Oxycodone and acetaminophen pills. (Patrick Sison/AP)

The opioid crisis knows no bounds.

Our last Federal Insider column was about President Trump’s long-overdue opioid strategy, which was deemed “missing in action” at a House hearing last week, despite his declaration that the epidemic is a nationwide public health emergency. It kills more than 115 Americans a day.

Now, a Senate hearing will explore the growing opioid abuse among seniors, and a recent report pointed to border staffing shortages that facilitate drug smuggling.

“In 2016, one in three people with Medicare Part D (which covers prescription drugs) — 14.4 million beneficiaries — received an opioid prescription, 500,000 received high amounts of opioids, and 90,000 were at ‘serious risk’ of misuse or overdose according to the Department of Health and Human Services Office of Inspector General,” says a statement by the Senate Special Committee on Aging announcing Wednesday’s hearing. “The Substance Abuse and Mental Health Services Administration also reported that opioid misuse doubled between 2002 and 2014 among Americans ages 50 and older.”

Sen. Susan Collins (R-Maine), chairwoman of the committee, said it is a mistake to “perceive the face of opioid addiction as young … the epidemic, however, intersects just as much with older adults. … Nearly half of older Americans suffer from chronic pain, and the incidence increases with age.”

Many of the opioids fueling the epidemic are smuggled in through ports of entry, where understaffing is an issue. The striking increase in smuggled fentanyl, a synthetic opioid, was raised in a recent report by Democrats on the Senate Homeland Security and Governmental Affairs Committee.

“Port Officers are, in the majority of cases, the last line of defense in preventing illicit opioids from entering the United States,” the report says.

But there are holes in the defensive line.

“In a single year, the amount of fentanyl seized by CBP [Customs and Border Protection] more than doubled, from 564 pounds in 2016 to 1,370 pounds in 2017,” said the report, released by Sen. Claire McCaskill (Mo.), the top Democrat on the Homeland Security Committee. “85% of all CBP fentanyl seizures took place at ports of entry.”

The seizures demonstrate the magnitude of the opioid smuggling and the vigilance of the CBP officers. Looming problems posed by agency staffing shortages are described in two key paragraphs from the report:

“Staffing shortages at ports of entry may be compromising interdiction efforts. Ports of entry across the United States have 4,000 Port Officers less than the number needed to staff all ports of entry. Ports of entry in the San Diego and Tucson areas, which together accounted for 57% of all opioid seizures by Port Officers between 2016 and 2017, have required CBP to assign temporary staff details to fulfill staffing needs at those locations. The practice of temporary details has become so systemic over the past two fiscal years that CBP has named it ‘Operation Overflow.’

“The opioid epidemic places disproportionate demands on Port Officers relative to other border security law enforcement officers. In its proposed FY 2019 budget, the Administration proposes to dramatically increase staffing at Border Patrol and Immigration and Customs Enforcement, but add no additional officers at ports of entry. This prioritization of other border security enforcement components over Office of Field Operations ignores the important role that Port Officers play in stemming the opioid crisis.”

In response to the report, a CBP statement said staffing has increased at the six main international mail facilities by 20 percent during the past six months. “CBP has made significant investments and improvements in our drug detection, identification, and targeting capabilities. …” the agency said. “As an indicator of our efforts, we have intercepted more fentanyl so far this fiscal year than the entire previous fiscal year.”

The National Treasury Employees Union, which represents about 25,000 CBP officers, agriculture specialists and trade enforcement staffers, said the report “provides further evidence that the staffing crisis is harmful to our nation’s safety and security.”

While Marjorie Clifton, executive director of the Center for Safe Internet Pharmacies, says the report outlines the problem well, she believes it misses “a significant point in what causes the problem at the ports of entry.”

Noting the report’s finding that “there are more than five times as many fentanyl seizures at mail facilities than at land ports of entry,” Clifton said “that fact alone begs the question of why is fentanyl being sent through the international mail system. Staffing shortages was listed as a reason, but I believe one of the primary reasons is the lack of security measures that are currently being imposed on international posts.”

Because of inadequate security measures, Clifton said “CBP must sift through hundreds of thousands of inbound postal packages daily — probably contributing to the need for many of the officers mentioned in the report.”

Caren Kagan Evans, a North Potomac, Md., public relations executive, knows firsthand the horrors of opioids. Joshua, her 25-year-old son who is a recovering heroin addict, has been in and out of jail and rehab over the past decade. He has been clean nine months, but “I have no idea what the future holds,” Evans said. “One day at a time is a real thing.”

“Not increasing the number of agents at the ports of entry,” she added by email, “is an invitation to bring this poison (can’t think of a better word right now) into the country.”

Read more:

Trump’s opioid strategy ‘missing in action’ as 115 people die every day

Is DEA a bad guy in opioid addiction fight?

Veterans tell of medical marijuana use in defiance of backward federal policy

The color of heroin addiction — why war then, treatment now?