More Alabama children live in poverty - 28 percent for 2014 as opposed to 22 percent in 2008. More Alabama children live in homes where parents lack secure employment - 34 percent for 2014 as opposed to 30 percent in 2008.

More Alabama children live in high-poverty areas - 17 percent for 2010-2014, as opposed to 13 percent for 2006-2010.

Dire statistics are nothing new for Alabama’s children, and indeed it can be hard not to become numb to more awful revelations.

But politicians shouldn’t get to be numb to such realities, or to remain silent.

Alabama’s weak recovery from the great recession of 2008 is to blame, in part, for the plight of Alabama’s poor children.

The anemic state economy, however, is closely related to policy decisions from the Republican-led Legislature and the governor’s office that have stymied growth and left the consequences on the backs of impoverished families.

We’re talking about a failure to invest sufficiently in public schools, a failure to aggressively open up the state’s model Pre-K program to every 4-year-old child. The Casey report ranks Alabama 48th overall on educational measures for reasons such as the number of fourth-grade children not proficient in reading in 2015. And eighth-graders not proficient in math.

We’re talking a failure to raise enough revenue to adequately fund Medicaid programs that serve Alabama’s poor kids.

We’re talking repeated failures to support the state’s currently useless affordable housing trust fund so fewer children live in households with a high housing cost burden.

Failed leadership starts at the top, and scandal-plagued Gov. Robert Bentley - recently given to claiming he understands better than anyone what Alabamians feel - has more than earned his position as a rank disappointment.

If he wants to repair his besmirched legacy he can start by reshaping himself as a much stronger advocate for Alabama’s children - in the classroom, the doctor’s office, blighted urban neighborhoods and impoverished rural counties.

A first step is to call a special session of the Legislature and insist stingy GOP lawmakers deal with the unconscionable $85 million funding gap for Medicaid that puts poor children’s access to health care at risk.

Goat Hill may well turn its back on such a crusade from a weakened governor, but at least it would be an honorable fail.



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