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The Call-In: The Opioid Epidemic And How Opioids Have Affected Your Lives


And this is The Call-In, our segment where you tell us what you're thinking. This week, we're talking about the opioid epidemic. The CDC released new numbers on Friday showing that the rate of fatal drug overdoses in the United States has increased more than two and a half times from 1999 to 2015. And the drugs that are killing people are shifting toward lethal compounds like heroin and fentanyl.


GARCIA-NAVARRO: It's becoming a sadly common story. People get prescribed painkillers. They become addicted. And then they seek out cheaper and more potent drugs like heroin and synthetic opioids. The head of the Drug Enforcement Administration told us that dealing with the crisis is their No. 1 priority right now.

CHUCK ROSENBERG: It's not getting better. It's getting worse.

GARCIA-NAVARRO: We'll hear more from him shortly.


GARCIA-NAVARRO: But first, we asked you to tell us how the opioid epidemic touched your life.


BRIANNA: Hi. My name is Brianna (ph).

UNIDENTIFIED MAN #1: Hello. Good afternoon.

ANN: Yes, my name is Ann (ph).

UNIDENTIFIED WOMAN #1: I'm calling about the opioid crisis.

UNIDENTIFIED WOMAN #2: The opiate crisis has been a huge impact on my life - both of my brothers, but my youngest brother mostly. He's been an addict for 15 years.

UNIDENTIFIED MAN #2: I'm calling about my son.

UNIDENTIFIED WOMAN #3: It's a real serious problem in young adults. And I'm sad to say that physician prescribing is part of the problem.

UNIDENTIFIED WOMAN #4: I have been negatively affected by the increasing opioid regulation. It has made my life much more difficult and much more expensive.

UNIDENTIFIED WOMAN #5: For the first time in 15 years, he's clean and sober.


JIM BARNUM: My name is Jim Barnum (ph). I'm 38 years old. And I'm a paramedic in Colorado. And last year, I lost my brother to opiate addiction.

GARCIA-NAVARRO: Jim Barnum has seen this issue from both sides. As a paramedic in Denver, he's had to administer the drugs. And he also saw his brother struggle with an addiction.

BARNUM: He went to Rutgers in New Jersey. He played baseball. He was a pretty funny guy.

GARCIA-NAVARRO: How did he first get involved with opioids?

BARNUM: He had a minor back surgery as a result of, I think, being a catcher in baseball. They gave him medications as a result of that. And that was kind of his first taste. And it went from having the pills to, you know, taking them with a few drinks to, maybe, snorting them at parties. And that was the - kind of the beginning of that.

GARCIA-NAVARRO: And then he got into heroin?

BARNUM: Yeah. To have him tell it, it was kind of like a financial decision. Buying legal medications on the street just becomes way too expensive. So he could get a lot more drugs for his money if he purchased heroin instead of prescription opioids. He ultimately died as a result of a long-standing kind of infection around his heart. At one point, he had been injecting into his neck. And that caused an infection that ultimately compromised him later in life.

GARCIA-NAVARRO: You're a paramedic. You administer the same kind of drugs that made your brother an addict. What would be the circumstances in which you would administer these drugs, and what specifically would you administer?

BARNUM: Fentanyl would probably be the primary one that you would find on ambulances across the country.

GARCIA-NAVARRO: And that is one of the most highly addictive.

BARNUM: Yeah, for sure. But it's a powerful drug, and it works when you need it to. So when you have somebody who's - maybe has a tremendous extremity injury as a result of a car accident, and you're not really able to assist them because of - maybe the pain. Or, you know, you have somebody in - who has a ski injury. And, you know, you need to be able to stabilize that leg. These pain medications - they play a very powerful role in being able to do that.

GARCIA-NAVARRO: Jim Barnum told us when he used to respond to overdose cases, he didn't think much of it. But now it feels different.

BARNUM: I think I found myself being more upset, you know? I don't - you know, I didn't - I don't think, in the past, it really bothered me. But now I realize that there's a whole family behind these people, which is something that I never saw before.

GARCIA-NAVARRO: Why did you want to tell this story? What did you want people to to understand?

