WASHINGTON – U.S. Senator Chris Coons (D-Del.), a member of the Senate Judiciary Committee, today questioned witnesses in a Senate Judiciary Committee hearing entitled, “Oversight of the Ensuring Patient Access and Effective Drug Enforcement Act.” The purpose of the hearing was to examine the effectiveness of the Ensuring Patient Access and Effective Drug Enforcement Act, passed in 2016, and potential unintended consequences.

“Delaware, under the leadership of our Attorney General, Matt Denn, recently enacted new regulations that allow prescribers to better monitor each opioid prescription and limit an adult from receiving a first-time prescription for more than seven days, except under exceptional circumstances. That's led to a 12% decrease in the number of opioid prescriptions just since April 1. Shouldn't we be looking at some of the positive, innovative work that's being done in states like Delaware?”

Full and audio available here

Excerpts from Senator Coons’ Q&A are below:

Senator Coons: Thank you, Mr. Chairman. I'd like to ask the committee and I'd like to, on behalf of all of us on the committee, thank those of you on the panel who have testified today. The ongoing opioid addiction crisis is something that has harmed every single community, has affected every state. Just my small state of Delaware lost more than 300 people who died in drug overdoses last year, and what we are trying to do is strike the right balance between making sure that people who suffer from persistent and chronic pain, like Ms. Chambers, can get access to appropriately prescribed and managed opioids and those who are abusing or misusing them are appropriately held to account. So, striking that balance is the purpose of our hearing here today, and I'd appreciate a few pointed answers to some simple, hopefully pointed questions. To Attorney General Frosh, Delaware, under the leadership of our Attorney General, Matt Denn, recently enacted new regulations that allow prescribers to better monitor each opioid prescription and limit an adult from receiving a first-time prescription for more than seven days, except under exceptional circumstances. That's led to a 12% decrease in the number of opioid prescriptions just since April 1. Shouldn't we be looking at some of the positive, innovative work that's being done in states like Delaware?

Attorney General Frosh, State of Maryland: Yes, absolutely. A number of states have prescription drug monitoring programs, they can be extraordinarily effective. Despite the fact that laws like those have been enacted in Delaware and across the country, we still have this tidal wave of opioids washing across, and those are important steps forward, but we have a lot of work that remains to be done. 

Senator Coons: So, help me, Attorney General Frosh, Dr. Catizone, if you would, the DEA's use of immediate suspension orders has dropped, but other enforcement tools like orders to show cause have increased. Are these other tools sufficient to combat the misuse or mis-prescription of opioids? 

Attorney General Frosh, State of Maryland: I don't think they are. I mean, and you only have to look through results to come to that conclusion. DEA has essentially had the same tools for four decades, and they have not been sufficient to overcome the wave of opioids that has washed across the country, so I would say not. Now, the prescription I would give is holistic: we not only need effective law enforcement, interdiction of illegal supply, but we also need treatment, we need prescription drug monitoring, we don't have nearly enough treatment beds in our country, and we're not making forward progress. We are making progress, but it's incremental. It needs to be much more rapid. 

Senator Coons: I agree. Dr. Catizone, what else do you think DEA should do or what else can we do as a committee and a society to address the significant problem of opioid addiction? 

Dr. Carmen Catizone: I think the answer is the balance that you spoke about. We need to have a balance between access of effective law enforcement, and to the prior question, we haven't had time to analyze the data the committee presented today, but if you look at the overview, the DEA has taken action in other areas to compensate for the inability or their concern about trying to take an ISO. So, there has to be some balance there as well. ISOs should be restricted the most serious, egregious cases, where the patients are going to be killed. If that pharmacy, that distributor, that doctor continues to operate. In those cases, the standard worked, you saw by the data the amount of times the ISOs were used was very limited. So, we think restoring or eliminating that data, that new standard, is a means that would give the DEA that important tool back to use that in very limited, but very serious situations.  

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