Alexander: “More Than 1,000 Tennesseans Die Each Year” From Opioid Abuse—“Nation Must Act to Combat this Growing Epidemic”

Says opioid abuse and overdose is a complex problem requiring action from the many federal, state, and local partners in the fight

Posted on December 8, 2015

WASHINGTON, D.C., Dec. 8 – The chairman of the Senate health committee today said that with millions of Americans abusing opioids—which include prescription opioid painkillers, like hydrocodone and morphine, as well as the illegal drug heroin—and more than 1,000 Tennesseans a year dying from opioid abuse, partners at the federal, state and local level must all act together to fight this “growing epidemic.”

Today’s hearing comes as the number of U.S. opioid-related deaths climbs—deaths from prescription opioid painkillers more than tripling since 2000 and heroin use taking more than 8,200 lives in 2013 alone.

Chairman Lamar Alexander (R-Tenn.) said, “The human costs of this epidemic are too high, and I hear about the challenges of dealing with this epidemic at home in Tennessee, particularly in East Tennessee where I am from. ...[b]ut, the truth is, this problem affects all states and is frontline issue for communities all over.”

He continued, “This is a complex problem that calls for action by all who have a role in preventing opioid abuse and responding to this problem, whether it is doctors, the health department, law enforcement, or families. …I am open to suggestions about ways to ensure that the federal government is helping address the problem, not hindering it.”

Alexander referred to a roundtable he held in Knoxville on opioid abuse in September with the Centers for Disease Control and Prevention Director Dr. Tom Frieden, where Frieden called deaths due to opioid overdose a problem “gripping our country.”

At that roundtable, Frieden announced Tennessee would receive $3.4 million over four years from the agency to help the state continue its work fighting prescription opioid painkiller abuse and overdose.

Alexander pointed out that according to a 2011 survey, more than 69,000 Tennesseans were estimated to be addicted to prescription opioid painkillers—and more than 1,000 Tennesseans die each year as a result of drug overdose, many related to abuse of prescription opioid painkillers

“I’ve mentioned a lot of statistics today,” Alexander said, “and it’s important to remember that behind these numbers there are very real human beings whose lives are cut short due to this growing epidemic.”

Alexander’s full prepared remarks at today’s hearing are below:

Today, we are meeting to discuss the growing epidemic in this country of opioid abuse and overdose.

The term opioid includes prescription opioid painkillers, like hydrocodone and morphine, and also the illegal drug heroin.

Some people can become addicted to prescription opioid painkillers, and the illegal drug heroin is highly addictive, placing people at risk for overdose. 

According to the National Institute on Drug Abuse, prescription opioid painkiller abuse may lead to heroin use.

Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention (CDC), said the heroin epidemic is a “one-two punch”: First, a growing number of people are exposed to and become addicted to prescription opioid painkillers, which he said primes people for heroin addiction later—and two, the accessibility to heroin has increased.

The number of prescription opioid painkillers prescribed to patients in the United States has skyrocketed in the last 25 years, from 76 million in 1991 to nearly 207 million in 2013.

In 2012, the CDC found that more than 2 million Americans were abusing prescription opioid painkillers.

And, sadly, along with that trend, we’ve seen a staggering increase in overdose deaths in the United States due to prescription opioid painkillers, which have more than tripled over the last 15 years.

Over 70% of prescription drug-related deaths were caused by prescription opioid painkillers in 2013.

Additionally, the number of heroin users has doubled since 2005 and reached 670,000 in 2012 and continues to trend upward, taking more than 8,200 lives in 2013 alone.

In September, Dr. Frieden came to Knoxville where we hosted a roundtable with local physicians, community leaders, and public health officials on ways to fight opioid abuse. There, Frieden called deaths due to opioid overdose “a growing epidemic that is gripping our country.”

The human costs of this epidemic are too high, and I hear about the challenges of dealing with this epidemic at home in Tennessee, particularly in East Tennessee where I am from.

Tennessee ranks near the top of the list for prescription drug abuse, which includes opioids, with the third highest rate of abuse in the nation.‎

According to a 2011 survey, more than 69,000 Tennesseans were estimated to be addicted to prescription opioid painkillers.

