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Burgess Opening Statement: E&C Subcommittee on Oversight and Investigations Hearing, "Examining the Growing Problems of Prescription Drug and Heroin Abuse

Congressman Michael C. Burgess, M.D. (R-TX) today delivered the following opening statement as prepared for delivery during a House Energy and Commerce Subcommittee on Oversight and Investigations hearing entitled, “Examining the Growing Problems of Prescription Drug and Heroin Abuse,” which he chaired:
Washington, D.C. – Congressman Michael C. Burgess, M.D. (R-TX) today delivered the following opening statement as prepared for delivery during a House Energy and Commerce Subcommittee on Oversight and Investigations hearing entitled, “Examining the Growing Problems of Prescription Drug and Heroin Abuse,” which he chaired:

“Good morning. I now convene this hearing of the Subcommittee on Oversight and Investigations entitled, “Examining the Growing Problems of Prescription Drug and Heroin Abuse.”

“These are separate and distinct problems with a common end point: abuse, overdose and death.

“As we know, the abuse of prescription drugs and illegal drugs such as heroin have plagued our nation for decades. However, over the last several months, there have been increasing reports that prescription drug and heroin abuse in communities around the country continue to grow. Sadly, those reports indicate that overdose deaths as a result of prescription drug and heroin abuse are also on the rise. Families have lost sons and daughters and fathers and mothers to this addiction.

“Data from the federal agencies charged with addressing drug abuse paint a startling picture of the severity of this public health crisis. Prescription drug abuse kills more than 16,000 people per year. From 2007 to 2012, heroin use rose by 79 percent in this country and 3,000 people die each year from heroin overdoses.
  
“U.S. Attorney General Eric H. Holder declared recently that heroin abuse constitutes “an urgent and growing public health crisis.” Certainly, there is a law enforcement aspect to solving this problem and stopping the bad actors who illegally distribute prescription drugs or traffic heroin. But the other part of the equation is treating addiction to prescription drugs and heroin — and preventing deaths. The answer to a burgeoning heroin epidemic, as the administration has called it, is not to wage a war on all opioids. To address a complex issue, the solution will not be simple.

“The purpose of today’s hearing is to examine the federal response, including the public health response, to prescription drug and heroin abuse. Our oversight has revealed that this is a complex problem. Those who abuse drugs often have an underlying mental illness. Treating their addiction means that the underlying mental illness must be successfully diagnosed and treated.  

“As the testimony of Mr. Botticelli states, substance abuse is a “progressive disease.” Those who suffer from addiction often start at a young age, with alcohol and marijuana, and then move to other drugs like opioids. In examining opioid abuse, we must also consider the factors that lead people to abuse – and what we are doing to address them.

“Many Americans also suffer from chronic and debilitating pain. It is important to remember the millions of individuals who safely use opioids under the guidance of their physicians, pain that we all hope us or a loved one would never suffer. 

“As Dr. Volkow of NIH recognizes in her testimony, we need to recognize the ‘special character” of prescription drug abuse.’ On one hand, we have growing prescription drug and opiate addiction; on the other, we have the very real need for these drugs to treat chronic pain and alleviate suffering, especially in patients with conditions like cancer. These drugs are safe when used as directed. It is their improper use that leads to abuse and overdose. 

“Over recent years, we have heard a great deal about doctor shopping, pill mills, and the efforts of Prescription Drug Monitoring Plans to address these problems. We need to ensure that doctors and pharmacists have the tools at their disposal to adequately fill their role in ensuring appropriate prescribing. But addicts also get these drugs through illegal channels, such as rogue Internet pharmacies, off the street, and obtaining them through family and friends. Although some question whether federal efforts to crackdown or prevent prescription drug abuse have contributed to the recent rise in heroin abuse, and whether this should have been anticipated, there is no question that both are on the rise and we have a responsibility to examine this issue fully. 

“While most prescription drug abusers do not go on to abuse heroin, there is data from the White House Office of National Drug Control Policy (ONDCP) and the Substance Abuse and Mental Health Services Administration (SAMHSA) that indicates 81 percent of people who started using heroin in 2008 to 2010 had previously abused prescription drugs.

“The federal government is devoting significant resources to drug control programs -- over $25 billion annually, of which about $10 billion goes toward drug abuse prevention and treatment programs across 19 federal agencies. We will ask today’s witnesses to identify the specific policies, programs, and initiatives have been most effective in combatting prescription drug and heroin abuse -- and which have not.  With 19 agencies having a hand in over 70 drug control programs — is this working? What can we do better? Oversight by the federal agencies is also an important issue, as significant funding is block granted to states for treatment programs

“Testifying before us today are representatives of the five agencies with lead roles in addressing opiate abuse: Mr. Michael Botticelli, Acting Director of the White House Office of National Drug Control Policy; Dr. Daniel Sosin of the Centers for Disease Control and Prevention; Dr. Nora Volkow of the National Institute on Drug Abuse; Dr. H. Westley Clark of the Substance Abuse and Mental Health Services Administration; and Mr. Joseph Rannazzisi of the Drug Enforcement Agency. This is a prestigious panel, and I thank you for being here today. We look forward to your testimony.”

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