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Rebecca Farley

Director, Policy & Advocacy, National Council for Behavioral Health

House Subcommittee Examines Approaches to Curbing Opioid & Heroin Abuse

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The growing problem of prescription opioid abuse and heroin use in the U.S. was the topic of a Tuesday morning House Energy and Commerce Subcommittee on Oversight and Investigations hearing. In his opening statement, Chairman Tim Murphy (R-PA) introduced the breadth of the problem, explaining that prescription painkillers are involved in more overdose deaths than cocaine and heroin combined and that prescription drug abuse kills more than 16,000 people per year.

As the National Council’s Chuck Ingoglia has written in Capitol Connector, the opioid and heroin epidemic has received major attention from state and federal lawmakers in recent months. The House hearing is the latest in a series of public events examining policy solutions. At the hearing, Committee Vice Chairman Michael Burgess (R-TX) noted the importance of striking the delicate balance between providing Americans who suffer from chronic and debilitating pain the access to prescription painkillers and assisting the physicians who provide care for them with the increasing incidence of prescription drug and heroin abuse.

Panelists at the hearing did not agree on one single path forward, but consensus appeared around expanding law enforcement efforts, providing additional education to physicians, and developing abuse deterrent formulas for prescription painkillers.

Mr. Joseph Rannazzisi (testimony), Deputy Assistant Administrator, Office of Diversion Control, Drug Enforcement Agency, U.S. Department of Justice explained that law enforcement officials have long been aware that non-medical prescription opioid use contributes to an increase in heroin trafficking and use. He advocated that any solution to reduce non-medical opioid use must include prescription drug diversion through educating the public about the dangers of the non-medical use of pharmaceuticals, increasing practitioner education on methods of diversion, and treating individuals with substance use disorders. He emphasized that people cannot expect to “arrest our way out of this.”


Mr. Michael Botticelli – who will also be speaking at next week’s National Council Conference – (testimony), Acting Director, Office of National Drug Control Policy, Executive Office of the President said that his agency works with federal, state, local, and tribal partners to continue to use an evidence-based strategy to address overdose deaths and opioid abuse. He stressed that the Administration has increased support for medication-assisted opioid treatment and overdose prevention, coordinated a government-wide response to the prescription drug abuse, and pursued action against organizations trafficking in opioid drugs.

Dr. Daniel Sosin (testimony), Acting Director, National Center for Injury Prevention and Control, Centers for Disease Control CDC) and Prevention pointed out that drug overdose death rates are higher than ever. Research suggests an increase in heroin use is tied to the increase in opioid painkiller prescriptions.  Dr. Sosin explained the three pillar upstream approach used by the CDC: first, expanding the availability of data on both providers and pharmacies; second, providing technical assistance for state enforcement efforts; and third, supporting providers and providing guidelines on prescription painkillers.

Dr. Nora Volkow (testimony), Director, National Institute on Drug Abuse, National Institutes of Health (NIH), gave a clinical perspective on how opioid drugs affect the brain and the link to heroin. She explained that opioids are the best option to manage pain but that the drug affects the brain in a way that makes it susceptible to addiction. She emphasized that NIH provides research grants to look for alternatives and repeatedly stressed that painkillers are needed for the 100 million Americans who struggle with chronic pain but that it needs to be balanced against the negative public health consequences of over-prescribing.

Dr. Westley Clark – who will also be speaking at next week’s National Council Conference – (testimony), Director, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA), discussed the cultural side of prescription drug abuse, noting that “prescription opioid and heroin abuse is a complex issue [and] requires a concerted effort by many.” He mentioned materials that SAMHSA has developed for physicians to help them manage patients with chronic pain but also discussed SAMHSA’s prevention and treatment strategies to target the drugs themselves and fund programs that support prevention, intervention, and treatment of substance abuse disorders.

Additional information on the hearing is available here.