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THE DAILY ASTORIAN • TUESDAY, APRIL 10, 2018
editor@dailyastorian.com
KARI BORGEN
Publisher
JIM VAN NOSTRAND
Editor
Founded in 1873
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Business Manager
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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