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Congress Confronts Americans' Opiate Abuse

FILE - OxyContin pills, an opioid drug, are seen at a pharmacy in Montpelier, Vermont, Feb. 19, 2013. Americans, even though they comprise only five percent of the world's population, consume 80 percent of the its supply of pain medications.
FILE - OxyContin pills, an opioid drug, are seen at a pharmacy in Montpelier, Vermont, Feb. 19, 2013. Americans, even though they comprise only five percent of the world's population, consume 80 percent of the its supply of pain medications.

Gary Mendell lost his son to drug addiction and suicide four and a half years ago. After eight tries at rehabilitation, Brian Mendell had finally conquered his addiction but he couldn’t escape the stigma of his battle.

“He took his own life out of shame and guilt over what he had done to us as a family and what he had done to his life,” Mendell said.

He is one of the millions of family members across the United States who have suffered as a result of America’s growing opiate abuse epidemic. Mendell founded the Shatterproof Foundation as a way of fighting an epidemic that will kill 30,000 Americans this year.

The U.S. Congress took up that fight this week with a series of bills addressing a startling reality: the United States represents only five percent of the global population but Americans consume eighty percent of the world’s supply of pain medication. Opiate use in the United States has quadrupled since 1999, helped along by low cost and ease of access to opiate pain-killers and a lack of understanding about their dangers.

The wide-ranging pieces of legislation reflect the complexity of addressing an opiate abuse problem that has only received major attention in the past decade, with policy-makers and healthcare professionals struggling to care for the 4.5 million people in the U.S. who are estimated to be addicted to prescription opiates.

‘Dying is happening every hour’

“The dying is happening every hour, every day, across this country,” said Rep. Susan Brooks, a Republican from Indiana sponsoring a resolution under consideration this week that would address the so-called “culture” of prescribing pain medications too quickly and easily to patients and without consideration of the possible dangers. A recent review found physicians checked a patient’s history only 14 percent of the time before prescribing an opiate pain-killer.

Brooks’ resolution is one of eighteen initiatives up for votes this week in the House of Representatives. The Senate is considering similar legislation and, in a rare bi-partisan effort, both Democrats and Republicans hope to unite their efforts for the president to sign one comprehensive bill into law.

“There’s not a silver bullet for this problem,” said Bradley Stein, a RAND Corporation senior scientist who studies government-level efforts to combat opiate addiction.

Stein said the multiple pieces of legislation address the problem using a variety of approaches.

“I’m encouraged seeing the aspects of the legislation trying to reduce the supply of opioids out there that may be contributing to the epidemic,” he said, “as well as efforts to increase access to some of the most effective treatments that we know are really needed to help people who are struggling with addiction.”

The bi-partisan effort has met with praise but Gary Mendell shares concerns with some House Democrats about how the structure and funding of the legislation would work in practice.

Changing perspectives

Mendell noted the legislation as it stands now is not yet funded, although that could change when the House combines its work with the Senate. If the structure remains in place, states would receive grants from existing funds to implement the programs and approaches.

“Only when money is appropriated will there be any effect at all,” Mendell said.

He has also advocated for a number of low or no-cost approaches – including mandatory education of physicians on drug prescription guidelines and widespread stocking of kits that provide antidotes to opiate overdoses.

But Mendell said the key approach in the battle will be understanding opiate addiction as a medical issue – not a subject of shame.

“He often told me – ‘Dad, I don’t feel like a patient. I feel like an outcast,” Mendell said of his son.

“He should have felt like a patient treated with a disease and he wasn’t. Society looked at him and said ‘Why don’t you just stop? You’re a loser’ and that’s the message he got from society.”

The stakes for changing perspectives and finding effective treatments are critical.

“This is a problem that affects all aspects of American society,” said RAND Corporation's Bradley Stein. “It affects all communities and as it has become more common it’s become one of those situations where increasing numbers of people know someone struggling with this addiction.”

House Speaker Paul Ryan acknowledged the need for understanding in the battle against opiate abuse during his weekly press conference Wednesday.

“No one should seek help and receive mistreatment in return,” Ryan said, noting the effort was personal for many members of Congress.

“This is not just about process. This is not just about legislation. This is about saving people’s lives.”