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U.S. representative hears officials, providers, others at roundtable discussion following visit to Beaverton office of LifeWorks Northwest.

U.S. Rep. Suzanne Bonamici says more money for drug treatment must be coupled with better education and pain-relieving alternatives to deal with the abuse of opioids.

The Oregon Democrat spoke after she conducted the last of five roundtable discussions with officials and providers of health care and social services — and some people in recovery — in each of the five counties within the 1st Congressional District of northwest Oregon.

Her Jan. 25 roundtable in Washington County was preceded by a tour of the Beaverton office of LifeWorks Northwest, a provider of mental health and addiction services, which also runs the county's Hawthorn walk-in mental health clinic in Hillsboro.

"We desperately need more funding for treatment," Bonamici said afterward in a brief interview.

"We need better education, especially in regard to prescribing practices. We need to make sure we have alternatives to dealing with pain, because often, insurance isn't covering them.

"This is something affecting families across Oregon in a personal way. It's not something we can ignore."

Bonamici is a cosponsor of four related bills, two whose chief sponsors are Democrats, and two who are Republicans.

One (HR 3692) would expand medication-assisted treatment. Another (HR 664) would expand prevention, promote treatment and recovery, and provide training and equipment for Naloxone, a medication that reverses opioid overdoses. Other bills would enable better screening of illegal opioid imports (HR 1057) and empower the Department of Justice to respond (HR 4073).

Referring to President Donald Trump's request for $18 billion for a border wall with Mexico, Bonamici said if that amount were made available for treatment, "we could almost eliminate the demand if we treat people who are addicted."

What to do?

According to the Washington County Department of Health and Human Services, about 35 people die each year due to an overdose of opioids. Deaths have risen 47 percent since 2003.

It estimates that each related death costs the community approximately $1.7 to $6.7 million.

Between 2009 and 2015, the county tallied 227 deaths related to opioids. Two of every three deaths — the same ratio as in the entire metro area for the same period — were from prescribed medications, the rest from heroin.

"The only way we will be able to address this crisis is to collaborate with our elected officials, local law enforcement, treatment providers, public health, and health care systems," HHS Director Marni Kuyl said.

"The ongoing support from Congresswoman Bonamici is critical to ensuring people and families receive the services and support they need."

Kuyl, Commissioner Bob Terry and Sheriff Pat Garrett were among the more than two dozen people who took part in the Beaverton discussion.

They heard from Tony Vezina, a former user who co-founded and now is executive director of 4th Dimension Recovery Center in northeast Portland. Many treatment providers employ former users to help others recover from their addictions.

"I saw myself change through their stories," Vezina said.

Tim Hartnett, executive director of CODA Inc., said the challenge is not limited to opioids, but encompasses all substance abuse.

"I would want you to know that I doubt you will have a workforce 10 years from now" unless broader action is taken, said Hartnett, whose tri-county agency has clinics in Tigard and Hillsboro.

"Substance use disorders are the single biggest challenge to Oregon's families and communities. This public health challenge will be with us for decades to come. It demands that we rethink our entire approach to the issue of substance abuse."

According to a 2016 report compiled by health officials in the three Portland area counties and the state Public Health Division, doctors in 2015 wrote 1.4 million prescriptions for opioids, compared with a population estimated at 1.7 million.

In Washington County, that total was 413,000.

"It's a staggering number when you think about the people who actually need prescriptions," Bonamici said.

When people are cut off for any number of reasons, they turn to heroin or fentanyl. Heroin is illegal and cheaper, and fentanyl — legal but obtainable on the black market — is far more potent and deadly.

Easy availability

When Purdue Pharma LP introduced Oxycontin in 1995, the new class of opioids was hailed as a miracle drug for treatment of chronic pain.

"How do you say no? As physicians, we tend to be soft-hearted. We got into medicine because we wanted to help," said Dr. Bradley Anderson, chief of addiction medicine at Kaiser Permanente Northwest.

"We in the Northwest, at one point, were prescribing as many opiates as both Kaiser California regions combined," he said. But over the past decade, "We have greatly reduced that to where we are one of the lower regions now."

Still, "kids know how to get them," said Mary Monnat, chief executive officer of LifeWorks NW, who recounted how a young girl was approached by a classmate following oral surgery about unused pain medication.

"If we do not have the ability to pay for things that are not pharmaceutical but are effective (at pain relief), what do doctors have to do?" asked Dr. Molly Olsen of Providence Health & Services.

Commissioner Terry said he had discussed the opioid issue with his own physician.

"But I've never heard it like this," he said. "This is the story that needs to get out to the public… so that the citizens of Oregon start waking up."

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