4 Thursday, May 31, 2018 The Michigan Daily — michigandaily.com OPINION 420 Maynard St. Ann Arbor, MI 48109 tothedaily@michigandaily.com Edited and managed by students at the University of Michigan since 1890. I n 2016, it was estimated that opioid overdoses killed more Americans than the Vietnam and Iraq wars combined. The Michigan-OPEN website which keeps track of roughly how many opioid-related deaths occur each day. At the time of writing this column, the number stands at 115. With hundreds of Michiganders dying of opioid overdose every week, you would think the state and local governments would have a pretty good handle on addressing this devastating public health crisis. While there are some effective government interventions available to help Michiganders struggling with opioid addiction, these efforts are not enough and the patchwork of policies and institutions to address opioid addiction is a mess to navigate. I have an internship at Workit Health this summer, a telehealth program that provides treatment for opioid addiction. Recently, our clinical operations manager and I sought to find a source of free naloxone kits for patients. Naloxone (brand name: Narcan) can reverse an opioid overdose and save someone’s life. It is available without a prescription at places like CVS Pharmacy; however, the cost of a Narcan kit for someone without health insurance is almost $100. In the emergency situation of an overdose, forcing a person’s friends or family to fork over $100 they may not have is both impractical and cruel. Access to free or reduced-cost naloxone kits is not only benevolent, but also makes fiscal sense. According to a White House- commissioned report, the estimated cost of overdose deaths in 2015 was $431.7 billion. That comes out to be about $30,000 per death by overdose shouldered by taxpayers. But what did we find when we went in search of free affordable naloxone kits for those at incredible risk for death by overdose? A lot of headache and no naloxone. First, we called the Washtenaw County Health Department and the Washtenaw County Sheriff’s Office. They told us there was a service to provide a free naloxone kit to those who survived an overdose but not for people who have yet to overdose. So much for prevention. Then, we called our state representative’s office to see if their constituent services desk knew about the resource. The person on the line did not know any places to find free or reduced-cost naloxone kits but said they would look into it for us and call back. The staffer called back soon after, giving us two numbers we could call. We were excited to be on the right track — that is, until we called both numbers. They were disconnected. Last summer, I experienced another side of Michigan’s attempts to combat opioid addiction as a pharmacy technician at an independent pharmacy in Detroit. Towards the end of my time there, Michigan State Police raided the clinic of doctor Mohammad Durrani in Dearborn because he prescribed more than 500,000 pain pills between January and August 2017. The bust spooked the physician in the clinic attached to the pharmacy in which I worked. In a panic, the physician began to only write prescriptions for a seven- day supply of opioids and a referral to a pain management specialist regardless of circumstance. This physician had no real reason to be afraid of law enforcement or of losing his license, but his patients suffered, as they lamented to us at the pharmacy, because of their provider’s unnecessary, but understandable, panic. I — and many people more educated and experienced in addiction care— worry that coming down hard on prescribers of opioids will limit the flow of pain pills to patients who might genuinely need them and risks needless suffering for patients. This may also push people from pain pills to heroin, which is much cheaper and easily accessible illicitly. Yes, opioids have been over-prescribed (there are more opioid prescriptions in Michigan than people). However, indiscriminately restricting access to opioids is not the answer. Medicine has come a long way in recognizing how to safely use pain pills and patients who need them should not be denied pain relief. Michigan communities have been devastated by addiction to pain pills and heroin. At the very least, state government should create a central, well-advertised directory for Michiganders looking to locate resources like affordable naloxone kits. State policymakers should also explore policy to encourage more clinicians to treat addiction with buprenorphine and ensure that clinicians who are prescribing opioids properly are not afraid of arrest or loss of license. ETHAN KESSLER | COLUMN EMMA CHANG Editorial Page Editor EMMA RICHTER Managing Editor Emma Chang Joel Danilewitz Samantha Goldstein Elena Hubbell Emily Huhman Tara Jayaram Jeremy Kaplan Sarah Khan Magdalena Mihaylova Ellery Rosenzweig Jason Rowland Anu Roy-Chaudhury Alex Satola Ali Safawi Ashley Zhang Sam Weinberger Unsigned editorials reflect the official position of the Daily’s Editorial Board. All other signed articles and illustrations represent solely the views of their authors. ASIF BECHER Editor in Chief EDITORIAL BOARD MEMBERS ALI SAFAWI | COLUMN An epidemic mismanaged Ali Safawi can be reached at asafawi@umich.edu. Expand the franchise A s spring gives way to summer, first-round campaigning has given way to primary elections, which will soon give way to final elections in November. Significantly low levels of voter turnout in midterm elections and among the American electorate in general mean every vote will count. Over 6 million Americans, however, are likely to be excluded from this influential swath of voters because of felony convictions, with many states offering felons little chance to actually regain the right to vote after imprisonment. This exclusion occurs across a surprising majority of U.S. states, signaling a consensus that has impinged on American democracy for long enough. It is time to categorically restore the right to vote among felons who have served their time. Denying ex-felons the right to vote may seem like a reasonable measure, but at its core, it is nothing less than an assault on the backbone of democracy. The practice most notably came into prominence in the South following Reconstruction. During this time, Southern states, eager to return their legislatures to a state of white dominance, set about finding ways to eliminate African-American votes. Felon disenfranchisement statutes succeeded at reducing African- American voter registration relative to white voter registration in the South, taking advantage of higher conviction rates among African-American people for many crimes. Beyond its role in subjugating African-American people to the laws of Jim Crow for most of the 20th century, felon disenfranchisement has damaged America’s democratic foundation by denying many citizens a voice in choosing our leaders. In 2018, generations after voting discrimination by race and by gender have been defeated, it is easy to take suffrage for granted. As citizens, however, we must not forget that voting is the preeminent method by which citizenship is exercised. Without suffrage, the power of the people to choose their leaders – the very dynamic that underpins representative democracy – ceases to exist. It follows that the extension of suffrage to more citizens serves to better the government’s representation of the people, preserving the essence of representative rule. We do not vote because we are citizens; we are citizens because we can vote. As long as this system of government for and by the people rests on the right to vote, voting must be upheld as a fundamental right. That is why voting, though not explicitly mentioned in the Bill of Rights, is constitutionally protected. It is also why restrictions on who can vote have recently been narrowed to exclude only those incapable of full legal capacity – that is, minors, convicted criminals and the mentally incapacitated. The continued application of voting restrictions to former convicts, however, invokes a moral argument contradictory to this established reverence for voting. Allowing states to bar ex-felons from voting because those unwilling to follow the law shouldn’t make the law, fails to establish a strong relationship between a legitimate state interest and the disenfranchisement of a narrowly tailored group. This failure becomes apparent when inspecting the relationship between, say, the legitimate state interest of reducing violent criminal activity and the commonplace restriction on firearm ownership by ex-felons. Convicted violent criminals are more inclined to use weapons for criminal purposes in the future, so in this case, they must yield their Second Amendment protections to the valid state Continue reading on page 5. “Over 6 million Americans, however, are likely to be excluded from this influential swath of voters.