Cities Ask the Federal Government to Fight Painkiller Deaths

On the heels of a new report from the Centers for Disease Control and Prevention about the rate of prescription painkiller overdose deaths on Tuesday, a coalition of big city health officials traveled to Capitol Hill to ask for federal action to help cities reduce overdose deaths caused by prescription painkillers and heroin.

Drug overdoses, particularly those resulting from painkillers and heroin, are now the leading cause of injury or death in the United States, according to the CDC, a problem brought to light with the death of actor Philip Seymour Hoffman earlier this year. Painkillers like Vicodin and OxyContin are the biggest driver of the problem, causing 17,000 deaths in 2011, nearly quadruple the number in 1999, and more than three times as many as cocaine or heroin.

The CDC report was not all bad news, though: The rate of increase in painkiller deaths slowed considerably, down from 18% each year from 1999 to 2006 to 3% each year from 2006 to 2011. That decrease was largely thanks to a decrease in overdose deaths caused by methadone, a drug that can be used as a pain reliever or for treating heroin addiction, after the FDA warned doctors about the drug in 2006 and manufacturers limited distribution of large doses to addiction treatment facilities and hospitals, according to the Associated Press.

Nevertheless, painkiller deaths are still on the rise. And in their Capitol Hill briefing on Tuesday, city health commissioners from Boston, Chicago, and New York, representing a group called the Big Cities Health Coalition, laid out ways the federal government can help cities battle the epidemic.

In a follow up conversation with TIME, the experts offered three promising ways the federal government and drug companies can help cities:

1. The Federal government can spread access to Naloxone, a drug that can reverse overdose. The Justice Department and the White House Drug Control office have advocated more widespread use of Naloxone by first responders. To help expand access to Naloxone for family members and first responders, the FDA could work with the drug companies that manufacture Naloxone to make it available over the counter, the city health commissioners told TIME. Congress could also pass legislation proposed by Senator Edward Markey (D-Mass.), the experts said, that would protect non-medical personnel who administer Naloxone to an overdose patient from civil liability.

2. The Feds can also expand access to Buprenorphine, a drug that can be used to treat opiate addiction. Federal law requires doctors to be trained and licensed to prescribe Buprenorphine and limits them to a cap of 30 patients in their first year of practice, with the option to apply to expand to 100 patients thereafter. The law resulted from fears that medicine-assisted treatments just replaced one addiction with another. But the city health experts told TIME that Congress should lift this cap, pointing out that there is currently no limit on the number of prescription painkillers that can be prescribed.

3. Finally, said Dr. Bechara Choucair, Commissioner at Chicago’s Department of Public Health, drug companies could do more to educate doctors and the public about the risks of addiction to pain medication. Chicago has has sued five drug companies, alleging they deceptively marketed opioid painkillers to treat chronic pain even though they knew the drugs were ineffective for certain conditions and carried a high risk of addiction.

“We don’t come forward a lot,” said Barbara Ferrer, Boston’s Public Health Commissioner. “When big cities say there is need for [a] federal policy agenda, people should stand up and listen.”