Congress ups support for opioid fight

The U.S. Senate passed a bipartisan opioid bill last week that authorizes new tools and $8.5 billion to combat the nationwide crisis of overdose and death fueled by synthetic drugs such as fentanyl.

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act overwhelmingly passed 98-1. (Sen. Ted Cruz, R-Texas, was absent and Sen. Mike Lee, R-Utah, voted against it, saying there wasn’t enough accountability built in for the spending.)

The National Institute of Justice, the research body of the U.S. Department of Justice, at a September summit called for a “practitioner-led response” to deter opioid use and for the disruption of illegal drug markets. The Centers for Disease Control and Prevention reported in 2017 that, even though the trend of opioid prescriptions is on the decline, “in 16 percent of U.S. counties, enough opioid prescriptions were dispensed for every person to have one [prescription].”

The SUPPORT Act funds new or expanded grants to help public health labs detect synthetic opioids, and it promotes state and local agency data sharing, first responder training, and many prevention and recovery programs.

The bill also takes aim at imported opioids available online, holds drug manufacturers accountable for their role in the crisis with stiffer fines for negligence, and requires Medicare enrollees to undergo screening for opioid use disorder (OUD). Currently, more than 300,000 beneficiaries have an OUD diagnosis.

The bill would also expand use of non-opioid medications and therapies, as well as research for pain management. Finding nonaddictive medications for pain is “the holy grail of pain management,” Sen. Todd Young, R-Ind., told The Republic. Young helped craft provisions later adopted into the current bill from another one he introduced, the Dr. Todd Graham Pain Management Act of 2018. That bill was named for an Indiana orthopedist killed last year by the husband of a patient for whom he refused to prescribe opioids for chronic pain.

Indiana figured among states whose opioid death numbers spiked in 2017, along with Ohio, West Virginia, and New Hampshire. Nearly 72,000 Americans died from drug overdoses in 2017—more than were killed in the Vietnam War (58,200). Data from 2016 shows that most drug overdoses in the United States involved opioids.

Two landmark provisions of the bill’s legislative package focus on treatment programs for entire families whose members are affected by opioids. Sen. Tim Scott, R-S.C., authored language that calls for “family-focused residential treatment programs” to allow children to remain within the family or with a guardian during treatment. In a tweet last week, Scott said families are “essential building blocks to a flourishing society.” Another Scott-crafted provision for recovery coaching would reunify families separated due to opioid abuse.

“Once signed into law, this legislation sends help to our communities fighting on the front lines of the crisis and to the millions of families affected by opioid use disorders,” congressional leaders from both parties said in a statement heralding the major bipartisan legislative effort.

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No more 9-to-5?

The Wharton School of the University of Pennsylvania’s top professor says shortening the workday from eight to six hours would result in a happier and more productive workforce, and his social media followers agree.

“We can be as productive in 6 focused hours as in 8 unfocused hours,” professor Adam Grant wrote in a LinkedIn post that got thousands of likes and hundreds of comments. Grant, who studies the psychology of work, also acknowledged the constant connection to technology used at jobs makes it harder to set boundaries even if working fewer hours.

A 2015 experiment in Sweden showed nursing home workers who worked only six hours a day—with the same pay—were more efficient, took fewer sick days, and spent more quality time with their patients. But the nursing home had to hire more staff to provide the necessary care hours for their patients, which led to a 22 percent increase in costs for the company, The Guardian reported.

A New Zealand–based movement advocates a similar idea: a four-day workweek. An estate-planning company that tried out a four-day workweek saw increases in productivity and employee satisfaction, but estate planning doesn’t need daily coverage like the healthcare, information technology, or transportation industries do.

Henry Ford back in 1926 reduced the workweek from six to five days for his autoworkers, reasoning that with more time on their hands they would shop on Saturdays and would “require more transportation in vehicles.” The shortened workweek was a clever follow-up to Ford’s 1914 doubling of all workers’ pay to $5 a day. With more money, workers would buy his cars.

Shortened workdays or -weeks benefit some but not all companies. The United States is already seeing record satisfaction among workers: American employees are happier at work now than they have been since the year 2000, according a 2017 Gallup poll. Many factors contributed to 34 percent of respondents being classified as “engaged workers,” a label meaning high enthusiasm and commitment to one’s job. The poll showed greater productivity from higher levels of engagement and better health benefits for employees, all without cutting work hours short.

And for those in poverty, a shorter workday or -week could hurt in the long run because it doesn’t take advantage of their full capacity to work. Creating more full-time work and breaking down barriers to accessing those jobs is the key to alleviating poverty, economic experts say.

“For the working class, as for all Americans, the sense of duty rests on cultural norms—norms that have been eroding and need to be reinvigorated,” Michael Strain wrote for the American Enterprise Institute in 2017. “The norm that if you can work, you should be working, even if the only job you can find pays 65 percent of what you made in your last job—and even if you have to move a few states away for a good job. A recovery of these basic norms would go a long way toward helping the working class lead full and flourishing lives.” —R.H.

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License to succeed

A federal judge in July ruled that the state of Tennessee can no longer revoke the driver’s licenses of poor people for failing to pay court debts.

U.S. District Judge Aleta Trauger ruled that Tennessee’s law contradicted the 14th Amendment of the U.S. Constitution’s due process and equal protection clause. Trauger said the state should have provided an exception for people who were financially unable to pay the fines instead of increasing their burden.

Forty states revoke licenses when people fail to pay their court fines or fees. But many states do not distinguish those who will not pay from those who cannot. Some argue that revoking a driver’s license is a counterproductive punishment: If the person cannot drive to work, he or she will be even less likely to pay the debt in the future.

The American Legislative Exchange Council encouraged lawmakers to limit license suspensions to offenders who may pose a danger on the road, including those charged with drunk driving or multiple moving violations.

Several states are reexamining their laws. Last summer, California stopped suspending licenses because of unpaid court fines. In September, the Oregon Law Center filed a class-action lawsuit against Oregon’s Department of Transportation and Department of Motor Vehicles for discriminating against poor people. Lawyers argue the state should let people try to prove they cannot pay the fees before revoking their license. Michigan, Montana, Pennsylvania, and Virginia have similar cases pending. —Charissa Crotts