e-News 4/06/2018

The Opioid Epidemic
The Surgeon-General’s Advisory
Congressional Action on Opioids
Improving Law Enforcement Efforts
Beyond Opioids: Supporting New Jersey Priorities
Salute: Cynthia Perrazzo, new senior leader at Picatinny
The Opioid Epidemic
Over the past 15 years, families and communities across our Nation have been tragically affected by the opioid epidemic, with the number of overdose deaths from prescription and illicit opioids doubling to over 42,000 in 2016. 
Over two million people in the U.S. struggle with opioid abuse and rates of opioid overdose deaths are rapidly increasing.  Since 2010, the number of opioid overdose deaths has doubled from more than 21,000 to more than 42,000 in 2016, with the sharpest increase occurring among deaths related to illicitly-made fentanyl and fentanyl analogs (synthetic opioids).  Opioid abuse has been declared a national public health emergency by the President killing more people than car crashes each year according to the Centers for Disease Control and Prevention (CDC).
Opioids are a class of drugs that include medications, such as oxycodone, hydrocodone and methadone, which are commonly prescribed to treat pain, as well as illegal drugs, such as heroin.
The steep increase in the opioid death rate is attributed to the rapid proliferation of illicitly made fentanyl and other highly potent synthetic opioids. These highly potent opioids are being mixed with heroin, sold alone as super-potent heroin, pressed into counterfeit tablets to look like commonly misused prescription opioids or sedatives (e.g., Xanax), and being mixed (unknowingly?) with other illicit drugs like cocaine or methamphetamine. The resulting unpredictability in illegal drug products is dramatically increasing the risk of a fatal overdose.
Another contributing factor to the rise in opioid overdose deaths is an increasing number of individuals receiving higher doses of prescription opioids for long-term management of chronic pain.  Even when taking their pain medications as prescribed, these patients are at increased risk of accidental overdose as well as drug-alcohol or drug-drug interactions with sedating medications, such as benzodiazepines (anxiety or sleep medications).  
The Surgeon-General’s Advisory
The United States Surgeon General issued an advisory this week recommending that more Americans carry the opioid overdose-reversing drug, naloxone.
The drug can very quickly restore normal breathing in someone suspected of overdosing on opioids, including heroin and prescription pain medications.
Dr. Jerome Adams emphasized that "knowing how to use naloxone and keeping it within reach can save a life." To make his point, Adams relied on a rarely used tool: the surgeon general's advisory. The last such advisory was issued more than a decade ago and focused on drinking during pregnancy.
Read the CNN story about the advisory here.
You can learn more about naloxone and the Surgeon-General’s Advisory here.
Congressional Action on Opioids
Congress has recognized the threat posed by the opioid epidemic and has acted. The Consolidated Appropriations Act, recently passed by Congress and signed by the President, provides nearly $4 billion to address the opioid epidemic, the largest investment to date, and helps execute the National Opioid Initiative.
Improving Law Enforcement Efforts
Prioritizes funding at the Drug Enforcement Administration for anti-opioid and other illegal drug enforcement efforts, including enhancements for heroin enforcement and additional resources to combat transnational crime:
  • Includes a $37M increase to enhance opioid diversion investigations and prosecutions
  • Provides $543M for the Organized Crime and Drug Enforcement Task Forces;
  • Includes $447M for Department of Justice grant programs that support drug courts, treatment, prescription drug monitoring, heroin enforcement task forces, overdose reversal drugs, and at-risk youth programs;
  • Increases funding for Department of Justice federal law enforcement programs such as U.S. Attorney and U.S. Marshals Service to prosecute and detain criminal offenders, including drug traffickers;  
  • Provides $280M for the High-Intensity Drug Trafficking Areas program;
Supporting Treatment and Prevention
  • Provides $1B in new funding for grants to states and Indian tribes to address the opioid epidemic
  • Supports increased opioid overdose surveillance and prevention at the national, state, and local level by providing $476M to the CDC for these activities, $350M above FY17
  • Provides at least $500M for research on opioid addiction support by the National Institutes of Health
  • Includes $117.1M for federal drug control programs under the Office of National Drug Control Policy
Assistance for Veterans
  • Provides $386M in Department of Veterans Affairs medical care funding for opioid abuse treatment and prevention, $14M above FY17
Stopping the Flow of Illegal Drugs into our Country
  • Includes $284M for port and drug inspection technologies within Customs and Border Protection, with $71M specifically targeted at opioid detection;
  • Provides $94M for the FDA to expand its surveillance and analysis efforts by conducting sampling of some of the millions of parcels that come through International Mail Facilities each year;
  • Adds an extra $10.4M above the budget request to the U.S. Postal Service Office of the Inspector General to continue drug interdiction efforts and investigations, providing a total of $245M to investigate illicit drugs coming through the mail;
Beyond Opioids: Supporting New Jersey Priorities
The Consolidated Appropriations Act contained vital funding for programs vital to New Jersey’s people and communities:  
  • The legislation provides $505 million for Section 811 housing vouchers for non-elderly, disabled persons, an increase of $385 million from current levels, providing an increase of 40,000 vouchers.  These “Frelinghuysen Vouchers” provide new housing opportunities for persons with disabilities, allowing them to live with independence and dignity.
  • The Land and Water Conservation Fund, slated to receive $425 million, including $10 million in FY 2018 for the federal Highlands Conservation Act (HCA).  The measure also reauthorizes open space preservation from willing sellers under my HCA. A major source of drinking water and in the most densely populated metropolitan area in the country, the Highlands is a critical area in need of protection.
  • The Department of Homeland Security’s Nonprofit Security Grant Program is increased by $25 million to a total of $50 million. Nonprofit Security Grants provide funding support for target hardening and other physical security enhancements to nonprofits, including faith based organizations that are at high risk of a terrorist attack. Synagogues, Jewish Community Centers and schools, including several in New Jersey, were targeted over the past year in a series of bomb threats. 
  • I recently traveled to Cambodia and Laos and when I returned I made sure that funding for the Defense POW-MIA Accounting Agency (DPAA) is significantly increased in order to accelerate the recovery of lost service personnel, especially from the Vietnam War in Southeast Asia.  Learn more about the DPAA here.
Learn more about what the Consolidated Appropriations Act included to support New Jersey’s priorities here.
Salute to Cynthia L. Perrazzo, a Picatinny Arsenal senior manager who this week joined the ranks of the Army's Senior Executive Service (SES).  The Civil Service Reform Act of 1978 states that the purpose of the SES is to ensure that the executive management of the Government of the United States is responsive to the needs, polices, and goals of the Nation and otherwise is of the highest quality.  Congratulations, Cynthia and thank you for your service!