- New rules would expand addiction treatment, government says
- Clinton, Trump have grappled with issue on campaign trail
President Barack Obama said Tuesday that the U.S. government, along with the American people, need to take more aggressive steps to fight a growing public health crisis of painkiller and heroin abuse that is killing tens of thousands of people a year.
His administration issued new regulations on Tuesday that it said would make addiction treatment available to millions more people.
“When you look at the staggering statistics, in terms of lives lost, productivity impacted, costs to communities, but most importantly cost to families from this epidemic of opioid abuse, it has to be something that is right up there at the top of our radar screen,” Obama said at the National Rx Drug Abuse and Heroin Summit in Atlanta. The event is hosted by a nonprofit founded by a Republican congressman, Hal Rogers of Kentucky, who was alarmed by the impact of the opioid abuse epidemic in his district.
The epidemic is a rising issue in U.S. politics that has found its way into the presidential campaign. Both of the front-running candidates, Democrat Hillary Clinton and Republican Donald Trump, have been confronted on the campaign trail by ordinary people affected by drug abuse, and have responded with widely disparate strategies to confront the problem. The Obama administration has meanwhile proposed a dramatic increase in federal spending, to about $1.5 billion in fiscal 2017, for addiction treatment and other measures to stem the epidemic.
“Today, we are seeing more people killed because of opioid overdose than traffic accidents,” Obama said.
“We’re taking a number of steps, but frankly we’re still under-resourced,” Obama added. “I think the public doesn’t fully appreciate yet the scope of the problem.”
Under one regulation the government issued on Tuesday, state Medicaid programs for the poor would have to cover treatment for drug abuse. Another proposal would permit doctors who prescribe medicine to treat opioid addiction to accept up to 200 patients, twice as many as currently allowed. The Medicaid change would make treatment for drug abuse accessible to about 23 million more Americans, the administration said in a regulatory filing.
The government also said it would provide states $11 million to purchase a drug that can reverse overdoses and train emergency workers to administer it. Last week, the White House sent letters to state officials encouraging them to require pharmacists to promptly update central databases when they fill prescriptions for opiate painkillers and to require doctors to check the databases when their patients request the medicines.
“What we have to recognize in this global economy of ours is that the most important thing we can do is to reduce the demand for drugs,” Obama said Tuesday. “The only way we reduce demand is if we’re providing treatment and thinking about this as a public health problem, and not just a criminal problem.”
The Senate earlier this month passed a bill, S. 524, that would take additional steps to combat opioid addition. The bill, which has been criticized by the White House for not providing new funding, is awaiting action in the House.
More than 47,000 Americans died of drug overdoses in 2014, exceeding the number killed in car accidents, according to the Centers for Disease Control and Prevention. Sixty-one percent of the deaths involved opioids, mainly prescription painkillers and heroin. The rate of deaths from overdoses grew 6.5 percent from 2013 and 137 percent since 2000.
Advocates for addiction sufferers and their families have been frustrated by the slow federal response to the epidemic.
“I don’t think anyone can blame someone for not reacting the first year or two or three, but this is 15 years,” Gary Mendell, the founder and CEO of Shatterproof, an advocacy group based in New York, said in an interview. “This is like two Vietnam Wars of people dying.”
The CDC on March 15 published guidelines for doctors who prescribe opioids, such as Purdue Pharma Inc.’s Oxycontin, to treat chronic pain, cautioning them against turning to the powerful and addictive pills until after less risky treatment is attempted. Widespread prescription of Oxycontin and similar opioids is blamed in part for the abuse epidemic, Mendell said.
Mendell’s son, Brian, killed himself in 2011 at age 25 after struggling for years with addiction. Mendell, a former president of Starwood Hotels & Resorts, founded Shatterproof in 2013 and said he has committed $5 million of his money to the group’s efforts.
“The foundation of all of this is stigma and shame,” he said. “What the administration is now doing very well, I think, is they are now framing this as a health issue, not bad people doing bad things.”
A drug called buprenorphine has been approved to treat opioid addiction since 2002, but doctors have been slow to embrace it. Mendell said more than half of U.S. addiction treatment centers encourage their patients to abstain from all drugs including buprenorphine, even though clinical evidence has shown the medicine to be effective.
“There is stigma, there is professional discomfort in some quarters” about prescribing buprenorphine, Richard Frank, assistant secretary for planning and evaluation at the Department of Health and Human Services, said Monday in a conference call with reporters. “We’ve been working closely with professional societies to get them to commit to doing more education among members so they’ll be more active in prescribing medication-assisted treatment.”
Obama appears to have taken a personal interest, in the twilight of his presidency, in accelerating the federal response to the epidemic. In October, he traveled to Charleston, West Virginia, one of the hardest-hit states, to discuss opioid abuse with local officials and families. Michael Brumage, executive director of the Kanawha-Charleston Health Department, said Obama was visibly moved by a woman, Carey Dixon, whose son suffers from addiction and who described the struggles of families like hers contending with the epidemic.
“I could tell, sitting just a few seats away from the president, that as a man he was deeply affected,” Brumage said. “Even in the presidential primaries, this has been a topic that has come up over and over again.”
Clinton and Trump
Trump, the front-runner for the Republican presidential nomination, and Clinton, the leader in the Democratic race, have addressed the issue after being confronted by people touched by the epidemic.
At a New Hampshire town hall event in January, a 12-year-old girl whose mother had overdosed asked Clinton what she would do to help children like her, according to the Boston Globe. Clinton said a month later during another New Hampshire town hall hosted by CNN that doctors should be better educated on the risks of prescribing opioid painkillers and that “every police department” should be equipped with a drug called naloxone that can reverse overdoses.
The Obama administration said today it would provide $11 million to states to purchase naloxone and train emergency workers to administer it.
“We’ve got to put more money into this,” Clinton said at the CNN event.
Trump attempted to comfort a man at a rally in Iowa in January who said he lost his son to a heroin overdose, according to Politico. Trump has since described the epidemic as a symptom of the country’s relatively open borders and undocumented immigration, the issue central to his campaign. Building a wall on the Mexican border, he has said, would reduce the availability of heroin.
“We’re going to build a wall, we’re going to stop it up, we’re going to have a border and they’re not going to have the problem anymore,” Trump said on the Fox News show Fox & Friends in February.