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Mayor Steve Williams of Huntington, West Virginia speaks with Axios' Mike Allen. Photo: Lawrence Jackson for Axios

Wednesday morning, Axios' Mike Allen hosted a series of conversations on health care's biggest challenges, focusing on the opioid epidemic and pain crisis in the U.S.

The big picture from Axios' Bob Herman, Policymakers want to find other ways to treat pain — given the destruction that addictive opioid pills have caused — and many companies sit on the other side of the table selling opioid alternatives, with the hope of getting higher government pay.

Dr. Vanila Singh, Chief Medical Officer, Office of the Assistant Secretary for Health
Dr. Vanila Singh in conversation with Axios' Mike Allen. Photo: Lawrence Jackson for Axios

Dr. Singh, who serves as the Chairperson for the Pain Management Inter-Agency Task Force, emphasized that many Americans are affected by pain, "50 million people in the U.S. are affected by chronic daily pain — that's a staggering number."

She shared that stigma is the greatest barrier to care. "Patients fell a sense of weakness, like they've somehow failed their family."

Dr. Singh's pain task force is focusing on ensuring non-opioid pain management measures get coverage — a priority at HHS.

Mayor Steve Williams, Huntington, West Virginia

Mayor Williams of Huntington, a town raked by opioid addiction, told Mike Allen that opioids are only one part of a larger addiction epidemic — what he believes to be the greatest existential threat facing the U.S.

He called for dedicated research and funding for the addiction epidemic, "We have no problem creating institutes to fight cancer or Alzheimer's — we need to have truly aggressive academic research into fighting addiction."

Mayor Steve Williams in conversation with Axios' Mike Allen. Photo: Lawrence Jackson for Axios

Mayor Williams highlighted the success of his new SAMHSA-funded quick response team. "We've found that the quick response team enables us to get 30% of individuals we speak to into treatment and that overdoes are down 40% year over year."

Senator Joe Manchin, West Virginia
Senator Joe Manchin talks health care with Axios' Mike Allen. Photo: Lawrence Jackson for Axios

Senator Manchin, Founder of the Senate Caucus on Prescription Drug Abuse, shared details of his 'penny tax' proposal with Mike Allen. "Pay me one penny per milligram of opioids you produce, and I'll take that money and direct it to treatment centers."

He said that pharmaceutical companies may believe they're putting out pills to provide a health remedy, when in reality it's solely for business.

When asked broadly about health care in the U.S., Senator Manchin said about ACA implementation: "We gave people the most valued gift in the world — a healthcare card — and never gave them any instruction on how to use it."

Senator Bill Cassidy, Louisiana

Senator Cassidy, Founder of the Greater Baton Rouge Community Clinic, a resource that provides care for the working uninsured, focused the conversation on patients, and their lack of choice. He is currently working on 8-10 bipartisan bills to give power back to the patient: "One solution is price transparency."

Senator Bill Cassidy and Mike Allen. Photo: Lawrence Jackson for Axios

Cassidy called for nuance in the way we discuss the opioid epidemic.

The addict. The chronic, but stable patient. And the person who is hooked because of an over-prescription. Those are the three types of situations we have to address separately.

He did highlight the work Congress has done, noting that the number of prescriptions for opioids is going down. He hopes for bipartisan support in addressing the illicit drugs that are filling the gap that fewer opioid prescriptions created.

Thank you Eli Lilly for sponsoring this event.

Go deeper

33 mins ago - World

HRW: Over 100 former Afghan security members dead or missing under Taliban rule

Members of the Taliban movement patrol Kabul's airport in September. Photo: Valery Sharifulin/TASS via Getty Images

The Taliban have "killed or forcibly disappeared" over 100 former members of Afghanistan's security forces since the group took power in August, a Human Rights Watch report published Tuesday found.

Why it matters: It means former military members and officials from the ousted government, activists and other Taliban critics are facing peril amid executions driven by revenge — despite Taliban promises of an "amnesty" with no retributions, notes the New York Times, which first reported the news.

2 hours ago - World

Barbados becomes a republic, replacing U.K. queen with president

Combination images of Dame Sandra Mason, president of Barbados, and Britain's Prince Charles at her swearing-in ceremony in Bridgetown, Barbados, late Monday.

Barbados officially became a republic at midnight local time after Dame Sandra Mason was sworn in as the Caribbean nation's first president in a ceremony attended by the United Kingdom's Prince Charles.

Why it matters: Mason replaced Britain's Queen Elizabeth as head of state Tuesday — removing the country's final remaining colonial tie to the U.K. almost 400 years after the first British ships arrived in Barbados.

Right-wingers making McCarthy sweat for future Speaker post

House Minority Leader Kevin McCarthy stands with his Republican colleagues outside the House on Nov. 17. Photo: Stefani Reynolds/Bloomberg via Getty Images

Right-wing elements in the Republican Party are complicating House Minority Leader Kevin McCarthy's attempts to become the next speaker of the House should the GOP take back the majority in 2022.

Why it matters: While McCarthy has worked carefully to build trust among the conservatives who tanked his chances at clinching the speakership in 2015, they're still circling ahead of the next Speaker vote in January 2023.