The U.S. Senate came to Loudoun on Monday to hear testimony on the epidemic abuse of opiate medication.
The inquiry took the form of a field hearing of the Select Committee on Aging, which was represented by one of its 20 members, U.S. Sen. Tim Kaine (D-VA).
The hearing was part of a broader effort to address the rapid increase in the number of fatal overdoes resulting from opiate and heroin abuse.
“It’s an issue of passion for me,” Kaine said, noting the problem has hit every corner of the commonwealth, all age groups, all races and every economic class. The problem, he said, “begins in our medicine cabinets.”
Potent and highly addictive painkillers, ranging from Vicodin to OxyContin, originally designed for short-term relief and palliative care for cancer patients, have come to be prescribed—and overprescribed—as part of routine care, he said.
Four out of every five heroin overdoses are linked to prior opioid use; and increasingly opiate overdoses are becoming a concern for older Americans, with the 55-64 age group now the fastest growing segment for prescription medication overdoses.
The solution? “It is going to take a big culture shift,” Kaine said.
To examine the issue, Kaine assembled a panel ranging from Attorney General Mark R. Herring (D) to Lisa Wilkins, a Berryville resident who lost her son, Chip, to an overdose in 2011.
Herring said he learned of the scope of the opiate abuse in Virginia as he toured the state shortly after taking office.
“I join you in sounding the alarm about the heroin and prescription drug crisis, and I want every family in Virginia talking about it now—not once there is already a problem, and God-forbid not after a loved one is lost,” Herring said in his testimony. “We have to start now, because I’ve heard from so many heartbroken parents who have lost a child, and so many devastated families who have lost a loved one, and they all say ‘I never thought this could happen to my family.’”
Both of Wilkins’ sons battled with addiction that grew out of being prescribed opioid medication—one following a car crash and another following a dog bite. And her mother was prescribed opiates for her chronic pain.
She told Kaine that doctors need to work more closely with families to make sure they understand how to use the medication. “We got no information about how dangerous those drugs were,” she said. “We got 30 or 60 pills in a bottle.”
Three other panelists were experts in the field.
Mellie Randall is the director of the state’s Office of Substance Abuse Services. Dr. Katherine Neuhausen is an assistant professor of Family Medicine and population health at Virginia Commonwealth University. Jane Terry is director of government affairs at the National Safety Counsel.
They universally supported one of Kaine’s initiatives now working through Congress. The Co-Prescribing Saves Lives Act, which would expand the availability of naloxone to those prescribed opioid medication and to the family of addicts. Naloxone—now being carried by trained Loudoun deputies as well as fire-rescue workers—can quickly reverse the effects of an accidental overdose. Residents can easily learn how to administer the life-saving drug, they said, noting that Kaine underwent the training last year.
The experts also advocated more physician education on the addictive qualities of the medication, new guidelines that would curb incidences of over-prescribing, and greater access to and funding for addiction treatment centers.
Also highlighted was the need for physicians to make greater use of the state’s prescription drug monitoring database that can help identify patients who try to secure prescriptions from multiple doctors. Making that happen may require an investment in the system so that the data flows automatically into patients’ electronic health records.
They also noted the importance of drug take-back programs during which authorities allow residents to drop off unused medication for safe disposal—getting the potentially dangerous drugs out of their medicine cabinets.
Responding to a question from Kaine, Neuhausen said that not since soldiers returned from World War II hooked on morphine had a medicine turned into such a large scale health crisis. She said the rapid growth of the problem was comparable to that of the HIV epidemic.