Rep. Marino: Truth is the key to solving the opioid crisis

“What is truth?” was Pontius Pilate’s famous question to Jesus. In our nation’s capital and the media, the answer seems to be “whatever the Washington Post says it is.”

Recently, an epic 7,800-word piece in the Post claimed that legislation I co-sponsored – and which passed both houses of Congress unanimously and was signed by President Barack Obama with the approval of the Drug Enforcement Agency (DEA) – represented a “victory” for opioid drug manufacturers. 

{mosads}Like most such “exposes,” the Post’s narrative features a lonely, righteous crusader – in this case, a former DEA enforcement official whom the paper acknowledged to be “a consultant to lawyers suing drug companies” – opposed by powerful and shadowy interests. 

The article insisted that by clarifying the “imminent danger” standard DEA used to pursue dozens of immediate distribution suspension orders, the legislation “weakened the agency’s ability to go after drug distributors.” And it averred that the bill was “the crowning achievement of a multifaceted campaign by the drug industry” which “worked behind the scenes with lobbyists and key members of Congress, pouring more than a million dollars into their election campaigns.”

The response inside the Beltway was frantic.  At least two senators declared, in Kerry-esque fashion, that they were against the bill after they were for it.  Spokespeople for the Obama White House and Office of Management and Budget disavowed responsibility. Media nationwide and around the world piled on. Ultimately, I withdrew my name from consideration as director of the Office of National Drug Control Policy (ONDCP).

I took that step to avoid distraction from a central mission of mine for years: the fight against misuse of addictive drugs.  And sustaining that war is why it is important to make clear that the Post’s characterization of the legislation – and its origins – departs widely from the truth.

Far from being the nefarious result of industry actions, the legislation originated with my own interactions with constituents. In 2012, I met with a community pharmacist having so much trouble obtaining prescription opioids that he had to turn away legitimate pain patients. When I directed my staff to research what was happening in the supply chain, they found that disrupted access to needed medications was indeed systematic.

In a 2014 survey, 75 percent of some 1,000 community pharmacists had experienced three or more delays or issues with stopped shipments over the previous 18 months – usually with no advance notice. On average, 55 pain patients per pharmacy were impacted by these delays, representing tens of thousands of patients.

My staff found part of the problem in the DEA’s Office of Diversion Control – led by the Post’s source.  The Office had become an adversary of good actors in the supply chain even as it ran roughshod over the will of Congress and even Justice Department leaders.  Asked publicly what the “imminent danger” standard means, its leader responded that it was whatever he thought it means.  

Effectiveness in any public health initiative is about optimally directing resources and getting parties to engage collaboratively.  It’s not about pursuing personal crusades at the whim of a single bureaucrat – while potentially interrupting needed medications to veterans, hospice patients and those with chronic conditions for whom opioids can be the difference between a bearable existence and utter agony.

That’s why I introduced and attracted bipartisan support for legislation to define the “imminent danger” standard – which also sought an extensive study of the opioid distribution problem to be delivered to Congress one year after enactment.

Yet work on that report has not even begun – and moving it forward would have been one of my first priorities had I been confirmed as head of ONDCP.  Because the truth about the opioid crisis, and the best policies to combat it, is complex and nuanced. 

But nuance doesn’t sell newspapers or “break the Internet.” It doesn’t serve trial lawyers suing drug companies, or their well-paid consultants serving as “expose” sources. Nor does it advance the cause of grandstanding politicians or those working overtime to disrupt the president’s agenda.

For my part, I’m going to keep the focus on the action agenda I have pursued over recent years and would have advanced as ONDCP director: to delve into the complexities of the opioid crisis, identify effective uses of resources, and build collaboration. 

As I have done in helping local officials in my district set up effective court diversion programs, prevention efforts targeting high-risk kids, and recovery support initiatives. And as I did as original co-sponsor and conferee of comprehensive legislation– based on the input of scores of experts – pursuing all these avenues while expanding access to treatment and aiding law enforcement.

In short, in contrast to media sensationalism, when it comes to the opioid crisis, I’m going to keep trying to find the truth – in the hope of designing the best policies to set millions of troubled Americans free.

Marino is a four-term member of Congress representing Pennsylvania’s 10th District and former U.S. Attorney. He recently withdrew his name from consideration to be the nation’s Drug Czar.