Texas House Select Committee Publishes Report on Opioids and Substance Abuse
Written by Editor   
Tuesday, December 11, 2018 01:08 PM

The substance abuse crisis in our nation and state prompted the Texas House of Representatives’ Speaker Joe Straus to appoint the Select Committee on Opioids and Substance Abuse (Committee).  The House Select Committee on Opioids and Substance Abuse was tasked by the Speaker of the House to “develop and present concrete principles and action items to reduce the scourge of opioids in Texas and to provide legislative solutions to address these issues, as well as examine other topics related to substance abuse in Texas.”

Rep. Four Price, the chair of the committee notes that the committee "conducted six robust hearings with over 70 invited expert witness testimonies.This led to the committee producing a detailed report outlining the current challenges, including recommendations that can make a positive impact if enacted by the Texas Legislature.”  TCA Scientific Affairs Department Coordinator, Dr. Craig Benton presented testimony at one of these hearings.

The Select Committee’s report, accessible at the hyperlink, notes, among many other findings that “every day, on average, 115 Americans die from an opioid overdose. Americans with an opioid addiction equaled 2.4 million in 2016, and approximately 20.1 million Americans aged 12 or older were reported to have a substance use disorder, with 11.5 million misusing pain reliever opioids.”

“In Texas,” the report notes “in 2016, 2,831 persons died due to a drug overdose. In 2017, 90 out of 172 child fatalities, of families involved with the Texas Department of Protective Services, were caused by abuse or neglect and involved a parent or caregiver actively using a substance.”

“With an actual recorded number of 2,831 overdose deaths in Texas in 2016 and a reportshowing four Texas cities in the top twenty-five United States cities for opioid abuse, Longview, Texarkana, Odessa, and Amarillo, the issue is alarming.”

The report notes that opioids are natural or synthetic. The substances are used medically for pain relief and recreationally for a euphoric feeling. Common opioids include morphine, heroin, codeine, oxycodone, and fentanyl.

Opioid overdoses slow down bodily functions, including the impulse to breathe. Physical characterizations are non-responsiveness, and blueness around fingertips and eyelids. Brain damage and death are possible results of an overdose. 

The report notes that the number of days needed to become dependent on or addicted to prescription opioids is only seven days.

The pharmaceutical industry trade association, PhRMA, comments that only a comprehensive approach can solve this complex problem and that all stakeholders must contribute to a solution.

The report also notes that “although the most widespread and deadly drug crisis in the nation’s history, the current opioid crisis is not the first involving addiction and government response.”  

"A brief history of opiate drugs in America entails high levels of addiction and withdrawal post-civil war with veterans developing addictions to morphine to relieve pain from war injuries. Also, medical tonics that contained cocaine and opioids had widespread sales and use.”

“To combat the crisis, alternative pain medications were developed, stricter prescription laws were enacted, professional literature was written and published to train physicians on morphine prescribing, the Pure Food and Drug Act passed in 1906 requiring better product labeling, taxes were placed on narcotics, importation bans were implemented on opium, and ultimately heroin was made illegal in 1924.”
"In the 1960s, heroin use surged, driven in part by the Vietnam War, and the counter culture movement’s acceptance of drug use. The prescribing of amphetamine tablets surged for psychiatric conditions and for weight-loss. To address, President Nixon declared a “war on drugs”; the Comprehensive Drug Abuse Prevention and Control Act passed in the 1970s which established the modern set of controlled substance “schedules”; and the DEA was established."

“In the 1970s, powder cocaine emerged and in the 1980s ‘crack'."

“The current epidemic is fueled by two primary factors, the unsubstantiated claims that were made in the 1980s about opioid addiction being rare and the increased prescription rates for opiates seen between the 1990s and the 2010s. Opioids also became easier and cheaper to obtain illegally. In 2000, Pain as the Fifth Vital Sign was introduced by the Joint Commission as a standard to measure the performance of healthcare providers. This was reinforced by patient satisfaction surveys and accreditation standards and may have contributed to the increased prescribing of opioids.

"The federal government declared a Public Health Emergency specific to opioids on October 26, 2017.”

According to the Texas Medical Board, illicit Pain Management Clinics have been a significant contribution to the opioid crisis and rise of addiction in America.  

The Texas Medical Association reported to the committee that in the 1990s medical students were told that pain was not being treated adequately and that opiates were not addictive.  Pain being named the "Fifth Vital Sign”tied patient satisfaction to prescribing by giving patients the ability to report a physician if they do not feel their pain was managed effectively. This contributed to a rise in opioid prescriptions.

Not only opioids are a problem.  “Other drugs are also increasingly present in inpatient stays, overdose deaths, and drug exposure calls made to the Texas Poison Control Center,” the report notes.  “Antidepressants have, and continue to be, the most frequently seen in drug exposures, and benzodiazepines are increasingly present in data collected by the Poison Control Center.”

Source:  https://www.house.texas.gov