Indiana Gov. Eric Holcomb's new drug czar on Thursday detailed a plan to combat the opioid crisis in the state, which has seen a dramatic increase in overdose hospitalizations and deaths over the past five years.
A key question remains, though: Will there be enough funding to make a significant difference?
"We are trying to identify how we can best utilize the resources the state has," said Jim McClelland, a former central Indiana Goodwill CEO who was tapped earlier this year by Holcomb to oversee the effort. "We need to know, 'OK, where are we now, where do we want to be? What's the gap? How do we fill that gap?'"
Indiana saw a more than 300 percent increase in the number of overdose deaths from heroin between 2010 and 2015, climbing from 54 to 239, according to state statistics. During that same period, opioid painkiller-related deaths increased nearly 20 percent, the statistics show.
Meanwhile, Indiana State Health Commissioner Jerome Adams said communities across the state are having a hard time maintaining and paying for a supply of the overdose-reversing drug naloxone, which state officials say has risen sharply in cost. Last August, officials scrambled to get a naloxone shipment to Jennings County after more than a dozen people overdosed in a matter of hours, depleting the county's stock of the drug.
Indiana recently obtained a $10.9 million federal grant. Much of it will pay for 60 to 75 year-round slots at treatment facilities across the state. The Legislature also set aside $5 million to fund the effort McClelland is overseeing.
But more will be needed.
Holcomb, a Republican, has asked the federal government for permission to use Medicaid funds made available through the state's HIP 2.0 program for drug abuse treatment. A ruling on that has yet to come, but it could bring upward of $60 million. However, that may not matter if Republicans in Congress succeed in passing a heath care overhaul that cuts Medicaid funding.
"I can't lie. It will be challenging, depending on what comes out of the federal government," said Family and Social Services Administration Secretary Jennifer Walthall.
Currently, the state doesn't know how much need there is for in-patient treatment. And Democrats criticized Republicans who voted to raise taxes this year for infrastructure improvements, while setting aside comparatively little to combat drug abuse.
"We keep nibbling around the edges. Luckily we got some money from the feds," said state Rep. Matt Pierce, D-Bloomington.
Many of the ideas broached during the Thursday meeting were discussed during the tenure of former Gov. Mike Pence, who is now vice president. McClelland said he wants to quickly put those ideas into action.
One of the state's plans is to develop a distribution network to get more naloxone into local communities at a lower cost. The price of the drug has skyrocketed, jumping from $31 a dose to $83, said Indiana State Police Superintendent Doug Carter.
But naloxone alone isn't a cure, said state Rep. Cindy Ziemke, a Republican whose two sons both struggled with drug addiction in the past.
"I'm an advocate for recovery," Ziemke said. But she added: "My constituents are saying how many times are my tax dollars going to pay for this naloxone every time this guy has an OD?"
McClelland said the key is making sure overdose patients don't leave the hospital and start using again. That requires wraparound services, inpatient and outpatient treatment, better coordination by medical providers and the help of the community.
Interrupting the supply chain for illegal drugs would also help, he said.
"We like to think that Indiana is the best state in the nation to do business in," McClelland said. "But we'd like to see it be the worst state in the nation to do that kind of business in."