Pierre, S.D. (CN)—Although meth remains the primary drug-related health crisis in South Dakota, legislators on the Health & Human Services house committee on Thursday morning focused their attention on opioid use in the state.
“When I was in the legislature a decade ago, everyone was talking meth,” said Rep. Tim Rounds, R-Pierre. “Now it’s opioids. They’re more deadly and more pervasive.”
But that’s not exactly true … at least not in South Dakota. Meth—a cheaper, more accessible drug in remote areas of the state—remains a top health risk. Still, in Pierre Committee Chairperson Wayne Steinhauer, R-Hartford, said he couldn’t open up a newspaper without seeing stories on opioid abuse.
In 2015, 24 South Dakotans died due to drug overdose; but only 36 percent of those deaths could be attributed to opioids. And while that number grew to 36 deaths in 2016, the state’s measurements in relation to opioid abuse are on the decline.
“We don’t want to minimize the problem,” said Deputy Secretary of the South Dakota Department of Health, Tom Martinec. “But we are making progress.”
Thanks to a new statewide monitoring program initiated by an opioid taskforce, doctors and pharmacies now know in real-time which patients have been prescribed opioids and when they pick them up. Moreover, the legislature mandated distributors register with the Department of Health. Melissa DeNoon, from the South Dakota Board of Pharmacy and representing the Prescription Drug Monitoring Program, said the number of legal controlled substance distributors who’ve registered with the state has risen from 30 to 96 percent since March.
“This helps improve patient care and reduce the diversion of dangerous drugs,” DeNoon said.
But South Dakota—like many states—has seen pills flood into its borders in the last ten years. Martinec said doctors prescribed enough opioids in the state last year to medicate every adult for 17 days – although he noted that was an improvement from the year prior, when each adult could have been medicated for 19 days.
The legislators’ approaches to the topic were as varied as the roots of addiction themselves.
Rep. Nancy York, R-Watertown, said she’d heard of opioid abusers bringing pets to veterinarians to procure painkillers.
“Are we doing anything about this?” she demanded.
Amy Iversen-Pollreisz, Deputy Secretary for the Department of Social Services, noted that medication dispersed directly by veterinarians is still not reported to a statewide database.
Leslie Heinemann, R-Flandreau, addressed what he thinks is a societal-wide problem of inaptly dealing with pain.
“How many of us in this room if we’re getting a tooth extracted tomorrow morning want to numb that pain?” Heinemann, a dentist, asked. The observers shifted in their seats. “We need to look at consumers. It’s us. And no one wants to say that.”
He said his daughter-in-law, a nurse, reports that her biggest problem is dealing with patients who come in asking for refills on their prescriptions.
Rep. Blaine Campbell, R-Rapid City, agreed with Heinemann, saying that he believed most pain could be handled with ibuprofen.
From the state’s perspective, pain conversations are part of a cultural shift that needs to happen.
“We want to get to a place where doctors are not asking, ‘How much pain do you have,’ but rather, ‘How functional are you?’” said Iverson.
Yet, structural changes have made a difference, too. Dispensers needing to report every day rather than every week has made life easier for medical clinics looking to prevent diversion.
Rep. Steven McCleerey, D-Sisseton, whose district includes parts of the Lake Traverse Reservation, said he used to hear reports of abusers driving to the Indian Health Service clinic and then going to the emergency room for more pain pills in the municipal hospital the next day.
“Now they’re saying this doesn’t happen as much,” McCleerey reported. “That’s a good thing.”
Earlier this week, three Dakota tribes—the Rosebud, Flandreau and Sisseton-Wahpeton—filed a lawsuit in Sioux Falls federal court against big drug makers, such as Purdue Pharma, and distributors such as McKesson Corp., blaming them for failing to warn patients of painkillers’ addictive nature.
Former U.S. Attorney Brendan Johnson is one of the lead prosecuting attorneys; his firm, Robins Kaplan, successfully sued Big Tobacco in the 1990s in Minnesota.
When Lower Brule Sioux Nation tribal chairman Boyd Gourneau addressed a joint session of the legislature on Thursday afternoon, however, he talked meth, not opioids.
“I’ve personally seen the impact,” said Gourneau, noting the dearth of law enforcement on the reservation, which he attributed to a lack of federal funding in Indian Country. “If ever there were an issue that the state and tribes should band together on … it’s meth.”
For a state like South Dakota, the conversations often bleed into one another. And often, misinformation abounds.
Rounds, in the morning session, suggested that he’d been led to believe from the fight against meth that advertising campaigns do more harm than good. “Do we have any evidence to suggest that these teenagers get more excited about it because of posters or billboards?”
Iverson, who’d earlier noted opioid abuse cuts across age demographics, bluntly replied, “We see the opposite.”
“We want to reduce substance abuse in South Dakota,” he added. “The more data you can provide students, the more we see those conversations pay off.”