Opioids: The Challenge of Covering 289 Million Prescriptions

Dave Mason via Standard Republic

Dave Mason (via Standard Republic)

There is an opioid epidemic occurring the United States but it rarely captures the front page. Yet over the last several months, more and more coverage is being devoted to how communities have handled the crisis. This matters because addiction of this magnitude does not occur in a vacuum. The epidemic is taking an emotional, financial, and social toll on families, thousands of communities, and now state agencies.

The opioid crisis is wide-spread and decentralized. The communities affected are rural, suburban and urban. They are of diverse ethnicities. The crisis extends across income levels. There are multiple causes and few well-implemented solutions. All of this makes it very difficult for a news organization to build a narrative. There is just too much to cover. Also consider that Donald Trump provides easy to report on fodder that generates more clicks, and you can begin to see why many people may be unaware the crisis is even occurring.

But the crisis is having a severe effect. Senator Rob Portman of Ohio caught attention during the most recent ACA repeal debate because he wanted funds to combat the opioid epidemic in Ohio. Portman tried to balance his political desire to repeal the ACA with the fact that Medicaid has played a crucial part in curbing the epidemic. He ultimately voted for the repeal bill. Elsewhere, Republican Governor of Maryland, Larry Hogan, declared a state of emergency over the opioid crisis in March. Even today, the Rhode Island Governor, Gina Raimondo, signed legislation to curb the epidemic.

First, some quick facts about the crisis:

Opioids include heroin, but also prescription pain-relievers including oxycodone, hydrocodone, codeine, morphine, and fentanyl. Pain-relievers have been the primary driver of addiction and health concerns in this crisis.

The crisis began in the 1990s and stemmed from doctors overprescribing highly-addictive painkillers. Last year, 2016, 289 million prescriptions were written for painkillers.

In 2015, 33,091 people died from overdosing on opioids.

The opioid crisis carried a cost of $78.5 billion in 2013.

Here is a fact sheet from the Department of Health & Human Services and one from the American Society of Addiction Medicine.

Opiod-Epidemic-Infographic-02-e1467128669109

We are going to look at how three major news organizations covered the opioid epidemic over just the last week. Keep in mind that most major news has covered the epidemic in some capacity within the last week. We are just sampling three perspectives today.

 

The New York Times

00treatment-02-master675 Christopher Capozziello NYTimes

Methadone treatment (Christopher Capozziello/New York Times)

Opioid Users Are Filling Jails. Why Don’t Jails Treat Them?”

The New York Times piece is the most in-depth investigation in recent months, both for its thoroughness in tracking one of the addicts featured in the story, and for probing at the solutions. Many news stories, especially on local news, feature phone-camera footage of an overdose but do not attempt to analyze it. It’s a frequent “Look at how shocking and horrible this is” read-through. The Times goes beyond that in their story. The piece provides a human element, data to color the big picture, an example of one of many solutions, and an analysis of why the solutions are facing headwinds.

Above, we mentioned that it is difficult the build a narrative because the epidemic is diffuse in nature. The Times opens with the personal struggle of a recovering addict, Dave Mason, in New Haven CT. They followed his progress for more than a year. Mason becomes the narrative drive through the story. By interviewing him in-depth and acknowledging his successes and failures, ambitions and contradictions, the epidemic is given a humanistic element.

The Times piece pivots from the personal to the macro-level response state agencies are taking to treat addicts. There are very few jails that treat prisoners with opioid addiction. But New Haven is one of them. The piece expands beyond a snapshot profile and into an investigation of what can be done to solve the crisis.

Here’s the quote that enlarges the story:

“We don’t take away people’s insulin or their asthma inhalers,” [Dr. Kathleen Maurer, Director of health services for Connecticut’s Department of Corrections] said. “Why should we take away their methadone?”

From there we learn the research studies on treatment efficacy have been limited. But they do show that treatment has a real positive impact.

The piece also touches on the limitations of the treatment: only some people qualify for the program, there is a stigma attached to partaking in the treatment, the measures of success are obscure, and budget shortfalls have curtailed existing programs despite success.

This is a summary of a piece worth reading because of its thoroughness that news reportage from other sources does not live up to.

Key Quote:

Like many jail officials, Jose A. Feliciano Jr., the New Haven jail warden, was skeptical. “I thought, ‘That’s another substitute for heroin,’” he said.

