Both of West Virginia's U.S. senators have serious concerns about whether the federal government is doing enough to fight the drug abuse epidemic. Coming as they do from senators who represent the state hurt worst by the crisis, their complaints have special credibility.
Sens. Shelley Moore Capito, R-W.Va., and Joe Manchin, D-W.Va., differ in their worries. Manchin's involves the Food and Drug Administration. Capito's focus has been the Centers for Disease Control and Prevention.
Capito and Sen. Kirsten Gillibrand, D-N.Y., last week introduced a bill that would require the CDC to issue guidelines health care providers could use to prescribe opioids safely for patients who need help managing pain.
"Too many stories of addiction in West Virginia and across the country start with patients taking prescription painkillers ... after suffering a minor injury or undergoing surgery," Capito pointed out. She added her bill is aimed at limiting "over-prescribing" of painkillers.
While Capito and Gillibrand are worried about a lack of federal action, Manchin fears the FDA may be contributing to the abuse epidemic. During a speech on the Senate floor, Manchin said the FDA "has actively stood in the way of efforts to address the opioid abuse epidemic."
One FDA action that outraged Manchin was the agency's approval for physicians to prescribe the painkiller OxyContin for children as young as 11 years old. "That's outrageous," he said.
A new FDA commissioner, Dr. Robert Califf, was confirmed last Wednesday by the Senate, in an 89-4 vote. Manchin was one of the four senators voting against Califf - largely because of his concern about how the agency has dealt with certain drugs.
Both Capito and Manchin have worked hard on multiple bills to address the drug abuse crisis. But federal activity remains directed primarily at enforcing drug laws, with comparatively little attention to other tools that must be used if West Virginians and other Americans are to win the battle.
Officials in several states, including West Virginia and Ohio, view drug abuse as a front-burner issue. As Manchin and Capito are suggesting, it is fair to ask whether a similar level of concern is being demonstrated in Washington.