Oversight Committee Hearing: Federal Approach to Opioid Treatment

Updated: Oct 27, 2019

Earlier this year, Chairman Cummings (D-MD 7th District) and Senator Elizabeth Warren introduced the CARE (Comprehensive Addiction Resources Emergency) Act to provide resources to begin treating the opioid crisis like a public health emergency. The Oversight Committee was holding a hearing with a panel of six medical experts on the federal approach to the opioid crisis. This hearing aimed to examine the potential outcomes of the CARE Act, as well as why so many patients and families who need treatment are unable to obtain it. There was a unanimous call to expand care efforts, the best way to stifle the number of opioid related deaths, however, differed for some in the room.

Chairman Cummings opened the hearing in his usual form: determined to make progress. His opening statement was said with such vigor that the severity and darkness of the crisis captured the room. He communicated that not only can we thwart this issue, but we must.

The six witnesses all championed the CARE Act and expressed a dire need for it to be implemented. They argued that because it was modeled off of the Ryan White Act, legislation that was successful in tackling HIV/AIDS, the CARE Act would also provide similarly positive results. While these two crises are profoundly distinct, many of the witnesses noted that just like the HIV/AIDS epidemic decades earlier, the opioid crisis is "highly stigmatized", "misunderstood", and has been "underestimated".

The CARE Act embraces a “whole person approach”, said Dr. Arthur Evans, CEO of the American Psychological Association. This type of approach entails psychosocial interventions in conjunction with medications to treat those struggling with addiction. This approach is particularly vital because it recognizes an aspect of the crisis that has gone unaddressed: the disease of addiction rarely stands alone, there are usually co-occurrences.

The idea of psychosocial intervention along with medicated treatment is no groundbreaking idea, and it has proven successful in practice. Dr. Evans recognized the necessity of this combination, but ventured further: He pointed to the idea that giving former addicts small grants or loans to start to rebuild a life has had extremely high success rates of keeping people clean. He explained that these sums of money may range from a grant to start a small business to a few bucks to get a haircut for a job interview. It is possible that if this strategy were to be written into the CARE Act, the support would not be as unanimous as it currently is.

The witnesses brought with them specific concerns about the unique ways the opioid crisis affects their respective communities. Many of the witnesses argued that one of the major reasons the legislation will prove successful is because it addresses the different ways regions have experienced the opioid crisis. Not only does the amount of funding vary based on the opioid-related history of the region, but precisely to whom this funding is going to was also carefully considered. Dr. Bailey, president elect of the American Medical Association, pointed out that this aspect of the legislation also helps the prevention effort. For example, some regions would be allocated more money for increased training for health professionals rather than a greater circulation of Narcan.

While there was overall agreement among the representatives and the witnesses, the topic of prevention is where Representative Jordan (R-OH 4th District) strayed from the sentiments of the witness testimonies. Jordan referred to the current state of the U.S. borders and the ability to smuggle drugs into the country as the current “root” of the opioid crisis that is ultimately allowing it to prosper.

After a little while, Ms. Angela Gray addressed Mr. Jordan’s statements about the security of the U.S. borders. She argued that law enforcement can disrupt the supply all they want, but the addiction has to be addressed. She pulled on her experience as a nurse in West Virginia when she argued that many of those who are addicted are suffering from a disease, and will just start using the next accessible drug.

It felt as though a wide range of victims were addressed during this hearing. There were references made to the baby born with Neonatal Abstinence Syndrome (NAS), the user who has been addicted since age 12, the inner city addict, the suburban addict, the families and friends of those addicted, those whose lives were taken to early by opioid addiction, and all the different roles of health professionals. As Chairman Cummings put it, “We came to speak for the living and the dead.”

#opioidepidemic #oversightcommittee #CareAct

Victoria is a rising senior at Duke University majoring in Cultural Anthropology and minoring in Neuroscience. Victoria believes that some of the overlap between Cultural Anthropology and Neuroscience manifests in the opioid crisis: Insight into the chemical alterations opioids cause in one’s brain is a helpful route to understand and empathize with the other, a cornerstone of cultural anthropology. Understanding others and graceful communication with others is not just what Victoria studies, but what she strives for. Last summer, she worked for a nonprofit and became even more invested in helping those affected by the opioid crisis than she was before, so Pilleve is an exciting next step. Part of Victoria’s investment in helping those bound by the grips of the opioid crisis comes from watching some of her loved ones become addicted to opioids in ways that could have been thwarted had Pilleve been in the picture. On a more artistic note, she always has a camera on her. Whether it’s a 35mm film camera, a digital camera, or a large format camera and a tripod, she loves taking photos as a hobby or in her work.


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