More than 1,000 Tennesseans die each year as a result of drug overdose, and many of these deaths are related to abuse of prescription opioid painkillers.

Tennessee is working hard to fight this fast-growing drug problem.

The state has taken a number of actions to prevent prescription opioid abuse and overdose, like making it harder for those seeking prescription opioid painkillers from multiple doctors—a practice known as “doctor shopping”—by requiring that doctors check the state’s prescription drug monitoring program before prescribing an opioid painkiller to a patient.

At our September roundtable in Knoxville, Dr. Frieden announced Tennessee was one of 16 states to receive funding from the CDC through its Prescription Drug Overdose Prevention for States program.

Tennessee will receive $3.4 million over four years to help the state continue its work fighting prescription opioid painkiller abuse and overdose, including support for the state’s database that has been crucial in combatting the practice of “doctor shopping” I have just described. 

At the roundtable, we heard from Austin Maxwell, a father who lost his son to a prescription opioid painkiller overdose, just days before his son had planned to head to college to start taking classes for his freshman year and begin practice as a walk-on to the school’s football team.

I’ve mentioned a lot of statistics today, and it’s important to remember that behind these numbers there are very real human beings whose lives are cut short due to this growing epidemic.

I know that I am not alone in hearing about the challenges of prescription opioid painkiller abuse when I return home.

This is a problem that I have discussed with members of this committee, including Sen. Collins whose home state has been hit especially hard.

But, the truth is, this problem affects all states and is frontline issue for communities all over.

Sens. Ayotte and Manchin have also led a group of nine senators in highlighting the damaging impact of opioid abuse and overdose, and I appreciate their attention to this issue.

Late last month, the president signed into law the Protecting Our Infants Act of 2015, legislation that passed the HELP Committee in late September—and the full Senate in October thanks to the hard work of the sponsors Majority Leader McConnell, our HELP Committee member Bob Casey, and Senator Ayotte and many other supporters of the legislation.

In Tennessee, for example, there has been a tenfold increase in the past decade of infants born addicted to drugs.

The Protecting Our Infants Act will work to reverse this disturbing trend in Tennessee and other states by directing the Department of Health and Human Services to develop a strategy to address any gaps in research—as well as gaps, overlap, and duplication in federal treatment and prevention programs for pregnant women with opioid use disorders and infants born addicted to drugs to help improve programs and make them more effective.

There is a lot of interest in addressing the problem of opioid abuse, and I look forward to our conversation here today about what we can do to really address this problem and prevent opioid abuse and overdose deaths.

I am open to suggestions about ways to ensure that the federal government is helping address the problem, not hindering it.

For example, at that same Knoxville roundtable with Dr. Frieden, one problem we specifically heard about was the Patient Satisfaction Survey that Medicare uses to ask patients about pain management. 

State Rep. Bill Dunn and others told me that the patient satisfaction survey for Medicare patients actually has the perverse effect of encouraging physicians to overprescribe prescription opioid painkillers because reimbursements for hospitals are based to some extent upon the score that patients give doctors about how well they’re satisfied with their treatment.

According to those in the roundtable, patients are unlikely to give doctors a high score unless they prescribe the maximum amount of painkilling opioids – and if doctors don’t get a high score, their Medicare reimbursement is reduced.

Well, I thought that sounded like a serious problem with a pretty obvious solution. So I called Health and Human Services Secretary Sylvia Burwell and recommended she take a look at the possibility this survey was encouraging this growing epidemic.

And in late October, the president made a big announcement in West Virginia about the administration’s plans to fight abuse of prescription opioid painkillers – and one part of the plan is to review this patient satisfaction survey.

So, I was glad to see such a direct response from the administration to the concerns I heard during our roundtable discussion in Knoxville.

This is a complex problem that calls for action by all who have a role in preventing opioid abuse and responding to this problem, whether it is doctors, the health department, law enforcement, or families. We look forward to continuing this conversation in the HELP Committee.

We know that recovery from opioid abuse is possible, but it can be long and challenging road.

I look forward to hearing from our witnesses here today about the challenges they face and the solutions they believe are needed to truly address this problem.

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