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Rx Summit: Speakers from Congress differ on recipe for opioid crisis

April 18, 2017
by Gary A. Enos, Editor
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Bipartisan cooperation in Congress helped to propel landmark legislation in addiction last year, but clear differences remain in the tone from the two major parties on the topic. This was in evidence on Tuesday during a morning plenary session held at the National Rx Drug Abuse & Heroin Summit in Atlanta.

In discussing legislative achievements such as the Comprehensive Addiction and Recovery Act (CARA), Massachusetts Democratic Sen. Ed Markey lamented the lack of funding attached to the law, saying “We need a billion a year every year” to fight the opioid crisis sufficiently. Just moments later, Georgia Republican Rep. Earl “Buddy” Carter pumped the brakes on a singleminded focus on funding, saying, “What we need is programs that work.”

Both members of Congress spoke passionately about stemming the tide of opioid overdose and addiction, although Carter also moved quickly into discussing a “pet peeve” about initiatives to legalize recreational use of marijuana (“There is no useful purpose for us to be legalizing marijuana at this time,” he said.)

But Markey also took a position that few Republicans in the Senate are likely to support in the coming weeks: He said he will fight the Trump administration's nomination of Scott Gottlieb, MD, to head the Food and Drug Administration (FDA), over Gottlieb's stated desire to move drugs more quickly to the market.

“His record shows that he doesn't support the [regulatory] tools at [the FDA's] disposal,” Markey said. He is especially concerned that Gottlieb has indicated opposition to drug risk management plans imposed by the FDA, and fears that this could result in more unfettered access to dangerous opioid medications.

Remarking on the title of the Institute for the Advancement of Behavioral Healthcare's conference and its addition of “heroin” to reflect current drug trends, Markey speculated that fentanyl likely would have to be added to the name before long. Three-quarters of the approximately 2,000 opioid-related deaths in Massachusetts last year involved illegally produced fentanyl, Markey said.

He told audience members from other states, “Massachusetts is a preview of coming attractions.”

Also addressing the audience was Pennsylvania Republican Rep. Patrick Meehan, who said the opioid crisis in his suburban Philadelphia district is affecting groups ranging from intercollegiate athletes to married women. He urged community leaders to communicate with their representatives about ways to tweak the system, saying that every component of CARA came out of communities' local experiences.

As part of the discussion of how the community can get involved, Kentucky Republican Rep. Harold Rogers told the audience that elected officials might respond the strongest to a visit to a drug court graduation ceremony, an uplifting event featuring individuals who not long before entering drug court had reached the depths of despair.

International perspective

Opening the morning session was William R. Brownfield, assistant secretary of the State Department's Bureau of International Narcotics and Law Enforcement Affairs, whose first comment was, “The United States of America today faces the worst drug crisis we have faced since the 1980s.”

Most of his impressions of progress internationally were quite positive, however: increased cooperative activity with Mexican officials, China's recent decisions to regulate carfentanil and other potent synthetic drugs, and a United Nations that has been able to find a middle ground between drug policy stances at the extremes.

“I insist that this is not a bad news summit,” said Brownfield, adding, “I see the line moving slowly, gradually, but in the right direction.”