Top 10: The road ahead is packed with big issues, and here are 10 of the biggest.

AuthorLays, Julie
PositionHOT ISSUES

The chaos in Washington, D.C., has preoccupied the nation. Except for the distraction of far too many horrific man-made and natural disasters, all eyes have been fixed on the federal government for the past year. Meanwhile, state legislators have been tackling tough problems and making difficult decisions--with no certainty of what's coming from our nation's capital.

All 50 state legislatures held regular sessions in 2017 and, despite waiting for action and answers from Washington on key issues, managed to pass more than 21,000 new laws, some on the hottest topics of the year. This year looks to be similar.

All legislatures, but the four biennial ones, will be in session in 2018, addressing an abundance of issues, many unique to their states. Issues that have a wide impact and presence in almost every state made it onto our annual Top 10 list this year. All have questions about federalism at their core--What role will states play? How much flexibility will legislatures have? Will state laws be pre-empted? If states are given more responsibility, will funding accompany it?

Amidst the questions and uncertainties swirling around D.C., state lawmakers will find ways to address these important issues, as they always have.

1

OPIOID EPIDEMIC

How do we stop opioid addiction and overdoses?

President Trump declared the opioid epidemic a public health emergency in October, but state legislatures have been fighting the crisis for years. Every state has enacted some type of measure addressing opioids in the past two years.

The number of victims is staggering. Opioids--which include prescription painkillers (oxycodone, hydrocodone, methadone), heroin and fentanyl--killed more than 33,000 people in 2015, more than any year on record. Nearly half of those deaths involved a prescription opioid. In fact, more people were killed by opioid overdoses than by motor vehicle crashes in 2015.

The extent of the epidemic is astounding. Opioid addiction affects people of both sexes, all racial and socioeconomic groups, from rural areas to big cities and everywhere in between. State resources are strained by overwhelmed emergency rooms and first responders, crowded morgues, jam-packed jail cells and mounting foster care caseloads, which are now at their highest level since 2009. Babies under age 1, sometimes addicted at birth, comprise around 17 percent of children entering foster care.

As the secondary effects of this crisis grow, officials in health, criminal justice, human services and other policy areas are working together to fight the epidemic on all fronts while also ensuring that those who need effective pain management drugs can continue to get them.

Hundreds of bills were introduced in 2017 and you can expect to see more in 2018. Legislation will address:

* Guidelines for, or limits on, opioid prescriptions

* Access to naloxone, the overdose reversal drug

* Immunity for those who call 911 to seek medical assistance

* Sentencing for drug users and traffickers

* Training and education for providers

* Access to community-based treatment

* Treatment for those in or involved with the criminal justice system

* Registration and licensing of pain clinics

* Programs to collect unused pills

2

IMMIGRATION OVERHAUL

Will states continue to take on a greater role in immigration policy?

Immigration policy, in general, has evolved into a shared responsibility among the local, state and federal governments. The federal government decides who's allowed in, while states provide services for them once they are here. The Trump administration has cut the number of refugees to its lowest level, and has asked Congress to decide the future of the Deferred Action for Childhood Arrivals program for unauthorized immigrants. But state lawmakers continue to press for a total overhaul of what many consider to be antiquated immigration laws, mostly unchanged since Ronald Reagan signed the Immigration Reform and Control Act in 1986. That law tightened security measures at the Mexican border, set penalties for hiring unauthorized workers and allowed immigrants who'd entered the country before 1982 to apply for amnesty.

With limited federal action, states have been tackling local immigration concerns. Legislatures in all but three states enacted 90 percent more bills dealing with immigration...

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