DeWine, Cordray trade attacks over opioids in pointed debate
By JULIE CARR SMYTH
Wednesday, September 19
DAYTON, Ohio (AP) — Ohio’s major-party governor candidates were harshly critical of each other in a spirited first debate Wednesday, jabbing each other over contrasting policy positions on opioids, abortion and e-schools and poking the other’s record in public office as a failure.
The evening’s rapid-fire exchanges, attacks and one-liners contrasted with the race’s reputation as a sleepy contest between two boring politicians.
Democrat Richard Cordray, who served as consumer watchdog under President Barack Obama, set the tone at the University of Dayton seconds after shaking Republican Attorney General Mike DeWine’s hand.
Cordray, 59, criticized DeWine as a career politician who believes the governor’s chair is the next step up the ladder, then said he had failed to do enough to stop the state’s opioid epidemic as the state’s top law enforcement officer.
“I will face down the drug traffickers and the big drug companies to fix the opioid crisis, but, Mike, you have had eight years to deal with this problem and you have failed Ohio,” Cordray said.
DeWine, 71, said Cordray was “living in a fantasy world” by claiming DeWine had not used his office effectively to fight pharmaceutical companies, e-school corruption and gun violence. He said Cordray left the office in disarray. “You’re all talk and you’ve done nothing. You’ve been a failure at every job you’ve ever had,” DeWine said.
Cordray said he is proud of his record, including at the Consumer Financial Protection Bureau.
But his primary aim was DeWine’s handling of the opioid crisis. He said taking advice from DeWine on solving the opioid epidemic would be like “asking for navigation advice from the captain of the Titanic.”
Cordray also took issue with DeWine’s proposal to appoint a drug czar if elected. “News flash: We already have an opioid czar,” Cordray said, meaning DeWine. “When you see him, tell him he’s doing a horrible job.”
The two are vying to succeed Republican Gov. John Kasich, who’s term-limited, in one of the season’s highest profile governor’s race.
On abortion, Cordray said he would veto a so-called heartbeat abortion bill limiting the procedure when the first fetal heartbeat is detected. After he was prodded by Cordray to state his position, DeWine said he would sign the stringent restriction if it crossed his desk as governor.
The candidates’ positions also differ on Issue 1, a statewide ballot question that calls for reducing criminal sentences for non-violent drug offenses.
DeWine said their stances on the issue give voters a clear choice.
“Richard Cordray would put a star on Ohio and every drug dealer … would come here,” DeWine said. He called Cordray’s support of the issue dangerous and “totally outrageous.”
Cordray called DeWine’s statement misleading. He said too many Ohioans are in prison for such offenses and there are more humane, productive and cost-effective solutions for drug offenders.
DeWine came out strongly against legalizing marijuana for recreational use and jabbed at Cordray for skirting the issue in his answer.
“You’re really a profile in courage,” DeWine quipped. “You’re not going to take a position on recreational marijuana?”
Cordray said DeWine was “living in the past.” Once pressed by DeWine, he said if recreational marijuana is back on the ballot, he would vote in favor of it — but he believes the question should be put to Ohio voters.
Cordray attacked DeWine for failing to do enough to protect Ohioans from the now-shuttered e-school ECOT, or the Electronic Classroom of Tomorrow, which Ohio education officials say over-billed the state $60 million by inflating attendance.
When DeWine said he is fighting in court to recoup money from the school, Cordray said, “That’s not a protect-Ohio lawsuit; that’s a I’m-running-for-governor lawsuit.”
How many Americans really misuse opioids? Why scientists still aren’t sure
September 20, 2018
Associate Professor of Population Health, New York University Langone Medical Center
Disclosure statement: Joseph Palamar receives funding from the National Institute of Drug Abuse
With rates of prescription opioid use disorder and opioid-involved overdose deaths on the rise, the U.S. opioid crisis appears to be continuing unabated.
Data on overdose and death are pretty reliable. But there’s still much that’s unknown about opioid misuse that doesn’t lead to an adverse outcome such as overdose.
Drug surveys are reseachers’ main method of collecting data on opioid misuse. I’ve been in drug survey research for almost two decades, but in recent years I’ve learned that collecting accurate data on opioid misuse in particular is difficult. Why? Because many people underreport misuse, while others unintentionally overreport misuse.
Colleagues have been asking me how to ask about opioid misuse on surveys. I’m finding that there’s no easy answer. But one thing I’ve learned in my research is that many people may misunderstand the basics about opioids, preventing researchers like myself from understanding the full scope of the epidemic.
Medical use and misuse
Drug surveys are already difficult to conduct, as many people lie about use. For example, some people deny use to appear more socially desirable, and others simply try to finish the survey quickly without really reading it. But opioid surveys are especially challenging.
A friend of mine recently took my drug survey. She texted me the next day, saying she believed she incorrectly answered my opioid questions. Even though my survey asked only about using to get high or using without a prescription, she admittedly didn’t read the directions and reported misuse of dilaudid, a pain medication.
Situations like this lead some researchers to distrust reportedly high rates of opioid misuse. For example, a few years ago, my colleagues and I estimated that 12 percent of high school seniors have ever misused prescription opioids. However, some of my reports focusing on such national data have (perhaps rightfully) been questioned, but we are limited by what people report.
On surveys, opioid misuse is sometimes defined as using without one’s doctor telling you to do so. Other times, it’s defined as using without a prescription. The most accurate definition is use not directed by a doctor, including using opioids without a prescription or using greater amounts, or more often or longer than directed.
It’s important to include definitions of opioids and misuse on surveys. However, such definitions are meaningless if those taking the survey refuse to read them.
Misuse is also a confusing concept, as it is possible to use as prescribed and still enjoy the feeling resulting from use.
Lack of knowledge
Even though the public is now largely familiar with the term “opioids,” many people still don’t appear to know which drugs are opioids and which are not. For example, my colleagues and I discovered that a over a third of high school seniors who reported nonmedical Vicodin or OxyContin use denied using opioids nonmedically overall. This suggests many users may be unaware that these drugs are opioids.
Opioids are commonly referred to opiates, painkillers, pain relievers, narcotics and analgesics. While “opioid” now appears to be the most common term, an individual familiar with the term may become confused when asked about different terms such as prescription painkillers or narcotics. The term “narcotics,” for example, can lead to confusion, as the Controlled Substances Act also includes cocaine as a narcotic.
Confusion may also arise regarding drug names. For example, OxyContin misuse may be overreported by individuals who used weaker oxycodone formulations. Codeine misuse may also be overreported by those claiming misuse of Tylenol III, which contains codeine, when they only used regular Tylenol.
I’ve also noticed that many people also don’t know the difference between methamphetamine, a potent stimulant, and methadone, an opioid. I learned about such confusion firsthand, after receiving multiple questions about methadone from social workers during a presentation I was giving about about methamphetamine.
Concoctions that contain opioids, such as “Sizzurp” (also known as “Lean” or “Purple Drank”), typically contain codeine cough syrup in a soft drink such as Sprite. Many users of this concoction likely deny codeine misuse.
It’s difficult to determine whether estimates of U.S. opioid misuse are too high or too low. Accuracy of these statistics is important, as they guide research, prevention, harm reduction and policy.
Researchers can use surveys to help educate people about opioids while collecting data. But first we need to figure out how to get people to read the questions.