Death by a foreign nuclear attack threatens, but horrifyingly, the United States’ largest mass killer is American-made and -distributed. Its nationwide body count in 2016 alone — 64,000 — surpasses the total U.S. troops killed in the 20-year Vietnam War. Already in Hawaii, an escalating number of people die of it each year, outpacing fatal auto crashes.
Its name is opioid — a class of painkillers that doctors often prescribe — and Hawaii’s statistics show we’re on pace to suffer the rampant consequences from the deadliest drug crisis to ever hit American soil, spreading faster than the HIV epidemic at its peak.
Gripped by this reality, we must push and support the state’s bipartisan Hawaii Opioid Initiative newly released last month, two legislative bills that I am introducing and heightened public awareness to protect ourselves.
Don’t be fooled about opioid’s reach. A surge of newborns is now entering the world dependent on the overprescribed, highly addictive drug. It claims victims of all ages, ethnicities, genders and income. Its various forms and names include fentanyl, hydrocodone and oxycodone, commonly known by its brand name, OxyContin.
Why else does this drug crisis matter to Hawaii’s people? According to the Hawaii Opioid Initiative report:
• the amount of opioid painkillers prescribed nationally in 2015 was enough to keep every American medicated 24/7 for three weeks;
• in Hawaii, there are nearly 490,000 dispensed prescriptions for oxycodone and hydrocodone, potentially consumed by one-third of our state’s population;
• 66 percent of 56 overdose victims autopsied in Honolulu County in 2016 showed positive for opioid pain relievers other than morphine, codeine and methadone;
• oxycodone, oxymorphone, fentanyl and hydrocodone were among the most common opioids found in the above autopsy sampling, while fentanyl is up to 100 times more potent than morphine;
• only one of the 56 victims was homeless;
• 91 percent of the deaths were accidental;
• around 400 nonfatal overdoses require treatment in Hawaii hospitals annually; and
• it costs about $40,100 for each Hawaii hospitalization and every opioid-related overdose costs $4,050 on average per emergency department visit.
Legislation Is On The Way
This year, I am sponsoring House Bills 1602 and 1603.
HB 1603 requires that pharmacies and any outlets selling opioid drugs must provide a warning label of the risks that the medication carries beginning in August 2018. The label shall:
• convey in plain and simple language messaging like “WARNING: THIS DRUG IS AN OPIOID. THE USE OF AN OPIOID MAY RESULT IN AN ADDICTION TO OPIOIDS AND DEATH”;
• feature at least 14-point font;
• contain all-capital lettering; and
• be affixed to the drug container.
HB 1602 requires health insurers and health maintenance organizations to provide coverage and benefits for opioid dependence for a minimum of six months of inpatient and outpatient treatment beginning January 2019. This includes:
• unlimited benefits at in-network facilities;
• out-of-network facility admittance within 24 hours when no in-network facility is immediately available;
• no prepayment of medical expenses by patients during the first six months per plan year of benefits except for copayments, deductibles or co-insurance; and
• providing inpatient stays for the first 28 days without any insurer’s backdated or retroactive reviews of “medical necessity.”
Our No. 1 Killer
How did this painkiller lead to the worst drug crisis in American history?
The Sackler family — worth $14 billion in 2015 and ranked as one of the 20 wealthiest families in America by Forbes — developed OxyContin in the 1990s through its Connecticut-based Purdue Pharma business.
Simply put, the Sacklers’ enormous wealth is blood money, earned at the expense of millions of people — Hawaii residents included — who have fallen prey to drug addiction and accidental overdosing deaths.
UPDATE: The Sackler family issued this statement Thursday morning: Arthur M. Sackler passed away in 1987, eight years before Oxycontin existed. His brothers, Mortimer and Raymond, purchased his one-third option in Purdue Frederick from his estate a few months after his death. None of his descendants have had any involvement with, nor ownership of, Purdue Pharma or benefitted from the sale of Oxycontin in any way.
OxyContin’s addictive properties were apparently well-known to the Sackler siblings but they denied any knowledge. Their marketing campaign misinformed doctors about the risks.
As a result of the Sacklers’ alleged complicity and collusion, the attorneys general of 41 states — including Hawaii — joined a coalition that last September served subpoenas on the Sacklers’ Purdue Pharma and four other major opioid manufacturers as part of a multistate investigation.
Other manufacturers under investigation are Allergan, Endo, Janssen and Teva/Cephalon. Three distributors were also subpoenaed: AmerisourceBergen, Cardinal Health and McKesson. Other states have filed lawsuits against the manufacturers and distributors.
Waging war against opioids resembles the multipronged strategies and tactics that I executed with fellow legislators, backed by unrelenting pressure by citizens on the biggest tobacco makers in the 1990s. Eventually, smoking was banned in public. Similarly, we can defeat the deadly widespread effects of opioids.
Meanwhile, “make America great again” is an overused, diluted slogan and frankly, America hasn’t been great when it comes to drugs since opioids’ production in the 1990s and likely before then. Let’s make America clean, or as pre-opioid clean as possible. A nation must quash its worst drug epidemic before it can be great.
At this juncture, it’s up to us to take action, such as the 41 attorneys general and I are doing, because incomprehensively, the president did not declare this a “national emergency,” as he originally promised to do. Had he done so, we’d have quick federal funding at our disposal.
Join me in supporting legislation that safeguards us, keeping the participants in the governor’s opioid response plan accountable, getting educated about opioids and safer alternatives, advocating for ourselves when interacting with doctors; and pressing insurance carriers to do the right thing. Let’s stand together to end opioid misuse and dethrone the “unstable genius” of America’s largest makers and distributors of “death and addiction by prescription.”