Washington – Washington has turned its attention to the epidemic of heroin addiction and overdose deaths – including more than 250 in Connecticut last year -- but there’s a limit to what the federal government and Congress can do, especially in times of tight budget constraints.
Members of the House Energy and Commerce Committee held a hearing Tuesday to review growing concerns about heroin and prescription abuse. Some wanted more funds for law enforcement and treatment, others wanted to know which programs worked best, and a few members said they worried that Congress would drop the ball on the issue.
“The question after this hearing is, 'Are we going to sweep this under the rug again?'” said Rep. Ben Lujan, D-N.M.
Witnesses painted a grim picture of what was called a national crisis.
“Overall, drug overdose deaths now outnumber deaths from gunshot wounds or motor vehicle crashes in the United States,” said Michael Botticelli, acting director of the White House’s Office of National Drug Control Policy.
Witnesses spoke of the dangers of a potent, and impure, form of heroin on the black market and about the increasing number of users of prescription drugs who “graduate” to heroin. Federal studies show that about 80 percent of heroin users began their addiction to opiates by abusing prescription drugs.
“The abuse of opioids – a category of drugs including heroin and prescription pain relievers like xycodone and hydrocodone -- is having a considerable impact on public health and safety in communities across the United States,” Boticelli said.
About 100 Americans die of drug overdoses every day, he said, and those deaths are on the increase.
In 2012, there were 174 overdose deaths in Connecticut. That rose to 257 deaths in 2013.
Several Connecticut lawmakers have jumped on the issue, which came to national attention after the death of a drug overdose earlier this year of actor Phillip Seymour Hoffman.
Rep. Elizabeth Esty, D-5th District, held a “Community Conversation on Heroin” in Waterbury earlier this month. She said Waterbury and Torrington are the cities in her district that are struggling the hardest to fight heroin use. Participants of the event included Waterbury Mayor Neil O’Leary, Torrington Mayor Elinor Carbone and law enforcement and public health officials.
A crackdown on addictive drugs have increased their price on the black market, spurring addicts to turn to heroin, which is cheaper, Esty noted. She urged the Food and Drug Administration to allow over-the-counter sales of Naloxone, better known by its brand name Narcan, a drug that can help reverse the side-effects of an overdose from opioid-based drugs like heroin.
“If it’s 2 in the morning, and you live in Goshen, and your son is overdosing, you want to have something to help him,” Esty said.
She also said the federal government should provide more grants to state mental health programs. "I was meeting last month in Salisbury," Esty said, "and a women came up and said, ‘My son is struggling with heroin addiction and I can’t afford to get good help.’”
Sen. Richard Blumenthal, D-Conn., said the Substance Abuse and Mental Health Services Administration, which provides grants to state and local governments, should have a budget increase. The agency, part of the Department of Health and Human Services, has a $1.8 billion budget. He also said law enforcement efforts to block the smuggling of cheap heroin from Mexico should increase, though he added, “We can’t arrest our way out of this.”
Lawmakers from both sides of the aisle have criticized the FDA for approving Zohydro, which is made of pure hydrocodone and is used to treat chronic pain. Other painkillers mix hydrocodone with weaker, nonaddictive painkillers like aspirin to balance the effect. But chronic use of aspirin can harm the liver.
At the Energy and Commerce Committee hearing, Joseph Rannazzisi, a deputy assistant administrator at the Drug Enforcement Agency, said federal health and law enforcement officials expected abuse of Zohydro to begin in the Appalachian region, “and spread out” in the same way as the oxycodone epidemic.
On Monday, Sens. Patrick Leahy, D-Vt., and Blumenthal, wrote the FDA demanding that the agency brief them on plans to monitor the use of Zohydro.
“Given their potency and ease of abuse, we have little doubt that pure opioid products may lead more Americans to addiction, some even to heroin,” Leahy and Blumenthal wrote. “As safer, abuse-deterrent opioids are approved, the FDA should act swiftly to remove any older, less safe versions.”
In addition, Senate Health, Employment, Labor and Pensions Committee Chairman Tom Harkin, D-Iowa, and the top Republican on the panel, Sen. Lamar Alexander of Tennessee, have formed a bipartisan Prescription Drug Abuse Working Group, and invited other lawmakers to join their efforts to fight addiction.