Issue Position: Opiate Abuse

Issue Position

Opiate abuse is a national and international problem of great urgency and one that must be solved. Legal and illegal drugs are involved, so the solution must come from a combined effort by law enforcement, the medical profession, pharmaceutical companies, and the public.

The role of Congress is to provide the necessary tools to these groups to combat the opiate plague. As a biomedical scientist with years of research and teaching experience in medical schools from LSU Health Sciences Center in New Orleans to Harvard Medical School, I have an understanding of the effects of opiates on the human brain and body. As someone who has watched heroin claim a family member, I also understand how opiates tear at the very fabric of our families and society.

First, we must take immediate action to stop the flow of illegal drugs into this country, and institute tougher penalties for those who enrich themselves from the drug trade. We must not ignore the fact that over 50% of the heroin and methamphetamine entering this country comes across our porous southern border, as well as over 80% of the cocaine. For the purpose of political expedience, we are killing our children.

We must shift our efforts and resources away from failed treatment modalities used in the past, such as methadone, and away from failed programs such as needle giveaways that only facilitate drug use and blight neighborhoods where parents are trying to shield their children from exposure to drug culture.

And with those redirected resources, we must support research and treatment programs that have produced a new generation of opiate antagonists -- remedies that are administered at longer periodic intervals and supress the need for heroin without the sought-after "high".

We must also address a relatively new and growing pathway to opiate addiction: over-prescription and over-use of opioid pain killers. It is estimated that 2.1 million Americans suffer from substance use disorders directly related to, or with origins in prescription opioid pain relievers. The consequences of this abuse have been devastating and are on the rise. For example, the number of unintentional overdose deaths from prescription pain relievers has soared in the United States, more than quadrupling since 1999.

A delicate balance is required, for we must confront the negative and growing impact of opioid abuse on health and mortality, while also preserving the fundamental role of prescription pain killers in healing and reducing human suffering.

One remedy is to limit prescriptions, similar to new laws being enacted in Massachusetts. Individuals should not be supplied by physicians and pharmacists with 30, 60, and 90 days-worth of these powerfully addictive drugs. In Massachusetts, initial prescriptions are limited to 3 days supply. In addition, policies can be put in place so that physicians and pharmacists can better monitor the issuance of painkillers. This addresses the problem of "doctor shopping", in which addicted patients procure multiple prescriptions by visiting multiple doctors, who in turn submit prescriptions to multiple pharmacies for patient pickup.

There are many people who are not aware of the dangers of addiction associated with opioid pain killers. They are prescribed, sometimes in large quantity, without warning. Patients may become addicted even when dosing themselves according to instructions. A clear warning should be included verbally and on the bottle with every prescription issued.

The National Institute on Drug Abuse (NIH/NIDA) has established four Centers of Excellence for Physician Information. The Centers are focused on advancing addiction awareness, prevention, and treatment in primary care practices, including the diagnosis of prescription drug abuse. They target physicians-in-training, including medical students and resident physicians in primary care specialties. Educational outreach of this kind should be fully supported by Congress.

Finally, we must attack addiction with a large-scale public communication program utilizing the power of social media, cable and broadcast television, radio and print. A public-private partnership with the most creative advertising minds in this country will help. Our kids should have to think -- and think hard -- before starting on the deadly road to addiction.

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