Heroin Addiction and Overdose:
What Can We Do to Address This Growing Problem?

A Congressional Briefing Sponsored by The Friends OF NIDA
In Conjunction with the Congressional Addiction, Treatment and Recovery Caucus

Monday, June 1, 2015

On June 1, 2015, the Friends of the National Institute on Drug Abuse held a congressional briefing titled “Heroin Addiction and Overdose: What Can We Do to Address This Growing Problem?” It was the most recent event in the coalition’s Charles R. Schuster congressional briefing series.

With more than 135 congressional and federal agency staff, professional society representatives and others in attendance, it was clear there is wide interest in combating heroin and opioid addiction ─ and with good reason. Over the last decade heroin and opioid addiction and overdose deaths have been steadily rising in the United States. In 2013 alone, there were 16,235 prescription opioid overdose deaths, almost double the 8,517 in 2003. Heroin overdoses have also increased dramatically, with more than 8,000 deaths in 2013, up from around 2,000 in 2003 (see figure).

But efforts are underway at the National Institute on Drug Abuse (NIDA) to support research that will enable this trend to be stopped and reversed. The three speakers at the briefing highlighted what we know about opioid and heroin abuse, what new research is being conducted and what addiction looks like at the human level.

Nora Volkow, the director of NIDA, was the first speaker. She presented evidence linking the increase in heroin usage to the increased use and abuse of opioid medications (view her presentation [PDF, 1.77MB]). The reasons behind this are still being studied, but a new study by Theodore J. Cicero and Matthew S. Ellis of Washington University in St. Louis showed that heroin was the leading drug of choice to replace OxyContin usage. Volkow also described NIDA-supported research aimed at developing overdose medications, treatments for addictions and analgesics with less abuse potential.

The second speaker was psychologist Sandra Comer, a professor of neurobiology in the department of psychiatry at Columbia University (view her presentation [PDF, 1.51MB]). She and her colleagues are investigating the use of medications to treat opioid abuse and dependence. Their research includes work that compares three potential treatments: buprenorphine, methadone and naltrexone.

Each of these medications has shown promising results but comes with both advantages and disadvantages for treatment. Buprenorphine can be administered in a doctor’s office, broadening its appeal and making it easier for patients to comply. However, it can be difficult to withdraw from. Methadone can be taken once a day, but requires administration of high doses (80-120 mg) to be effective. Naltrexone completely blocks the effects of opioid agonists and has no abuse liability. However, it requires patients to completely abstain from opioid use prior to treatment and does not have as good a compliance rate when compared with the other two.

Brooke Scannell, chief of staff for Rep. Katherine Clark, D-Mass., who was in attendance, gave a moving speech about her brother Kyle’s fight with addiction and the toll it has taken on her family.

Kyle’s struggle with addiction began in high school when he was introduced to opioids by a friend. He then progressed to heroin use and dependence.

Scannell first learned of her brother’s addiction when he engaged in criminal behavior to fund his drug purchases.

Like many individuals with this chronic relapsing disease, Kyle wanted to quit using. Highlighting the difficulty in finding treatment, Scannell recounted one episode in which Kyle had to travel from Massachusetts to New Jersey — while experiencing full-blown withdrawal symptoms — to find a detox bed.

With support from his mother, Kyle would periodically enter treatment and enjoy periods of sobriety. During one such period, Kyle became distressed by the death of a close friend and again turned to heroin. He overdosed and died on April 12, 2015.

Scannell called for the roomful of her fellow congressional staffers to focus on this problem. Kyle’s poignant story linked a name and a face to the human toll of opiate dependence and highlighted the pressing need for additional NIDA research into prevention and treatment.

The American Psychological Association (APA) is an active member of the Friends of NIDA and the event was organized on behalf of the coalition by staff of the APA Science Government Relations Office. Please contact Will Starck at APA for more information.

Heroin overdoses have also increased dramatically, with more than 8,000 deaths in 2013, up from around 2,000 in 2003