BARNUM: I think it's important to talk about these things. You know, it's not - just burying it and not talking about it's not really going to change anything. You know, these drugs are not going anywhere. And they have a tremendous benefit for people who are in extreme pain, either from surgery or for legitimate means. But this abuse is not to be taken lightly.

And, you know, the direction of the culture is that no one should be in pain ever. I think that we've gone too far on the other end of the spectrum in that sense, where we're trying to nullify all of the pain that any humans feel. And I'm not so sure that's the best course.


GARCIA-NAVARRO: That was Jim Barnum talking about his brother, who died last year of complications from a heroin addiction. Like many people, his brother's addiction started after he was prescribed painkillers. Eventually, he sought out cheaper, illegal drugs like heroin. I spoke with Chuck Rosenberg, the acting administrator of the Drug Enforcement Administration, about how his agency is trying to crack down on this epidemic.

ROSENBERG: First and foremost, we're a law enforcement agency. So we go after the suppliers. And by that, I mean, you know, big international cartels and the dangerous street gangs that distribute throughout the United States. But we're also a regulator, right? We have regulatory authority over scheduled substances, including prescription pain pills. And we also do a lot of community outreach work.

GARCIA-NAVARRO: Why can't the DEA do more to crack down on American companies who are flooding parts of the country with addictive opioid painkillers?

ROSENBERG: Well painkillers - opioids are legal products. And we don't regulate the practice of medicine. And those are two really important things to keep in mind. So we talk to practitioners. We talk to pharmacists. We talk to manufacturers about how dangerous this stuff can be. But this stuff is legal. And if doctors prescribe it - and they do quite obviously prescribe it in large numbers - we hope that they have conversations with their patients about how to handle this stuff and how to dispose of this stuff if they don't use all of it.

GARCIA-NAVARRO: Because these legal opioids are sort of the gateway drug, if you will, to addiction and to heroin, don't the distributors, though, bear some responsibility for the epidemic as we're seeing it now?

ROSENBERG: I think we all bear some responsibility. I think we can do a better job on enforcement. I think we can do a better job on demand reduction. And, certainly, you know, we're asking the manufacturers and everybody in the supply chain on down to the prescribers to think really hard and really long about what this stuff is and what it can do to people.

GARCIA-NAVARRO: A lot of the supply comes from China. You recently had your negotiators convince Chinese officials to ban four synthetic drugs. Is this a game changer, as one of your spokespeople said?

ROSENBERG: Well, back in October of 2015, Chinese officials banned 116 substances from export from China to the rest of the world. And that was a great step. That really helped a lot. Most recently, I was in China in January, speaking with my counterparts. And they agreed, as of March 1 - so in just a few days - to ban four more substances. That helps a lot.

GARCIA-NAVARRO: The thing that we've seen, though, is that it's a bit of a cat-and-mouse game, isn't it? You ban a certain substance. And then they change a few molecules. And then it comes back into the supply system.

ROSENBERG: I think that's right. There is a bit of cat and mouse to this. The evil scientists will tweak a molecule or two, change the substance and evade the regulation. So we've got to try and move more quickly in scheduling and banning substances. We also have to convince people about the danger of using this stuff and try and get them to change that behavior.

GARCIA-NAVARRO: I also want to ask - you know, China has banned this. But what's to stop Mexican cartels from setting up factories and producing these dangerous chemicals in Mexico?

ROSENBERG: Well that's the Whac-a-Mole aspect of it, right? You ban it in one place, and it pops up somewhere else, which is why we appreciate what the Chinese did. But it is not a cure-all. It is not a panacea.

GARCIA-NAVARRO: We hear that illegal opioids are being shipped through the U.S. Postal Service. How do you crack down on that?

ROSENBERG: That's a tough nut to crack. Lots of stuff is going through the Postal Service. We're working with our counterparts in the Postal Inspection Service. But I've got to tell you that's a big problem. And we're going to get as much of it as we can. But it's unlikely that we're going to get all of it.

GARCIA-NAVARRO: Chuck Rosenberg is acting administrator of the U.S. Drug Enforcement Administration. Thanks so much for being with us.

ROSENBERG: Thank you for having me.

(SOUNDBITE OF MOSS OF AURA'S "SWEAT") Transcript provided by NPR, Copyright NPR.

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