PORTLAND, Ore. -- As the opioid crisis continues to haunt the country, communities are looking for ways to fight back.

Opioid use causes about 91 deaths a day in the United States and resulted in an historic high of 33,000 deaths in 2015. And the Centers for Disease Control and Prevention said that number actually could be an under-estimation.

In Oregon, the rate of opioid deaths is higher than the national average. Dr. Safina Koreishi, medical director at Columbia Pacific Coordinated Care Organization, said it's even worse for the North Coast where she works. She said cultivating trust among community members can be a useful prevention tool, because addiction doesn't happen in a vacuum.

"Talking about, within the community, how trauma can affect all of this; and that is something that we've been working on with our community,” Koreishi said. "And our community within the North Coast is really passionate about it and has been struggling with it and moving forward regarding what does community resilience mean and how can we collectively build that."

Koreishi said there are many facets to fighting the epidemic, but the best tool is education. She said opioids should not be the first choice for treating chronic pain, and it's important for medical professionals to know that.

For instance, getting better sleep may be a more effective tool for treating pain than prescription pain medications. And Koreishi said it's imperative to get pills off the streets.

"We've funded and helped the community start drug take-back boxes within pharmacies so it's easier for people to give back unused pills,” she said.

Koreishi said she believes we're in the midst of a societal paradigm shift regarding these drugs, but she isn't sure we've reached the tipping point yet. She said everyone has to help to stop the staggering destruction that opioid abuse has wreaked on the country.

"It's everybody's responsibility to get us out of this, and I literally think every single person within society plays a role in addressing this,” she said; "just like in addressing any other major, complex societal issue."

In April, the federal government distributed money to states to help fight opioid abuse, including $6.5 million for Oregon, as part of the 21st Century Cures Act. Some members of Congress have argued the legislation does not provide nearly enough to fight the crisis.



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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.