Lawmakers and federal health officials are gathering Wednesday on Capitol Hill to talk about how to stop the nation's swelling opiate addiction.
The government is already working to combat high rates of prescription-drug and heroin abuse, but Wednesday's hearing at the Senate Caucus on International Narcotics Control is an opportunity for senators — led by Democrat Dianne Feinstein of California and Republican Chuck Grassley of Iowa — to check in on whether existing policies are working.
"Policies have to balance the needs of chronically ill patients to get necessary medicine with the realities that opioid addiction is a serious, dangerous epidemic," Grassley said in an email statement. "The hearing is important to inform Congress of the complexities of the challenges before us and the tools available to help treat and prevent opioid abuse and overdose."
Wednesday's discussion is one in a series of recent hearings on Capitol Hill about opiate addiction, following reports earlier this year that efforts to stop prescription-drug abuse have resulted in a heroin boom.
Following the Centers for Disease Control and Prevention's move classifying prescription-drug abuse as an epidemic — a term used to describe a significant number of cases of a disease beyond what should be expected — the Obama administration designed the 2011 Prescription Drug Abuse Prevention Plan. Recent efforts have focused on education for patients and providers, monitoring to keep patients from doctor shopping to get multiple prescriptions for pills, proper medication disposal to limit the supply of unused drugs in homes, and enhanced law enforcement to stop illegal pill mills.
"We're working to change the availability of the pills and the notion that because these pills are used to treat pain that there's low risk," said Rafael Lemaitre, communications director of the Office of National Drug Control Policy.
Health officials from ONDCP, the Substance Abuse and Mental Health Services Administration, the National Institute on Drug Abuse, and the Drug Enforcement Administration are scheduled to be in attendance Wednesday.
The issue stems from the fact that prescription painkillers — like heroin — are opioids that can lead to addiction. When doctors overprescribe Vicodin or OxyContin, two commercial drugs containing the opiate active ingredients hydrocodone and oxycodone, patients are at risk of developing a deadly habit.
Some four out of five heroin users started abusing prescription drugs first, according to a report released last year by SAMHSA, and 68 percent of new prescription-drug abusers say they get their pills from a friend or family member. As people become chronic users, that number drops to 41 percent — shifting in large part to buying pills from friends, dealers, or the Internet.
But just because someone is abusing painkillers doesn't mean they're on the road to heroin addiction: Only 3.6 percent of people abusing prescription drugs moved onto heroin within five years, the SAMHSA report found.
In all, heroin use climbed to 620,000 people in 2011 from 373,000 people in 2007, according to the report, compared with the roughly 12 million people who report using painkillers nonmedically each year.
Opioid pain relievers alone resulted in 16,651 deaths in 2010, up 21 percent from 2006. More people are dying now from drug overdoses than they are from car accidents or suicides. Andrew Kolodny, a doctor and the chief medical officer of Phoenix House, a national nonprofit addiction-treatment and prevention organization, is scheduled to testify at Wednesday's Senate hearing.
"People think this must be safe to experiment with because it came from mom's medicine chest and a doctor prescribed it," Kolodny said. "They don't understand that these are essentially heroin pills. The active ingredient in Vicodin is nearly identical to heroin. The effect that heroin produces in the brain is indistinguishable from hydrocodone and oxycodone."
The reason why some people move onto heroin, Kolodny said, is because they run into trouble getting doctors to prescribe the pills or find that in their area, heroin is a cheaper alternative.
A spokesperson for Grassley said that problem — the cost and ease of access of heroin — would be part of the focus of Wednesday's hearing.