A city that has been at the forefront of the American opioid epidemic since its start, Louisville, Kentucky recently experienced an even higher-than-usual increase in overdoses this past week. The city’s Metro Emergency Medical Services reported 151 overdose calls in less than seven days. Concerned that these spikes are no longer mere anomalies-but rather the new normal as the rest of the state and the entire country continues to contend with an increasingly pervasive and sophisticated opioid problem-Louisville has pledged to hire 150 new police officers to crack down on dealers. Louisville Mayor Greg Fischer also plans to collaborate with the DEA on overdose death investigations to get heroin dealers off our streets, and forming a task force with other agencies, including the FBI, the DEA, ATF, the US Attorney, Kentucky State Police and the State Attorney General's Office, to pursue, arrest and prosecute violent offenders.
Other Louisville officials-namely Dr. Joann Schulte, who heads the Metro Department of Public Health and Wellness-have a different approach to combatting the statewide public health issue. In a recent apparent indictment of Louisville’s attitude toward medication-assisted treatment, Schulte told council members that Louisville needs to “grow up” and bolster medication-assisted treatment resources, as abstinence doesn’t work for everyone. Schulte forecasted a dim and prolonged battle with drug addiction in the city that saw 695 overdoses in the first month of 2017 alone. She lamented programs that don’t offer medications like methadone or buprenorphine-based drugs due to fears that patients will be replacing one drug with another. Proponents of mediation-assisted treatment claim that abstinence-based care doesn’t work for every patient.
While there is certainly wisdom in bulking up prevention and enforcement resources in the area, little has been said about Louisville’s plans to expand treatment to its sizable population of opioid addicts. Officials at Louisville’s Norton Audobon Hospital report that more overdoses are being treated at the hospital and the patients require larger amounts of the anti-overdose drug Narcan. They cite a significant spike in ER admissions and that more patients are needing to admitted for prolonged periods, rather than just being treated and released. Hospitals alone can’t offer the comprehensive treatment resources of a high-level treatment facility with medically supervised detox and rehab. While the situation in Louisville is unique in its own right, it also paints a larger picture of the ongoing battle between treatment and enforcement-first approaches when it comes to addiction.