Government officials on Thursday said they’re scrambling to keep Americans from getting hooked on opioids, from cutting the number of pills in circulation to crafting drugs that attack pain without triggering brain receptors that crave another high.
Scott Gottlieb, commissioner of the Food and Drug Administration, said his agency will promote medical devices that attack pain without the need for addictive pills, while making sure doctors don’t prescribe more opioids than they need to.
“This comes down to math — a certain percentage of patients who are exposed to opioids will become addicted,” Dr. Gottlieb told the Senate Health Committee. “The key to reducing the rate of new addiction is to reduce the rates of new exposure. We’re going to do that, first and foremost, by changing prescribing behaviors among physicians.”
The Trump administration and Congress are trying to wrap their arms around a prescription painkiller and heroin epidemic that is getting worse as potent synthetics like fentanyl flood the U.S. drug market.
Preliminary government figures suggest that overdose-related deaths soared to more than 64,000 in 2016, a more than 20 percent increase from 2015.
Committee Chairman Lamar Alexander said 3-in-4 overdoses in his state are related to opioids.
“This is a crisis not just in Tennessee but across the country, with 91 Americans dying every day from an opioid overdose,” the Tennessee Republican said.
Research suggests many addicts got hooked on prescription painkillers first, so many state and federal lawmakers are looking to cut the supply of pills that make it out of the pharmacy.
Sen. Susan M. Collins, Maine Republican, said Thursday she would like to see more doctors dole out “10 pills, not 50 — that sort of thing.”
Dr. Gottlieb said he supports reasonable efforts to scale down the amount of pills dispensed by doctors, so long as patients aren’t harmed.
His endorsement enthused Sen. Elizabeth Warren, Massachusetts Democrat, who highlighted a measure she sponsored with Sen. Shelley Moore Capito, West Virginia Republican, to let patients receive less than a full prescription’s worth of opioid medication.
Dr. Gottlieb also said the FDA wants to fast-track generic painkillers that are harder to crush and snort or dissolve and inject into the bloodstream.
“FDA strongly supports a transition from the current market, dominated by conventional opioids, to one where the majority of opioids have meaningful abuse-deterrent properties,” he told the committee. “While these products can still lead to addiction, they’re harder to manipulate in ways that make them attractive for abuse by routes such as inhalation or injection.”
Francis Collins, director of the National Institutes of Health, said his agency, the FDA and private-sector companies are developing nonaddictive drugs for the 25 million Americans who suffer from pain that interferes with their daily routines.
One effort involves disentangling the brain receptors that deal with pain from ones that get hooked on opioids.
“New technology is now being applied to design drugs that provide the pain relief without activating the reward system that leads to addiction,” Dr. Collins testified.
He said the partnership also is devising medications that aid addicts in treatment.
Elinore F. McCance-Katz, assistant secretary for mental health and substance abuse at the Department of Health and Human Services, said many addicted Americans are struggling to find help.
“We still do not have adequate access to treatment, to evidence-based treatment for people who need it,” she testified. “As long as that situation occurs, we’re going to continue to have the terrible kinds of tragedies that are the opiate epidemic.”
Mr. Trump in August said he plans to use emergency powers to address the opioid crisis, though his pledge hasn’t translated into a formal declaration. The White House says the administration is researching the legal steps it must take to employ those authorities.
Democrats have faulted Mr. Trump for pledging strong action, while endorsing GOP legislation and budgets that would slash Medicaid insurance for the poor — a key source of treatment.
Still, the fight has largely been a bipartisan effort.
Sen. Rob Portman, Ohio Republican, and co-sponsors are pushing a bill that would require foreign postal systems to send advanced electronic data on packages they send through the mail so customs agents can target packages that may contain illicit drugs.
As it stands, officials say traffickers are using the mail to send dangerous synthetics such as fentanyl and carfentanil from clandestine labs in China to the U.S. market.
“They’re simply overwhelming the system,” Dr. Gottlieb said.
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