W.Va. senators push for opioid answers

WHEELING — U.S. Sen. Joe Manchin asked panelists testifying before a Senate subcommittee Tuesday if the high number of opioids historically prescribed in West Virginia “wasn’t a model for business,” instead of “a model for healing.”

And while West Virginia leads the country in per-capita opioid overdose deaths, the state doesn’t receive a proportionate amount of federal funding to provide addiction treatment, Sen. Shelley Capito told the subcommittee.

Capito, R-W.Va., and Manchin, D-W.Va., spoke and asked questions during a hearing before the Subcommittee on Labor, Health and Human Services, Education, and Related Agencies titled “Addressing the Opioid Crisis in America: Prevention, Treatment and Recovery.”

Panelists included Dr. Debra Houry, director of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention; Dr. Elinore McCance-Katz, assistant secretary for Mental Health and Substance Use at the Substance Abuse and Mental Health Services Administration; Dr. Francis S. Collins, director of the National Institutes of Health; and former Rep. Patrick Kennedy, a recovering prescription drug addict and member of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.

Manchin told the committee opioids had been “a silent killer for far too long” in West Virginia. He provided statistics indicating 780 million hydrocodone pills were issued between 2007 and 2012 in West Virginia — a state with just 1.8 million residents.

“That’s 433 pain pills for every man, woman and child in West Virginia,” he told Houry. “You’re saying a flag was never raised, and now all of a sudden you are looking at them? You all believe from the pharmaceuticals, to the distributors, to the (pharmacy benefit managers) — has this been a business model, or a health healing model?”

He wanted a “yes” or “no” answer, which neither Houry nor Katz provided.

“Yes,” Kennedy said. “There’s no way to explain it. … There’s guilty hands all around.”

Collins said he wasn’t knowledgeable enough to know if this had been a business model.

“But it does seem market forces were involved,” he said.

Capito also pointed to statistics showing a high rate of pain killers prescribed in West Virginia. In 2015, there were 638 overdose deaths in West Virginia, and that figure is expected to increase over the next several years, she said.

Capito then questioned the allocation of state-targeted grant funding through the Substance Abuse and Mental Health Services Administration.

SAMSA distributed $485 million in funding, with just $6 million coming to West Virginia. Another small state, New Hampshire — which is second in per-capita opioid deaths — received $6 million over two years.

Capito said it’s no surprise smaller states have the deepest problems with opioid addiction, and if not nipped in the bud, the problems will increase in proportion in larger states.

Katz said SAMSA officials decided to keep the same funding formulas in place after many states expressed concern they might have to cut programs already in existence if they saw funding cut in the next round of allocations. SAMSA opted, instead, to find alternative ways of funding smaller states.

“We have decided this is not going to solve this problem,” Capito told Katz. “We are trying to encourage SAMSA to look at mortality rates, lack of access to treatment and services when doing the state-targeted response to opioid crises grants. Let’s write these grants to where the greatest needs are.”