Confronting the opioid crisis

What do Americans think should be done about the opioid crisis?

More than 100 Americans die every day from a prescription drug or heroin overdose. A recent study by The New York Times estimates that overdoses accounted for more than 59,000 deaths in 2016, a rate expected to increase in 2017, despite a drop in new opioid prescriptions.

State leaders, including Gov. John Kasich, R-Ohio, and public health professionals have pressed the federal government to invest more to combat the crisis. Last year, Congress successfully passed the Comprehensive Addiction and Recovery Act to do just that, but the total funding level disappointed congressional Democrats.

How do voters think about opioid addiction, and where do they stand on the potential solutions? Are there any geographic or partisan differences that might be translating into political response?

Most Americans believe opioid addiction is a problem.

There’s a widespread consensus that opioid addiction is a pervasive national problem. Two-thirds of respondents in a national Kaiser Family Foundation poll agree that prescription drug abuse is a very serious problem, while 44 percent say they personally know someone who has struggled with addiction.

Opioid addiction is viewed with more sympathy than addiction to other substances, like crack cocaine. In a poll by the American Psychiatric Association, researchers found that 39 percent of respondents believe that it is easy to obtain prescription opioids in their communities, while 69 percent “understand how someone accidentally gets addicted.”

But the public thinks the crisis hasn’t been adequately addressed.

Americans generally believe that neither the government nor medical professionals have properly addressed the crisis. Roughly two-thirds of the Kaiser Family Foundation poll’s respondents agreed that states, the federal government and doctors are not doing enough to combat opioid addiction.

Those numbers are roughly equal — even though state governments have begun experimenting with new measures to address the crisis. Buffalo, N.Y., created the nation’s first opioid court. Massachusetts is applying civil commitment laws to those struggling with addiction, sending them to hospitals or treatment centers to get clean — and several other states are considering similar approaches.

These more compassionate responses largely track public opinion. The American Psychiatric Association poll found people strongly favor expanding access to treatment, with 58 percent in favor. In surveys by STAT and the Harvard T.H. Chan School of Public Health, researchers similarly found that 84 percent of the public prefers treatment programs to jail. Sympathy is fairly consistent across racial groups in relation to opioids, but differs when it comes to drugs like crack cocaine.

But Americans are divided about whether government spending is the solution.

However, the public remains divided on how much the federal government should spend on fighting opioids.

The STAT-Harvard Chan survey, conducted in March 2016, found that only 41 percent of respondents believed that government spending was too low. That poll found relatively small partisan differences, with 45 percent of Democrats supporting higher spending while only 37 percent of Republicans agreed.

I found wider partisan differences in polling conducted as part of the 2016 Cooperative Congressional Election Study. Roughly the same share of respondents — 43 percent — supported increased spending. But that changed significantly by party. Fifty-two percent Democrats supported more spending, compared with only 38 percent of Republicans and 30 percent of independents.

Why the difference? It may be that the Cooperative Congressional Election Study question explicitly mentioned congressional spending, thus prompting partisan reactions to the role of federal power. As always, how you frame a question changes the answer.

Support for more spending is highest where more people are dying.

Another factor changes respondents’ support for federal funding: It’s higher in states with more opioid-related deaths.

The crisis is particularly acute in West Virginia, New Hampshire and Ohio. When respondents are from states with a high per capita opioid-related death rate, at greater than 20 people per 100,000, fully 55 percent of them support more federal spending on the crisis.

Meanwhile, in states with fewer such deaths, public support for more federal spending hovers around 40 percent.

But overall, despite widespread concern with opioids, the public doesn’t seem to feel that more federal dollars are what will make the difference.

So we should not be too surprised that Congress has been reluctant to fund treatment programs, or that such spending becomes a bargaining chip in issues like health care revision.

Travis Johnston is an assistant professor of political science at the University of Massachusetts, Boston. He wrote this commentary for The Washington Post.