The NCSL Blog


By Kevin Frazzini

The scale and urgency of the opioid crisis is clear in the numbers.

MIchael BotticelliTamara Dodge, with the Wisconsin Legislative Reference Bureau, cited two powerful ones in her remarks opening the session “State Strategies to Address Opioid Misuse,” at the Legislative Summit in Boston.

There were about 33,000 opioid-related deaths in 2015, or roughly 91 deaths a day, she said.

The session’s main speaker, Michael Botticelli, put it in different terms. Opioid misuse and addiction is “the greatest health crisis since the height of the AIDS epidemic,” he said. Deaths from AIDS peaked between 1995 and ’96 with more than 42,000.

Botticelli, one of the nation’s leading addiction experts and executive director of the Grayken Center for Addiction Medicine at Boston Medical Center, then led the group through what he views as the most effective ways to tackle the crisis.

Starting with prevention, so that we begin to reduce the number of new addicts, lawmakers need to focus on:

  • Creating evidence-based prevention programs that treat opioid addiction as an early-onset disease.
  • Reining in the overprescription of opioid painkillers.
  • Providing better ways to dispose of unused medications.

In responding to a crisis that’s highly stigmatized and that doesn’t discriminate socioeconomically, lawmakers must draw on community resources, he said. They must seek partnerships with law enforcement, who often are the first to encounter addicts in crisis and work with employers, who can add treatment to their benefits plans. Private foundations, which might be willing to support programs financially, and faith communities, which were vital sources of support during the AIDS epidemic, also play a role.

On the legislative front, lawmakers might consider expanding Medicaid, requiring private insurers to meet federal standards of compliance and establishing or expanding needle-exchange programs. Investing in data-collection systems is vital, Botticelli said. Federal data is old, and to address the crisis in your community, you must have your own data, giving you a clear, real-time picture of your resources—treatment beds, naloxone supplies, etc.—and program effectiveness, including emergency-room admissions and discharges.

A panel of legislators continued the discussion after Botticelli’s presentation. For more on the opioid crisis, check out these NCSL resources:

Kevin Frazzini is the assistant editor of State Legislatures magazine.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.