WASHINGTON — Trying to understand who gets addicted to opioids, and what drives them to drugs in the first place, can help shape a response to the issue, according to a Republican lawmaker.
At an American Enterprise Institute (AEI) briefing on Tuesday, Sen. Mike Lee (R-Utah) tied the roots of the opioid abuse epidemic in the U.S. back to the Civil War, and the “social turmoil” that followed. The war “robbed Americans of a sense of purpose” that left people vulnerable to addiction, just as opioids were entering the country, he stated.
A Republican lawmaker and policy experts explored the role of social and cultural factors in the opioid epidemic and ways to address the crisis during an AEI panel discussion on Tuesday.
Lee added that he sees parallels with that crisis and the current epidemic. “The people most vulnerable to opioid addiction are often lonely and cut off from sources of personal fulfillment. And by that I mean family, meaningful work, and engagement with friends and with neighbors.”
Lee and others gathered at AEI to discuss “The Numbers Behind the Opioid Crisis” — a recent report from the Social Capital Project of the Joint Economic Committee, for which Lee serves as chair. The research initiative focused on “the evolving nature, quality, and importance” of social relationships to the nation.
People who are divorced or unmarried account for 32% of all American adults (ages ≥25), he said, but also accounted for 71% of opioid overdose deaths in the U.S. in 2015. Adults with only a high school education are also “disproportionately likely” to die from an opioid overdose, he added.
Other key findings of the report include:
- In 2016, 64,000 people died from drug overdoses, with two-thirds of those overdoses attributable to opioids.
- Prescription pain relievers “freely given by friends and family” represent 40% of the drugs taken by “abusers.”
- In 2015, 40% of adults had only a high school diploma or equivalent degree but “accounted for 68% of opioid overdose deaths.”
- From 2009 to 2014, the proportion of children whose cases of “out-of-home placement” related to a parent’s drug or alcohol use increased from 29.4% to 35.1%.
Lee underscored the second point, noting “most people don’t ultimately get their pain pills through a legitimate prescription.”
He cited AEI resident scholar Sally Satel, MD, who recently penned an op-ed for Politico, highlighting the “false narrative” that the opioid crisis has been largely fueled by patients becoming addicted to opioids prescribed by doctors. Satel is a practicing psychiatrist at a Washington methadone clinic, and a lecturer at the Yale University School of Medicine in New Haven, Connecticut.
In the piece, Satel wrote that while the number of opioid prescriptions “did increase markedly from the mid-1990s to 2011,” and “some people became addicted through those prescriptions,” surveys and reviews of the data show “only a minority of people who are prescribed opioids for pain become addicted to them, and those who do become addicted and who die from painkiller overdoses tend to obtain these medications from sources other than their own physicians.” The op-ed has drawn nearly 100 comments to date. (Leaders of Physicians for Responsible Opioid Prescribing, which urges that the drugs be prescribed sparingly, subsequently wrote a rebuttal.)
There are no easy legislative solutions to the crisis, Lee cautioned, while also warning against “knee jerk responses” by the federal government.
“There is strong evidence that the government has itself done substantial harm by, among other things, paying for a flood of pain pills through Medicaid and the Medicare Prescription drug program,” he stated.
Instead, Lee called for solutions at a local level. The opioid epidemic is strongest in “already eroding communities” and its most vulnerable targets are those who are already isolated, he said.
“If we’re going to the halt the spread of opioids, and if we have any hope of stopping the next drug crisis, then we need to build resilient families and resilient communities. That’s a project that can be accomplished only at the community level; only at the personal level,” he said.
He cited two treatment programs in Utah as examples of such community building. Odyssey House is a not-for-profit which steers people with addiction away from the criminal justice system and into supportive treatment. The Other Side Academy is a 2-year program for people who have already detoxed that aims to prevent relapse by helping individuals find work.
Five years after graduating, more than two-thirds of participants in the Other Side program are “crime-free” and “drug-free,” Lee said. “The examples could be multiplied.”