Just as denial can perpetuate the struggle for individuals affected by addiction, denial among policy-makers can toughen the challenge that advocates face, suggests the co-founder of a Missouri nonprofit that has been shifting its emphasis away from state lawmakers who have traditionally blocked several sought-after initiatives.
Once again in this year's legislative session, legislation that would have ended Missouri's status as the only state without a prescription drug monitoring program (PDMP) failed to win passage. Also, a 911 Good Samaritan bill that would have offered limited immunity to individuals reporting an overdose languished at the state level.
“It's the stigma associated with addiction—the thought that, 'You're just allowing them to get away with it,'” says Robert Riley II, co-founder of the Missouri Network for Opiate Reform & Recovery, explaining the failure of the Good Samaritan measure. “It's the old mind frame.”
While Riley and his advocacy partner, Chad Sabora, won't give up their state-level efforts against long odds, they also are not focusing solely on the state. Riley, who works as an addiction counselor at the Clayton Behavioral intensive outpatient program in St. Louis, counts among recent victories the establishment of a local-level PDMP in St. Louis County. He adds that leaders in both the county and city of St. Louis generally have been more receptive to initiatives to combat the opioid crisis than state legislators have.
Part of the problem in swaying state legislators, Riley says, is that most of the lawmakers represent suburban and rural communities, and many of those communities' drug users migrate to urban areas to buy and use drugs. He says dats have shown that more than 60% of St. Louis's drug-related deaths involve non-residents.
Riley says of many state legislators from non-urban areas, “They're still in the old stigmatized mindset of, 'We don't talk about heroin here.'”
Both Riley and Sabora were personally familiar with the scourge of addiction. Heroin derailed Sabora's career as a prosecutor in Chicago. He now works in marketing for a Florida treatment center. Riley served federal prison time on drug-related charges and was released in 2008. He began working at Clayton Behavioral last fall.
The two friends' efforts in advocacy started not long after they had helped an individual detox from opioid addiction. “We found we really clicked,” says Riley.
The Missouri Network launched in 2013. In one of his first efforts in the organization, Riley backed a successful measure to authorize all first responders to carry the opioid overdose reversal drug Narcan (naloxone).
He talks like someone who embraces multiple paths to recovery, even though he credits the 12 Steps as the primary influence in his own journey. “Medication-assisted treatment is not being integrated, with all the data being reported, with it being shown as far more effective for opioid addiction,” Riley says.
One victory for the nonprofit at the state level this year involved legislative passage of a measure that will expand access to standing prescriptions at a pharmacy for naloxone, allowing third parties to purchase the drug (the bill now awaits the governor's signature). But there is a grreat deal of unfinished business from advocates' perspective, and Riley and Sabora will be back at it in 2017.