Like the pragmatic businessman he is, Gary Mendell came to town armed with facts to make his case, although a few years ago, he never could have imagined discussing the topic at hand, drug addiction.
Prescription opioid sales increased almost fourfold between 1999 and 2010; overdose deaths rose fivefold. There are 25 million addicts; 15 people die every hour of every day of addiction. And so on.
Mendell was chief executive officer of a high-end hotel chain based in Connecticut where he lives. And then his son, Brian, became an addict. He was 25, living in a halfway house in Los Angeles and hoping to become a drug counselor when, as Gary pieced it together, depression struck, and his son committed suicide. That was in October 2011.
“What really took his life was shame, the stigma of it all, feeling like an outcast,” Mendell said.
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Over a beer he didn’t finish at the downtown Hyatt bar and later by phone, the father recounted the devastation, how he was unable to get out of bed or leave his home or make it to work.
As the pall lifted, he steeped himself in addiction research and used his business acumen and much of his wealth, $4.1 million so far toward a $5 million commitment, to create a research and advocacy organization, Shatterproof. It’s dedicated to ending prescription and illicit drug addiction and combating the stigma associated with it. He works there full time, for no pay.
The other day, Mendell awoke unable to see out of his right eye. At the hospital, he was diagnosed as having suffered a stroke. He was treated with kindness and respect throughout the ordeal. How different it was for his son.
“Frankly, I can’t think about it without crying,” Mendell said. “He had a brain disorder. Instead of being treated like a patient, he was treated like an outcast.”
You can’t avoid evidence of addiction these days. It’s on television and on the streets. I crossed the railroad tracks walking toward Peet’s Coffee on 19th Street and saw three used syringes.
On the campaign trail, presidential candidates from both parties turn somber and discuss prescription drug and heroin addiction. President Barack Obama requested $1.1 billion more from Congress to combat addiction earlier this month. Last week, representatives of the National Governors Association met with Obama to discuss strategy.
In Sacramento County, where overdose deaths hit 111 in 2013 after falling to 64 the year before, local officials will gather this week to focus their efforts.
Nationally, 18,893 people died of prescription opioid overdoses in 2014, up from 4,030 in 1999. An additional 10,574 died from heroin overdoses in 2014, up from 1,960 in 1999, the Centers for Disease Control and Prevention reports.
Brian is not one of those statistics, though Mendell has no doubt that addiction to prescription painkillers and heroin led Brian to the end of his rope in 2011.
Once, doctors were too hesitant to prescribe opioids for serious pain. That began changing in the 1990s. In 1995, the U.S. Food and Drug Administration approved Purdue Pharmaceuticals’ slow release form of opioid, OxyContin.
In 1999, well-intentioned California legislators sought to ensure that patients in terrible pain would have access to medication, so they wouldn’t beg for death.
A Senate analysis of the most far-reaching bill, AB 791, said it was intended to “change the medical community’s approach toward pain management and end-of-life care.” Medical students would be schooled on pain and doctors would receive training. Pain management would become “a part of the standard practice of medicine.”
The powerful California Medical Association supported the bill, as did hospice care providers. The Legislature approved it without a single dissenting vote. Several states followed California’s lead. Health care providers now ask patients to rate pain on a scale of one to 10; pain is a vital sign, like blood pressure.
“Everybody thought it was a great idea,” said the bill’s lead author, then Assemblywoman Helen Thomson, a Democrat from Davis. And it is, except that too many practitioners handed out too many painkillers for too many ailments, not fully understanding that they are addictive, like their illicit twin, heroin.
We spend tens of billions of dollars on prescription painkillers, and Mendell travels the country, lobbying for ways to reduce drug abuse.
In California, his focus is on a bill by Sen. Ricardo Lara, a Los Angeles-area Democrat, that would require doctors to check a state database, known as the Controlled Substance Utilization Review and Evaluation System, before writing prescriptions for opioids. Among its purposes, the system is supposed to stop patients from going to different doctors to feed their addictions.
Mendell offers facts: In the year after New York adopted a similar drug monitoring program, opioid prescriptions fell by more than 9 percent, and instances of doctor shopping fell by 74.8 percent.
“It is just simple math,” Mendell said.
But nothing is simple in the Capitol. The California Chamber of Commerce, insurance companies, police groups, consumer advocates, plaintiffs’ lawyers and unions support Lara’s SB 482. But because of opposition by the California Medical Association, the bill has stalled.
“At its most basic, it legislates the practice of medicine, which CMA opposes,” the doctors’ opposition letter says.
Doctors know best, evidently.
Most are responsible. Last year, doctors, pharmacists and law enforcement tapped into the database to check on 6.1 million patient records, up from 3.5 million the year before.
Yet clearly, some doctors aren’t paying attention, or are overprescribing to make a quick buck. And so Mendell travels the country, offering his facts, hoping to save the next father’s son.