Editorial: Legislation attacks addiction at its source

The best thing about an anti-heroin proposal that's been gaining some traction in the legislature may not be its direct impact on heroin abuse so much as its value in emphasizing the role of the medicine cabinet in producing addicts.

According to the National Institute of Drug Abuse, nearly half of young people who inject heroin surveyed in three separate studies said they abused prescription drugs before they became involved with heroin. The Foundation for a Drug-Free World estimates that every day, 2,500 teenagers abuse a prescription pain reliever for the first time.

The path from the prescription bottle to the needle starts with pills of pain relievers like Fentanyl, Vicodin or OxyContin that easily can be crushed to powder and snorted. In strict pill form, the drugs are absorbed differently by the body and don't produce the dramatic high that results from snorting them as powder. New technology enables manufacturers to produce pills that cannot be crushed, but these pills are considerably more expensive and many insurance companies won't cover them. New legislation pushed by Democrats Dan Kotowski, of Park Ridge, in the Senate and Emily McAsey, of Lockport, in the House would require insurance companies to provide coverage when tamper-proof pills are available.

The issues are by no means clear cut. Many so-called opioid pain relievers aren't even available with abuse-deterrent properties, so the law does not attack the entire complement of modifiable prescription drugs. Moreover, even if covered by insurance, abuse-deterrent pills will cost patients considerably more than generic, crushable forms of a given pain reliever, and many patients no doubt will choose the less-expensive option.

But the new legislation, known as HB 2743, sponsored by Chicago Democratic Rep. Sara Feigenholtz, would at least ensure that patients and doctors have an option. Without it, experts say, the cost differential is too great for most patients to overcome. That may change over time, of course, as abuse-deterrent pills become more common and as more pain relievers become available in that form. In the meantime, prescription drug abuse remains a significant problem in its own right in addition to its link to heroin abuse. It's clear we need solutions that will make it more difficult to convert legally prescribed and, let's not forget, medically necessary pain relievers into a form that is easily abused.

Insurance companies understandably fret over the potential for legislation like this to lead to substantial increases in the cost of these already expensive drugs. And, to be sure, the insurance companies can't be the only responsible party in the complex network of individuals and agencies linked to the problem of prescription drug abuse.

But HB 2743 doesn't place an onerous burden on them, and some of its upfront costs will surely be offset by reduced medical costs of dealing with addiction. Nor should anyone be fooled into thinking the bill provides any sort of panacea or takes us to the threshold of a solution. But it is one useful weapon in a growing arsenal of ideas that attack addiction where it starts, which increasingly is not in some dingy city back alley but in the bathroom of a suburban home.