Given the ongoing problems across the country with both prescription painkillers and heroin, congressional hearings are being held to investigate the national opioid abuse epidemic.
On April 23, Rep. Tim Murphy (PA-18) gave the opening address in the Oversight and Investigations subcommittee hearing “Combatting the Opioid Abuse Epidemic: Professional and Academic Perspectives.” Top academic and medical professionals offered their diverse perspectives on the challenge at hand.
In his statement, Congressman Murphy described what the hearings hope to accomplish long-term. “I am calling for a patient-centered initiative with a goal of matching patients with the most appropriate care coupled with a focus on transition not just off of street drugs but eventual transition from opioids altogether, » he said. « I hope to modernize our existing opioid addiction treatment system to ensure that the right patient gets the right treatment at the right time.”
The goal of the committee is to develop bipartisan national policies for opioid abuse treatment and the use of buprenorphine as an opioid replacement program. The hearing considers the widespread use of recovery drugs to be problematic with Congressman Murphy noting that, “According to testimony presented to this Committee last year by the director of SAMHSA’s Center for Substance Abuse Treatment, nearly one million people were prescribed buprenorphine in 2011. We know that number is much higher today, probably closer to 1.5 million people or more.”
In response to the fears of the committee that opioid replacement drugs would lead to new addictions, Dr. Marvin Seppala, the Chief Medical Officer of the Hazelden Betty Ford Foundation, explained that institution’s approach. The Hazelden Betty Ford treatment approach employs buprenorphine in the form of Suboxone. Suboxone adds the opioid antagonist naloxone to the mix. They also use the opioid antagonist naltrexone or no medications at all.
“We use medications to engage our opioid dependent patients long enough to allow them to complete treatment and become established in solid 12-step recovery, » Seppala said. « The highest risk period for relapse is the first 12 to 18 months after treatment, so we prefer to have our patients remain on medication and involved in outpatient care throughout this period. Our goal is to discontinue the medication as our patients become established in long-term recovery.”
Dr. Anna Lembke of Stanford University and Dr. Adam Bisaga of Columbia University Medical Center also provided expert testimony, both of whom will be participating in the future as part of The Fix’s new panel of treatment experts.
The main question raised by the hearing is whether such an extended period of follow-up treatment with opioid replacement therapy is necessary. From the congressional perspective, such treatment extends beyond the limits needed by most patients. The objective for both the subcommittee hearing and the treatment professionals is to find a balance between the two perspectives.