During my watch as Indiana’s Attorney General, our state and nation have come to realize what the former head of the U.S. Food and Drug Administration, Dr. David Kessler, recently called one of the “great mistakes of modern medicine.” The opioid addiction epidemic is uniquely an American disease as our nation, which is 4 percent of the world’s population, consumes about 80 percent of the world’s prescription opioid narcotics.
For years these powerful medications have been prescribed without much understanding of their addictive properties and without “best practices” to guide doctors in their proper use. Dr. Kessler pointed out that “FDA has responsibility, the pharmaceutical companies have responsibility, physicians have responsibility. We didn’t see these drugs for what they truly are.”
Now we are all painfully aware of this great mistake and are paying a tremendous price. Rates of addiction and overdose deaths have skyrocketed, with an average of 78 people dying every day from overdoses of prescription opioids. For the first time in a decade, the U.S. death rate rose last year, attributed in part to rising drug overdose deaths. The costs of care have skyrocketed as well. Add to these the costs of lost time at work, drug-related crime, incarceration, rehabilitation and treatment, and the full enormity of the problem is overwhelming.
As Indiana’s Attorney General, I created the Prescription Drug Abuse Prevention Task Force in 2012 following a state-level symposium my office held to explore the extent of the problem. In the years since, this problem has become an epidemic. This term “epidemic” is not hyperbole but a clinical term used by the U.S. Centers for Disease Control and Prevention to recognize the fact that more people die from overdoses than in automobile accidents each year.
The task force is made up of volunteers from throughout the state who are professionals in the fields of medicine, heath care and law enforcement. It includes two legislators, State Rep. Steve Davisson and State Sen. Ron Grooms, who are both pharmacists. This task force has been funded solely from funds obtained through lawsuits that my office has brought against pharmaceutical companies over claims of off-label marketing (selling prescription drugs for purposes not approved by the FDA).
The results from the work of this task force over the past four years are truly remarkable, but it is no time to claim success. With a greater understanding of the problems associated with prescription opioids as shown by a recent reduction in the amount being prescribed, we hope to see fewer people entering the downward spiral of addiction.
For those already suffering from the disease of addiction, the cheap alternative opioid — heroin — is taking more lives. In order to stem the loss of life from opioid overdoses, my office created a grant program to train law enforcement in the use of Narcan, also called naloxone, which is an easily administered antidote for an opioid overdose.
This work by law enforcement officers speaks well of the men and women who have always been there to “serve and protect.” Now they can add “save” as part of their duties. In the past two years, Narcan has been administered 9,695 times by EMS units alone in attempt to save Hoosier lives.
Even Congress has now begun to recognize the extent of this national problem. Several bills have recently been passed with rarely seen bipartisan support and efforts continue to try to fund desperately needed treatment programs. But much more must be done. We need to better integrate addiction treatment into our health care and justice systems, increase education on mental health and addiction prevention, and continually improve prescriber guidelines.
This is a man-made, uniquely American problem that requires large scale, systemic solutions.
Greg Zoeller is attorney general of Indiana. More information is at bitterpill.in.gov.
