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About The daily Astorian. (Astoria, Or.) 1961-current | View Entire Issue (April 10, 2018)
6A THE DAILY ASTORIAN • TUESDAY, APRIL 10, 2018 editor@dailyastorian.com KARI BORGEN Publisher JIM VAN NOSTRAND Editor Founded in 1873 JEREMY FELDMAN Circulation Manager DEBRA BLOOM Business Manager JOHN D. BRUIJN Production Manager CARL EARL Systems Manager OUR VIEW Mercy, wisdom key to opioid response O pioid overdoses are killing an average of 115 Americans a day, with 40 per- cent involving prescription painkillers. Opioids accounted for two-thirds of the country’s 63,600 overdose deaths in 2016. Frightening statistics like these have become mind numbing and might be dis- missed as typical government scare tactics were it not for the fact that Americans personally experience opioid-related losses and see the impacts in our communities. Here near the mouth of the Columbia River, unavoidable clues include arrest reports, needle exchanges and the swelling industry of addiction recovery. Intertwined in the complexities of citizens share: “Good drug policy is about balance between reducing sup- getting a handle on opioid damage is the ply and reducing demand, and a lot of fact that severe pain is a profound every- the language and rhetoric that comes day crisis for millions in the country and out does feel a little thousands in the Lower too heavy on the law Columbia communities. There will be enforcement side.” With a population that Much of what skews distinctly older than much less support is happening in average, many of whom terms of govern- have led physically strenu- for imprisoning ment response to ous careers, pain control is those caught the opioid epi- a vital public service here. using the drugs, Any effort to lessen the demic isn’t hap- for whom toll of opioid deaths must pening in criminal carefully determine how to treatment and justice, but in reg- alleviate suffering. ulations on the fed- efforts at recovery eral and state levels. Not just enforcement These are obviously remain the most The Trump adminis- of great importance tration’s newly appointed humane and cost- in keeping more opioid coordinator in effective options. people from getting the U.S. Department of stuck on the addic- Justice, Mary Daly, has tion treadmill. At witnessed the crisis ramp the same time, such steps require more up during her 13 years as a drug pros- nuance and flexibility than bureaucra- ecutor in New York and Virginia. She cies typically are able to bring to such promises “aggressive enforcement,” sensitive matters. something we all agree is appropriate In late March, for example, the New when it comes to dealers in heroin and York Times published an in-depth story the powerful new synthetic opioid fen- with this headline that caught the atten- tanyl. There will be much less support tion of many pain sufferers and their for imprisoning those caught using the loved ones: “Medicare Is Cracking drugs, for whom treatment and efforts at Down on Opioids. Doctors Fear Pain recovery remain the most humane and Patients Will Suffer.” Medicare’s cost-effective options. amended rules, which have been set for An East Coast addiction-treatment final approval this month, seriously limit advocate expressed a view to National payments for long-term, high-dose pre- Public Radio that many ordinary U.S. scriptions. Unless it is modified in some AP Photo/Elise Amendola President Donald Trump gestured as he spoke about his plan to combat opioid drug addiction at Manchester Community College in March. way, Medicare will start denying cov- erage for pain prescriptions equivalent to 90 milligrams or more of morphine daily, except for patients with can- cer or in end-of-life hospice care. Not only will this affect more than 14 mil- lion whose pain drugs are covered by Medicare, but private insurance com- panies and hospitals often pattern their own coverage policies after Medicare. Clumsily done, this will hurt. Nuance needed “A lot of the opioid dose escala- tion between 2006 and 2011 was terri- bly ill advised,” a pain physician told the Times. “But every week I’m trying to mitigate the trauma that results when patients are taken off opioids by clini- cians who feel scared. There are superb doctors who taper as part of a consen- sual process that involves setting up a true care plan. But this isn’t it.” Such transitions off opioids will be even trickier here and other rural areas, where physician-guided alternative pain care is scarce, and where tight finances and poor health make it hard to obtain care along the Interstate 5 corridor. For many, staying off opioids is easier than getting off them. Moving forward, the World Health Organization sup- ports a three-step approach that begins with nondrug therapies for pain, includ- ing physical therapy, massage, exer- cise and education. The next step could be a weak opioid, possibly coupled with something else, such as an antidepres- sant. Only as a last resort would stron- ger opioids be prescribed, with ongoing efforts to identify less potentially dam- aging alternatives. All this is reasonable. But we must not pull the rug out from under existing pain patients with- out identifying an achievable fall-back strategy for managing pain and weaning them off opioids. for years, and because the FTLAC won’t be advising the Board of Forestry until the Linn County lawsuit is resolved, which could take several years. That renders irrelevant the hackneyed argu- ment made by Tillamook County Commis- sioner David Yamamoto the night of the vote. He stated repeatedly that our county might lose its “seat at the table.” Why was he there, anyway? The reason could be that our commission’s strong stands on the Linn County suit, and not paying the CFTLC dues, call into question the validity of the lawsuit — which, if successful, would most likely result in increased timber harvest in state forests, a position advocated by Yamamoto and fellow commissioner Tim Josi, who has long chaired the FTLAC, where he has pushed his personal