STEVE INSKEEP, HOST:
And let's focus on a state facing this crisis. In Pennsylvania last year more than a dozen people died daily, each day, from a drug-related overdose, heroin and opioids covered there. The state's Democratic governor is Tom Wolf. He's on the line. Governor, good morning.
TOM WOLF: Good morning, Steve.
INSKEEP: Do you want a national emergency declaration from the president?
WOLF: We'll take any help we can get. And I think it remains to be seen what this means, and as Noam said, there's a real disconnect between the Trump administration's disparaging of Medicaid expansion and the Affordable Care Act and what they're going to do. It doesn't look like they're looking at a lot of new resources. Here in Pennsylvania, we've done a lot. We have done a number of things, including a standing prescription for every Pennsylvanian to get naloxone. And we've been able to do that without a health emergency.
INSKEEP: Why don't you describe what naloxone is and why that would be critical?
WOLF: Naloxone is an antidote to overdose. So if someone overdoses, a first responder can administer naloxone - a loved one, a first responder - and can bring a person back to life. Now, that's not the cure. There is no - this is a chronic disease. But someone who's going to receive treatment has to be alive, and so it's a first step to a treatment. But this is...
INSKEEP: Well, then you go on to treatment, and that was discussed there by Noam Levey, who used the phrase an enormous unmet need. The vast majority of people who could use treatment aren't getting it and, presumably, in many cases, don't have access to it. Is that the case in Pennsylvania?
WOLF: It has been, and we're still working on that. Last year in a bipartisan effort, we created 45 new treatment centers all around the state. We've done things like drop-boxes. I think Pennsylvania's doing a lot. And one of the things that has made this effective in Pennsylvania is that we've used the expanded Medicaid. A hundred and twenty-five thousand people are getting treatment, and their providers are getting reimbursed by the expanded Medicaid through the Affordable Care Act.
INSKEEP: OK. So I hear you saying one thing that you want the federal government to do, don't mess with Medicaid or the Medicaid expansion which was part of Obamacare. If President Trump were to call you up and say, give me something else, what is one other thing that I could do as the president of the United States for Pennsylvania, what would you tell him?
WOLF: Well, I'll give you two of the things. In addition to that, the second thing would be to expand the opioid training for doctors. That's something that we're doing in Pennsylvania, but medical schools, the deans of medical schools really, really seem to want. And the third thing would be create a national standing order, a national prescription. Use the surgeon general's power to create a standing order for Narcan for everybody. We've done that in Pennsylvania. It really works. And with this health emergency, he can do that nationally.
INSKEEP: So we've noticed that in Pennsylvania, you've tried to crack down on people who go to multiple doctors to get multiple prescriptions. It's one of the ways that if you're addicted, you would get well beyond the proper amount of certain drugs. But this has also raised concerns. There was an op-ed the other day this week in the Los Angeles Times, and the headline was, "The Opioid Crackdown Is Making Life Untenable For Chronic Pain Patients Like Me." It's a cancer patient writing getting to the dilemma that we are talking very often about, prescription drugs that can be properly used but at the same time can be very addictive. Are you concerned about going too far?
WOLF: Yes. We need to strike a balance, and that's why what we've done in working with the medical profession is to work with them, to work voluntarily where we can. And I think the result is we've had a big drop in doctor shopping, but we have doctors who I think are using opioids much more responsibly. So the person who does have cancer and needs pain medication can use this. There are good uses and bad uses. We're trying to strike that fine balance, and I think in Pennsylvania we're making good progress doing that.
INSKEEP: Governor, I want to understand how you see the problem on the highest level. We've spent a lot of time this year interviewing voters in different counties in your state. Somerset County, to give an example, which is in the center of the state and the Appalachian area of the state. And we talked with employers who said they had jobs that they would struggle to fill because it was hard to find people to pass the drug test. And when you talk with voters, they talk about this as a drug problem, but it seems almost to be a symbol of a collapsing community or a collapsing portion of society. Do you see the drug problem as a symptom of something larger that's going wrong in your state and across the country?
WOLF: No. I think that's what we have to shift away from, the idea that this is some sort of a moral or social failing. This is a medical epidemic, and we need to treat it as such, and people are dying. It's this very serious epidemic. Some have called it a plague. And I think we need to address it. I think employers, families, everyone - it's all over the state. This is affecting rural and urban, north and south, rich and poor, female, male. It's affecting everybody. I think a recent survey said that there are very few Pennsylvanians who don't know someone near and dear who is suffering from substance use disorder. So we need to look at this as the medical problem it is and treat it as such, and I think if we do that, we will be addressing a really important economic and social problem.
INSKEEP: Is it really just different rules for doctors, some better training and more money for treatment? Is that all it takes?
WOLF: I don't think there's any magic solution to anything, least of all this. But I think most doctors want to actually do a good job here for their patients, and so I think the route that we've taken in Pennsylvania is a very effective route to go.
INSKEEP: Well, we'll see what the president adds to that today. Governor Tom Wolf, Democrat of Pennsylvania, thanks for your time. Really appreciate it.
WOLF: Thank you very much, Steve.
INSKEEP: And he talks with us on this day when President Trump is expected to make an announcement on opioids. Transcript provided by NPR, Copyright NPR.
