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enator Joe Manchin stepped onto the Senate floor last week to read a letter sent to him by Leigh Ann Wilson, a home caregiver whose 21-year-old daughter, Taylor, died from an opioid overdose last fall.

“Please work quickly to prevent thousands of other Taylors from the same fate,” Manchin read.

That was just the latest of many such letters that Manchin, a Democrat, has read on the Senate floor over the past year. He represents West Virginia, which has the highest rate of drug overdose deaths in the nation. And he seeks to amplify the voices of those most affected.

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Leigh Ann Wilson’s story, chronicled in STAT earlier this month, was all too familiar: She and her former husband tried for weeks to get Taylor into treatment for her opioid addiction, but were unable to get her either medication to reduce her cravings or an inpatient bed in a treatment facility.

Manchin spoke with STAT about his efforts to tackle the the opioid epidemic, including an unusual proposal he’s taken to President Trump. This interview has been condensed and edited for clarity.

What else can the federal government do to address the opioid crisis in West Virginia?

We’ve moved the needle more than ever before in the last couple of years. We [reclassified] opiates from Schedule III to Schedule II drugs [which means they have a high potential for abuse]. We got the CDC to finally put out prescribing guidelines, which doctors have never [previously] used.

There are many things we can do. Most things are educational. [When] talking about smoking cessation or using seat belts, we start in the schools educating at very young ages. We’re going to have to do the same [with opioids].

You’ve spoken about needing a ‘war on drugs.’ What does that look like to you?

I told [President Trump], “Mr. President, you’ve come out with a statement saying we’ve been over-regulated in this country, and for a new regulation any agency wants to come up, we’re make them do away with two.”

I said, “Mr. President, would you take the same approach to the FDA in approving drugs — and opiates.” I’d like to go one for one: For every new opiate they want to bring on the market, there has to be something obsolete they should take off, and quit producing it. We talked about that.

Also, with the “war on drugs,” you have to understand that addiction is an illness that needs treatment. Twenty years ago, we all thought addiction, or messing with any types of drugs, was a crime and we put you in jail. Well, we know that didn’t work.

Right, so what do you do now?

That’s where I’ve come out with bills. First of all, the LifeBOAT Act. No one gets treatment because we don’t have treatment centers. The LifeBOAT Act asks for a one-penny fee on every milligram of opiates that are produced and sold in America. One penny. That would give us a perfect funding stream. They tell me that’s $1.5 to $2 billion a year that goes into treatment centers only. That gives us a chance to start treating and getting people clean again.

The other part is: What do you do if get them clean? We’ve got the Clean Start Act. If you go through a one-year program, and passed that program and become clean, then you have another year of mentoring other people. After that, you’re able to get the people that sponsored you before your sentencing judge and arresting officer. You plead your case of what you’ve been able to accomplish in a two-year period.

Hopefully, they’ll give you an expungement for a one-time chance at a clean start. So we’re doing everything we can do.

In the past, you’ve talked about marijuana as a gateway drug. Attorney General Jeff Sessions seems ready to take a more aggressive approach toward enforcing laws on recreational marijuana. Do you agree with that?

I did four town hall meetings last week. I go to the treatment centers. I talk to the addicts. I always ask, “How did you get started?” Most told me they started out with recreational marijuana. Legalizing recreational marijuana is something I have not been able to accept or support.

What about medical marijuana? What about commercial cannabis? These are things I don’t know much about. But I’m interested in learning and finding out more. That’s what I’m doing now.

Of everything we’ve discussed for now, what has the best chance of moving forward to help addicts?

We’ve got to get more treatment. If I talk to a person, and they don’t understand that addiction is an illness, I’ve got serious problems, and that’s going to take a long time. It took me a long time to understand the chemistry in talking to the professionals. You have to come to that conclusion first. If you don’t, you won’t have one ounce of sympathy for anybody.

I don’t know any human being that doesn’t know someone in his or her immediate or extended family, or a close friend, who has been affected. My family’s included like everybody else’s. When you see a person from a good family doing something illegal, you say, “How did that happen?” They might steal or do this or that to support their habits.

There are other people — drug pushers and pill mills — that we won’t tolerate. But in a merciful way, I need these other people back into the workforce. They want some assistance. They want to live a good life.

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  • As a long time toker I know that the black market in Marijuana is 10 times the value of all other illegal drugs combined.

    It is a war on Marijuana period.

  • Mr. Manchin if marijuana was a gateway drug wouldn’t Colorado and other states with recreational use have a huge drug epidemic. If you look at the statistics and data from states with legal marijuana use (medical & recreational) opioid addiction and overdoses have went down along with crime. Oxford University has started a research program on marijuana. The professor Dr. Ahmed Ahmed who is apart of the research is excited about the early results and the potential marijuana has to treat multiple health issues at once. So let’s stop with marijuana is a gateway drug we all know that’s not true.

  • The War on Drugs didn’t work the first time. Target the pharmaceutical companies. Shut down pill mills. Legalize marijuana instead. And no Joe, marijuana IS NOT a gateway drug. Opioids certainly are.

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