APA Reaches Out to Capitol Hill on Opioid Epidemic

The day was dreary enough. As if thunderstorm warnings were not enough, there were tornado threats in Washington, D.C. APA was scheduled to host a congressional hearing on an equally dreary, if important topic: the opioid epidemic. We rushed from APA headquarters to the Cannon House Office Building, tumbling out of the taxi, umbrellas helplessly flapping in the wind. We passed through security, the metal detectors quiet as we made our way in. The white marble halls were full of people bustling around. The House had just finished its morning session minutes before we arrived.

We entered our assigned room, and it was packed. There, we would meet with House staffers and members of the public to give them information about the epidemic and persuade them to stay focused on this deadly problem.

The speakers in the line-up were simply spectacular. Dr. Nora Volkow, director of the National Institute on Drug Abuse, talked about the biological basis of addiction and what was needed to stem the increasing toll of prescription opioid misuse. In her inimitable, compelling style and completely off the top of her head, she described the challenges of treating pain and the limitations of our toolbox to appropriately address it without exposing patients to the risk of addiction. She spoke passionately about the importance of research to find new methods for identifying vulnerable individuals and to delineate the neurobiological changes that lead to the inexorable addiction that haunts some of those exposed to prescription opioids.

Dr. Kyle Kampman discussed the medication treatments currently available for opioid addiction. He detailed, in an accessible way, the pharmacology of the various medications that can avert withdrawal, craving, and the experience of euphoria to varying degrees. His description of why medications with a short half-life have limited utility was vividly persuasive. As well, he underscored the importance of psychotherapeutic interventions, so critical to a holistic approach to psychiatric conditions.

Dr. Nasir Naqvi presented a case that poignantly illustrated the challenges of health insurance denials for those with opioid dependence. He explained how stigma is codified in the way that some insurance companies go about approving detox or inpatient treatment, increasing the risk of relapse and even death. A key aspect of the case he presented was that it challenged many preconceptions about opioid addiction. He exposed how this is not an illness of the disenfranchised or marginalized; it touches every corner of our society, regardless of income or education.

Early in the session, we were delighted to have Rep. Paul Tonko from New York tell the audience about his inspired work to quell this national disaster. He urged those present to stay in the fight and keep this issue front and center. His speech was nothing short of rousing.

People directly impacted by this hideous epidemic gave presentations that moved the discussion from scientific facts to real life. Ginny Atwood Lovitt is the executive director of the Chris Atwood Foundation, which was started in memory of her little brother who died from a heroin overdose at age 21. She eloquently described her brother’s opioid addiction, which ultimately caused the spiral that led to his death. Galvanized by this tragedy, she described how she became a state-certified master opioid overdose reversal trainer and led a successful effort to pass a Virginia law to allow instructors like herself to dispense naloxone.

Joseph Zabel, president of Great Falls Pools in Great Falls, Va., described his trajectory in recovering from substance use disorder. Poised and thoughtful, Joseph explained how his work with Arise & Flourish to promote addiction prevention to teenagers and parents dovetailed with his passion for working with people with alcoholism and other addictions to help them recover and to bring a message of hope to parents and children who struggle with addiction.

I rejoined at the end, to talk about a well-kept secret: hidden behind the terrible epidemic of opioid overdose deaths looms the fact that many of these deaths are far from accidental. They are suicides.

I cannot say it was a fun afternoon. Many in the audience, myself included, nodded in recognition as we listened. There was many a moist eye among the listeners. And yet is was a powerful and moving afternoon. We had an unparalleled opportunity to reach those in government who may be able to effect change. All in all, it was an excellent day on the Hill, and perhaps, as it turned out, the harsh weather had set the right tone for this important discussion. ■