Lawmakers continue to wrestle with ways to solve Kentucky's growing heroin epidemic as the start of a new legislative session in Frankfort nears.
Legislators have pre-filed several bills aimed at the combating the issue, but the parties remain divided on key points.
Democrats like Rep. Tom Burch of Louisville disagree with Republicans who want to implement harsher penalties against heroin traffickers.
“Although I'd like to hang them out, I'm interested in saving the person who's addicted,” Burch said. “We need to shift from putting people in prison to putting them in treatment.”
Sen. John Schickel, a Union Republican and former police officer, and Republican Sen. Chris McDaniel, of Taylor Mill, have co-sponsored a bill that pushes penalties more than treatment.
“The sad fact is that treatment has not been successful,” Schickel said. “Until we get our hands around this cheap supply, treatment is really futile.”
The bill would focus on treating addicts in jails, giving $7.5 million to county jails for inmate treatment, and $5.8 million would go to mental health agencies for additional treatment. The bill has already been endorsed by the Kentucky Association of Jailers and the Northern Kentucky Chamber of Commerce.
The legislation could be a challenge for already overburdened substance abuse treatment programs in state corrections facilities.
The waiting list for the six-month residential Substance Abuse Program through Kentucky’s DOC is currently more than 2,000; the program is offered in only nine of the 13 state prisons.
Legislators have known about this dilemma for at least four years, though some lay the blame on new Kentucky laws that in 2013 clamped down on pill mills.
A 2010 report advised lawmakers that ”with no increase in state or federal funding over the past 14 years, treatment capacity cannot increase and, in fact, cannot maintain its current level of service without reducing the intensity of care provided.”
They were warned again in 2011: The University of Kentucky Center for Drug and Alcohol Research noted that residential substance abuse treatment beds, including those funded by the Department of Corrections, are consistently at capacity and most report waitlists, indicating an extremely over-burdened system of care.”
And in 2013, another warning that even with the added 5,800 Medicaid slots and projected savings from prison reform, the need will continue to exceed supply.
The state currently puts $6.8 million into correctional substance abuse programs ( upfrom $1.76 million in 2009, at a cost of $1,851 per person for substance abuse treatment. The funds come out of the state’s mental health budget, which has been cut significantly in recent years.
Between 2009-2011, $193.7 million in state mental health funds were cut from the budget, about half of the overall General Fund budget for mental health services.
In Kentucky, as in 43 other states, more mentally ill people are housed in prisons than in hospitals. In 2012, there were 10 times the number of mentally ill people in jails as were in hospitals nationally, and jails are often unable to help these inmates.
Recent statistics show Kentucky has an average daily jail population of 21,471. Between 19 and 25 percent of those inmates are serving time for drugs, but only 618 completed a substance abuse program.
Schickel is also sponsoring a second bill which would re-elevate heroin trafficking charges to a Class C felony from a Class D, a classification they’ve held for four years.
“For the first time in the history of Kentucky, we have more lenient trafficking laws than Ohio,” Schickel said. “And that’s part of the reason we have such large numbers of heroin trafficking in northern Kentucky.”
Class D felons typically serve time at county jails, according to the Kentucky DOC, meaning the proposed additional $7.5 million directed to county jails in the McDaniel bill would be less likely to provide treatment for those Class C felons.
Mounting Casualties
While the parties search for common ground, addiction remains at an all-time high.
Over the last 12-month period, Kentucky judges have presided over 1,635 heroin-related cases, according to the Administrative Office of the Courts.
Veterans are a particularly vulnerable population for heroin addiction. Laura Schafsnitz of the Robley Rex Veterans Administration Medical Center reports that in Louisville alone, the VA took in 416 new patients for heroin addiction over the past calendar year.
“This does not count hundreds of veterans who were already in treatment. We served 178 Veterans in our residential treatment center this past year,” said Schafsnitz.
Sixty percent of Kentucky’s heroin prosecutions occur in northern Kentucky, along the Ohio border, according to the Kentucky Office of Drug Control Policy. And even high-school students are using heroin at twice the national average in the area, according to 2011 numbers from the Center for Disease Control and prevention.
Constitutional Concerns
A bill that would have allowed law enforcement to charge heroin traffickers with homicide, if a user fatally overdosed on their drugs, died in the final hours of the 2014 legislative session.
Support waned for it as questions arose about the measure’s constitutionality.
Schickel, who pushed that legislation with Sen. President Pro Tem Katie Stine, explained that his new bill excludes these provisions. Instead, convicted traffickers would have to serve 50 percent of their sentence before considered for probation.
"Some of the provisions in there I thought were somewhat awkward and possibly unconstitutional,” Schickel said of last year’s bill. “The legislation we have this year is both practical and constitutional. And I also think it will be an effective deterrent for traffickers coming from Ohio."
Sticking Point
For many Republicans last session, a Democratic push for establishing needle-exchange programs was a point of contention.
“I won't vote for any bill that has a needle-exchange in it,” Schickel said.
“People make choices in life. And using heroin is a choice. To provide these people, at government expense, the very tools they need to abuse themselves is not good policy.”
Rep. Joni Jenkins, a Shively Democrat who has been working on the Burch bill, appears open to compromise here.
“We need to pave the way for local communities to voluntarily have needle exchanges,” Jenkins said recently. “They've been highly successful in other parts of the country. Not only do they cut down on the number of stray needles you find in places like parks, but the centers also become places of intervention when addicts come in.”
Common Ground
Both parties favor equipping police to better tackle heroin. Lawmakers want to train police and emergency personnel on heroin-specific crimes and equip them with anti-overdose medication Naloxone.
Jenkins intends to file a bill that would allow family members to check addicts into treatment centers if they're incapacitated. Similarly, a Good Samaritan clause in several proposed bills would prevent someone from arrest if they brought an overdosed user to a hospital.
“We're seeing people push overdose victims out of the car into the hospital parking lot, and just leaving them to die,” Jenkins said.
Lawmakers will convene in Frankfort on Jan. 6 at the start of the 2015 legislative session.
