Magazine article State Legislatures

Overdosed on Opioids: A Deadly Opioid Epidemic Sweeping the Country Has Lawmakers Working Hard to Find Solutions

Magazine article State Legislatures

Overdosed on Opioids: A Deadly Opioid Epidemic Sweeping the Country Has Lawmakers Working Hard to Find Solutions

Article excerpt

What Are Opioids?

Opioids are a class of drugs that act on the nervous system to relieve pain. Long-term use can lead to physical dependence and withdrawal symptoms when stopped. Opioids are classified as narcotics and include illegal heroin as well as legal prescription pain relievers such as morphine, codeine, methadone, oxycodone, hydrocodone, fentanyl and hydromorphone. You might know them better by their trade names: OxyContin, Percodan, Percocet, Vicodin, Lortab, Norco, Fentora, Dilaudid and others.

State legislators are battling a lethal epidemic that is killing more people a year than motor vehicle crashes. More than 47,000 Americans died of a drug overdose in 2014--18,900 from prescription painkillers and 10,600 from heroin, according to the American Society of Addiction Medicine. Heroin overdoses alone have quadrupled since 2000.

"Everybody knows someone who's been affected--a family member, a friend, an acquaintance," says New Hampshire Senator Jeb Bradley (R), who chaired a task force on the epidemic last year.

There is also the expense. The total annual costs to society associated with prescription opioid abuse was estimated at $55 billion in a study published in Pain Medicine in 2011. The estimate includes health care and criminal justice costs and the loss of productivity in workplaces.

The responses from statehouses as well as from the federal government reflect a growing concern about how to stem the tide.

President Barack Obama called for an increase in funding earlier this year to expand treatment and prevention programs, crack down on illegal sales and improve access to the opioid antagonist naloxone. And at press time, U.S. senators were debating the level of funding for the Comprehensive Addiction and Recovery Act.

State legislators from both sides of the aisle are working to enact comprehensive packages of legislation to address this widespread problem, which transcends politics and blurs the boundaries separating the public policy areas of criminal justice, international drug trafficking, social services and health care.

"This isn't about normal procedure, or partisan politics. It's a life-or-death, literally, a life-or-death situation," says Alaska Senator Johnny Ellis (D).

A Two-Pronged Problem

Looking at data from 2014, the Centers for Disease Control and Prevention recently reported that the "opioid overdose epidemic includes two distinct but interrelated trends: a 15-year increase in overdose deaths involving prescription opioid pain relievers and a recent surge in illicit opioid overdose deaths, driven largely by heroin."

Overdoses of both kinds of opioids--pain pills and all forms of heroin--have surged, but several studies have found the increase in heroin use began before tighter restrictions were placed on prescription opioids.

Abuse of opioid pain relievers is the strongest risk factor for heroin abuse. According to the CDC, 75 percent of new heroin users were first addicted to pain pills. But it is unclear whether a crackdown on the availability of prescription pain relievers has led to the rise in heroin use.

It appears more likely that an increase in the availability of heroin in the U.S., along with lower prices and greater purity, have all contributed to the rising rates of abuse and death, according to the CDC.

"It's become the drug of choice. People are using it instead of marijuana or crystal meth," says Illinois Representative Lou Lang (D). "The cost of heroin is so low that you can get high for $5. You can't get high on marijuana for $5."

Attack on Many Fronts

Increasingly, states are treating the problem as a public health issue that requires a multi-pronged response.

There's a balance to maintain. "We need to curb abuse," says New Mexico Senator Craig Brandt (R). "At the same time, we need to make sure we don't make it more difficult for those who need pain medication to receive it," says the disabled veteran who lives with chronic pain. …

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