“Although prescription opioids were driving the increase in overdose deaths for many years, more recently, the large increase in overdose deaths has been due mainly to increases in heroin and synthetic opioid overdose deaths, not prescription opioids. Importantly, the available data indicate these increases are largely due to illicitly manufactured fentanyl,” testified Dr. Debra Houry in her prepared testimony before the U. S. House Energy and Commerce Committee's Oversight and Investigations Subcommittee.  Dr. Houry is Director of the Director of theNational Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC).  

Health and safety/enforcement policies have been quickly developed to stem the opioid epidemic. What seems unclear from policy makers to the public, Congress, and people either providing or receiving health services for chronic high impact pain is the definition of "opioid" epidemic.  Clarity is necessary for better communcation in development of better and more reasonable policies without severe "unintended consequences" to people who need pain relief.

Houry described in her testimony how CDC gathers information to guide its policies:   In August of 2015, Massachusetts Department of Public Health (MDPH) investigated the extent to which illicitly-madeIn August of 2015, Massachusetts Department of Public Health (MDPH) investigated the extent to which illicitly-made fentanyl (IMF) contributed to the surge in opioid-related overdose deaths because the supply had sharply increased in Massachusetts from 2013 to 2015. Work with federal agencies determined that illicitly-manufactured fentanyl mixed with or sold as heroin was primarily responsible for the surge of deaths from 2014 to 2015.  Eighty-two percent of fentanyl related overdose deaths were suspected to involve illicitly-made fentanyl, four percent were suspected toinvolve pharmaceutical fentanyl, and the remaining 14 percent lacked sufficient evidence to determinethe fentanyl source. In Ohio, there were 84 fentanyl-involved deaths in 2013, which increased to more than 526 in 2014 -- a 500 percent increase.

National Institute of Drug Abuse defines opioids:  Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others. These drugs are chemically related and interact with opioid receptors on nerve cells in the body and brain.

What is the definition of opioid epidemic?  At time of death if someone is using their legally prescribed opioid medication, is this called an opioid-related death?  If alcoohol is present with a legally prescribed opioid medication, is this an opioid-related death?  Are the standards of toxicology reporting consistent on death certificates in all states?  NFCPA believes that definition of broad terms such as "opioid-related" and "opioid" epidemic should be publicly available with easy access.  Securing public confidence in the federal agencies' reported statistics is the first step in education about safe use of prescribed opioids as part of an integrative pain treatment program.