U.S. Sen. Joe Manchin (D-WV) has declared his own personal war on West Virginia’s opioid epidemic which he says should be treated as a public health crisis, not a crime.

In an exclusive interview with WeHeart West Virginia, Manchin told us that despite efforts, we may actually be losing ground in the fight to curb drug use.

“There’s no doubt that we have a growing number of communities in the state where heroin is an epidemic, especially places like the Eastern Panhandle and Huntington.”

West Virginia has the highest rate of overdose deaths in the country. Cabell (Huntington) and Berkeley (Martinsburg) lead within the state.

Manchin has been involved in everything from changing the culture at some federal agencies—like the Food and Drug Administration and Centers for Disease Control—to reaching out to addicts and their families. He says he’s working at the national, state and even local level to stem the flow of heroin and morphine as well as prescription painkillers like OxyContin and Vicodin.

But there has been a fundamental shift in the way he views drug abuse. Simply locking addicts up isn’t the answer. It’s a public health crisis, not just criminal activity.

Manchin is the first to admit that for too many years, he – not unlike other policymakers, law enforcement officials and regulators – didn’t realize that addiction is an illness.

“Looking back to when this epidemic starting hitting communities, we thought it was a crime and sent them to jail. Now we know it’s an illness, and an illness needs treatment,” he said.

“We have virtually no treatment that works, especially in a rural state like West Virginia where this epidemic is really hitting hard. We do not have treatment centers, and no way to support treatment centers. So it is a vicious cycle,” he said.

“We’re now fighting all of this, and it is just unbelievable what we’re up against. We’re actually losing ground, that’s why I’ve been trying to make up for some of it,” he said.

He’s not alone in this concern: Other federal offices estimate as many as 2.5 million Americans are addicted to opioids. The Drug Enforcement Administration has identified heroin as the “biggest threat to public health in the Northeast.”

Washington is primarily responsible for things getting so out of hand, but some change is happening, he said.

“There are some changes at the CDC where they have now put their prescribing rules out that deal with prescribing opioid medications for chronic pain,” he said, referring to federal action taken earlier this month.

At that time, the CDC recommended 12 guidelines before opioid medications are prescribed,

“It has been a heck of a fight for the last three or four years. But now the opioids have gone from a Schedule III to a Schedule II, and that’s a big deal,” he said. “That means one billion pills will be taken off the market due to this change. That’s billion with a B.”

This is only one link in a weak chain, however. He’s critical of the Food and Drug Administration’s approach to painkillers, especially in light of the growing opioid epidemic.

“What’s needed at the FDA is a cultural change there, and they need to start taking prescription drug abuse seriously,” he said.

Manchin has also argued that FDA nominee Robert Califf is too closely tied to the drug agency to be named head of this national agency charged with regulating drugs.

Even the medical community needs help to fight this battle.

“All this time doctors haven’t really been instructed about the effects of opioids, and have been prescribing them like candy. Pharmaceutical sales people have convinced doctors there is no addiction from them. And consumers also haven’t been educated, so it is just awful all the way through.”

One of the guidelines encourages them to prescribe the lowest effective dosage for pain relief, but everything takes time to change, he said.

The numbers tell the tale of why change is so difficult, he said.

“Of all the opioids produced in the world 80 percent of them are consumed in the United States. That means we could put a bottle of opioids in the hands of every adult in America because we prescribe so many,” he said.

“And we have less than five percent of the world’s population, so what does that tell you about the opportunity for an epidemic that we are just how starting to begin to comprehend. We better know we have a problem,” he said.

(Featured photo via Third Way Think Tank/Flickr from an unrelated event in 2013).

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