The last time opioids were this big a deal in Idaho was almost a century and a half ago, when they made their way into Boise and beyond through trade routes on the west coast. Opium became a big enough commodity that - in part because Chinese immigrants were implicated - the territorial legislature clamped down, and raids and prosections ensued. The opium market was not eliminated but was largely quashed.
All these years later, opioids have found Idaho again.
The stereotype of an opioid problem area might bring to mind Appalachia or the troubled industrial areas of the northeast, or maybe parts of the rural south. Surely not places like Idaho.
But it’s been no mistake that the state of Idaho (through the attorney general’s office) and a growing bunch of local jurisdictions (Twin Falls just joined the list) have joined into a national lawsuit over opioids - especially their marketing.
Idaho, it turns out, is one of those places in the country harder-hit than most by this new epidemic.
And unlike most contagious diseases and unlike most problems with drug abuse - methamphetamines, say - the opioid drug abuse problem has many of its roots in “legitimate” society, with licensed physicians who got their patients hooked, and with corporate manufacturers of patented products. Filing a lawsuit against a meth dealer would be ludicrous (such an actor would simply be locked up), but that’s not so in the case of opioids, where the road to addiction so often has started with legal prescriptions.
On May 3, the Idaho Falls Post Register reported, “If you live in eastern Idaho, you don’t need anyone telling you about the ravages of the opioid epidemic. Bonneville and Bannock counties have the highest percentage of drug-overdose deaths in the state. Bonneville, along with Elmore, Owyhee and nine other Idaho counties got so fed up with the opioid epidemic they joined a federal lawsuit last year against the makers of OxyContin, Lortab and other opioids.”
And yet the worst of the opioid problem in Idaho seems to be further north. The Centers for Disease Control has broken out prescription rates for opioids by county, and the hottest area in the region - in either Idaho or Washington state - turns out to be the Lewiston-Clarkston area, with adjacent Lewis County (on a per capita basis) coming in slightly higher still. For many recent years, little Lewis County had the highest prescription rates of any county in the western United States.
The Lewiston Tribune’s detailed August 18 story on the problem locally quotes veteran Moscow physician Dan Schmidt, who works around the region - and doesn’t seem especially surprised at the high rates. He notes that Lewiston and Clarkston, with their large stores, may rate high because people from smaller nearby counties shop (and get their drugs) there. He also suggested that the medical community has failed to regulate itself - the profession “dropped the ball.” He recalled, the story said, “drug company sales representatives showing up at his clinic with free food, three times a week.” When Schmidt declined to buy, their visits stopped. But, as he seems to indicate, not all physicians in the area may have reacted the same way.
And he thought the large number of people on disability or who live on very small incomes have a strong incentive to sell legal opioids they get through the local pharmacy.
Legal opioids, of course, often have led to heroin and other illegal opioid addictions; the problems are closely related.
The reports we’re seeing seem to show that the problems are systemic as well as personal. Any attempt to solve the problem will have to consider the systems of medical and pain treatment as well as control over the substances.