But even he had been personally touched by the problem: Two of his relatives had been heroin addicts who died of AIDS. And one of his three children is recovering from addiction.

“To say that’s something that didn’t influence me would be a lie,” he said. “Not until it impacts people close to you do you understand. It’s incredible how quickly it can overtake a person.”

 

CNN

170803154516-sheriff-robert-leahy-clermont-county-ohio via CNN

Robert Leahy (via CNN)

Here, Heroin Spares No One, Not Even the Sheriff’s Wife

 

CNN is a good example of doing an adequate job of covering the crisis without investing as much as the New York Times did. They do not have the resources to spend a year tracking a single man’s progress. But they do blend the personal narrative with the larger context well.

The first part of the CNN story details how a law enforcement officer in Ohio, Robert Leahy, dealt with the reality that his wife was addicted to heroin nearly a decade ago. It is personal and provides a face for the epidemic – this time someone whose family is torn apart by it instead of one combatting the addiction.

Then comes the pivot to broaden the scope. CNN uses a statistic – that 33,000 died in 2015 from overdoses, 2,700 of them in Ohio. Then follows with the statement that law officers are realizing they can not treat addicts like criminals. “To stop an epidemic, they have to think like medical professionals.”

This piece focuses on the strain the crisis has placed on the state. When compared to the New York Times piece, it illustrates how many different angles there are to cover the epidemic. CNN demonstrates the grisly result of the epidemic: more coroners have been hired, accomodations have been made to handle all of the bodies coming in for examination, and refrigerated trucks are being re-commissioned for extra space to house bodies. The trucks were originally purchased to store bodies in the event of a mass terror event.

CNN broaches the solutions aspect by returning to Robert Leahy. Now he is the sheriff. The solutions presented are two-fold. Officers carry Narcan to revive overdoses. There are also new treatment programs and the acknowledgement by law enforcement that traditional prison sentences are not the best avenue for rehabilitation.

Key Quote:

[On Narcan and Alternative Sentencing Programs correlating with a decrease in deaths] “Is it too early to tell? Well, I think by the end of 2017, if we can get two or three years in a row with those numbers trending down,” Leahy said, “I think people will realize and say, ‘I think somebody’s doing something that’s working.’”

 

Fox News

 

Mugshot via Fox News

Mugshot (via Fox News)

Fox has two stories. One is the kind of sensationalist reporting we mentioned in the beginning.

Police: Video Shows Ohio Mom Shooting Heroin In Front of Young Son

This contains all of the elements co-opted by nightly news. In this case, Fox News is elevating a story covered by one of their local affiliates in Cincinatti. It has a visceral video of two adults in an alleyway getting high while a young boy looks on. There is no attempt to humanize. There is no attempt to look at the causes. There is not attempt to look at solutions. This is a piece that raises awareness that heroin is present. Unfortunately it does not even mention that there is an epidemic.

Key Quote:

“I think the people [who live here] are solid people,” [the bystander who shot the footage] said. “The people that are the problem are the people that come down here and sell their dope and the people that come down here and buy their dope.”

 

Also Fox News: “Ohio Police Chief: Somebody Snorted Heroin Off My Business Card

Fox’s second story was taken from a Facebook post shared by an Ohio Police Chief. If you read the headline, you got the story. Everything said above applies to this story.

 

Decoding

1. Should Fox be faulted for the lack of in-depth coverage of the opioid epidemic? On one hand, they are covering it. In this regard, it is a form of advocacy. On the other hand, they are not providing any context. Within the framework of Fox reporting, readers could just as likely infer that these are more examples the world is going to hell as they could determine there is an epidemic.

2. Should this be covered more? Both the New York Times and CNN covered different regions and different solutions. But there are ways to further explore the effectiveness of treatment, the studies being performed, the causes of the epidemic, the political reaction, the budgetary challenges, the medical response to overprescription, etc. Any of these could be the focal point for a stream of articles. But do you feel it is serious enough to warrant that dedication of resources?

3. What can you do? Since this is an issue of media exposure, we recommend contacting your local news sources. Ask how the opioid crisis is affecting your town, your community, and your local agencies. This can be local TV news or local newspapers. You can reach them via writing letters to the editor, emailing the editor, or tweeting at the local beat reporters if you know who they are.

 

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