agenda of more clear-cutting of older forests before endan- gered species inhabit them. ROGER DORBAND Astoria the number of mental health persons is one of the reasons why we need a bigger and bet- ter jail. One does not need to be a psychiatrist, however, to understand that confinement to a jail is wholly inappropriate for persons with extensive mental health issues. Clatsop County is the seventh-highest income producer among the 32 counties of Ore- gon. Perhaps it’s time for the Lutheran and Cath- olic hospitals to join with the county in soliciting funds to establish an inpatient care facility for those with severe mental illness. It appears that this is a basic Christian and human need. GEORGE McCARTIN Candidate, Clatsop County commissioner, District 1 Astoria LETTERS TO THE EDITOR Your veterans need your help E very weekday at 7 a.m., the Disabled American Veterans van departs from the parking lot on Marine Drive just west of Burger King, with veterans who have medical appointments at the Veterans Affairs Medical Center in Portland. Our local veterans depend on this trans- portation for medical treatment they other- wise would not receive. Many are treated for life-threatening conditions, and have no other way to see their physicians. This crucial service is provided by volun- teer drivers who deliver the veterans to their appointments, have breakfast and lunch (on the VA) or read in a drivers’ lounge, then return to Astoria that afternoon when all the veterans have received their treatments. We need additional drivers to continue pro- viding uninterrupted service to our veterans. You can make a difference by ensuring our veterans receive the medical treatment they deserve. Do you have one or two days a month to help serve our veterans? Find out how you can help by calling Dick Lang at 503-298-8757 or send- ing an email to AstoriaDAVvan@charter.net The commitment to be a driver will earn you a free physical examination, breakfast and lunch in the veterans’ cafeteria on the days you drive, and a wonderful feeling of satisfaction you get by helping our veterans. Please, join us now. DICK LANG Astoria Wev is the best choice for District 3 C latsop County needs a District 3 commis- sioner with fresh ideas and actual expe- rience in leading change. That person is Pam Wev. Her life experiences and her background in planning and business development make her a perfect fit. Pam has worked with dozens of govern- ments to help them prepare for and capitalize on growth. She is from a Coast Guard family, giving her insight into what it takes to sup- port one of our largest economic drivers. She has raised a family as a single mother, show- ing her the value of work, discipline and empa- thy for those struggling to make it from today to tomorrow. Pam is focused on the same community concerns we all share — sustainability of our forests, fisheries and farms; affordable housing; and transportation and emergency response infrastructure to cope with geologic or weather events. She knows those same transportation upgrades are needed to move our people, tour- ists and port shipments. The biggest reason I am voting for Pam is her character. In a time when politicians will say anything to get elected, Pam stands out for her honesty, fairness and moral character. Pam Wev has my vote for District 3 commissioner, and I ask you to vote for her, too. BRYAN KIDDER Astoria Vote Orr for House District 32 I am delighted to endorse John Orr for Ore- gon House District 32. The progressive val- ues of the North Oregon Coast could not be better served. John is clearly ready to take on issues that are important to the district. He’ll demand eco- nomic and social equity. He’ll champion our small businesses. And, he’ll be a strong voice to protect our irreplaceable environment. John has the discernment and tenacity to influence the state government to respect the needs of his constituents. With his attention to detail, he’s ready to create and improve com- plex legislation from the day he takes office. I’ve known John for several years, and I’ve often enjoyed his thoughtful insights. He has a brilliant mind, matched with genuine curiosity and respect for the views of others. This is an opportunity to elect an engaged and accessible representative. Thank you, John, for offering your service. PETER HUHTALA Former Clatsop County Commissioner Tigard Commissioners got it right T he Daily Astorian’s recent headline, “County mistakenly exits forest com- mittee” (April 6) suggests that the commis- sion bungled their decision not to pay dues to the Council of Forest Trust Land Counties (CFTLC) because they were not fully informed they could lose their voice on the Forest Trust Land Advisory Committee (FTLAC). But there was no mistake made by the com- mission. A more accurate headline would have read, “Commissioners take a brave stand for balanced forest management.” Chairman Scott Lee’s explanation makes it clear that the commission’s status with the FTLAC was insignificant in their decision, because that body has not represented our county’s balanced forest management position Inpatient care needed for mental illness O nce again the North Coast experiences “anger, frustration and uncertainty,” at the actions of a seriously mentally disturbed indi- vidual, Noel Moor (“Behind a tragedy in War- renton, an uncertain diagnosis,” The Daily Astorian, April 6). Ms. Moor is presently incarcerated. She is not alone, as the sheriff indicates that Vote Orr for state representative J ohn Orr is my choice for Oregon House District 32. He is forward-thinking and independent from any special interest groups. John has passion and will fight for us, the cit- izens of District 32. People from outside our district have worked at getting his opponents to run. These are people trying to get someone they want in Salem. We need to decide who represents us, and not special interest groups. Please join me in voting for John Orr in the pri- mary. We need a strong Democrat to represent us, the people of District 32. JAN COUGHLIN Astoria
