ATLANTA — Lending his voice to the fight against a drug scourge that kills 28,000 Americans a year, President Obama told nearly 2,000 policymakers, professionals and parents Tuesday that the nation must provide more treatment for people addicted to opioids and reframe the addiction problem through the lens of public health.
“The most important thing we can do is reduce demand for drugs, and the only way that we reduce demand is by providing treatment and thinking about this as a public health problem and not just a criminal issue,” Obama said during a panel discussion at the 2016 National Rx Drug Abuse & Heroin Summit.
“Part of what has made it difficult to emphasize treatment over criminal justice system has to do with the fact that the populations affected in the past were ... stereotypically identified as poor and minority,” he said. “And as a consequence, the thinking was it is often a character flaw in those individuals who live in those communities. ... One of the things that’s changed ... is a recognition that this reaches everybody.”
Given its widespread reach, administration officials announced a wide range of actions to fight the epidemic, such as expanding access to drug treatment, bolstering efforts to ensure health coverage for substance abuse and mental health are on par with benefits for other medical services, investing in partnerships between law enforcement and communities, and providing guidance on using federal funds to start or expand needle exchanges.
Surgeon General Vivek Murthy, meanwhile, said he will release a report later this year on substance use, addiction and health, similar to the landmark surgeon general’s report on smoking released 50 years ago that focused public attention on that issue.
They shared their news at the fifth annual summit, organized by Operation UNITE, an Eastern Kentucky anti-drug organization launched in 2003 by U.S. Rep. Hal Rogers. The summit has grown from an upstart event into the major national gathering on the issue, drawing people from both sides of the political aisle.
“This is a bipartisan issue — actually a non-partisan issue,” Rogers, a Republican who represents Kentucky’s fifth district, said in an interview. “We’re united in the drive to stop this death rage that we’re in.”
Across the USA, more Americans die every year from drug overdoses than from motor vehicle crashes. In 2014, drug overdoses killed 47,055 people, the highest number on record, according to the U.S. Centers for Disease Control and Prevention. The majority, around 28,000, involved opioids such as prescription painkillers and heroin.
In fact, heroin-related overdose deaths have more than tripled since 2010, totaling 10,500 in 2014.
“Opioids are devastating our communities and they are costing us lives,” Murthy said. “We cannot afford that anymore.”
New weapons in the fight
New initiatives announced Tuesday attack the problem on several fronts.
One is a $7 million Department of Justice anti-heroin grant program, which would help law enforcement agencies in hard-hit states investigate the illicit distribution and trafficking of prescription painkillers and heroin. The Office of National Drug Control Policy is also expanding its heroin initiative among regional High Intensity Drug Trafficking Areas by adding Ohio and Michigan to several existing regions. That initiative combats heroin by linking law enforcement and public health professionals.
Meanwhile, the U.S. Department of Health and Human Services is issuing guidance for the use of federal funds to start or expand needle exchange programs, which allow addicts to trade dirty needles for clean ones. Congress effectively lifted the nation’s long-standing ban on federal funding in the omnibus spending package Obama signed last year. Though federal funds still can’t be used for the syringes themselves, they can go toward costlier expenses such as staff, vans, substance abuse counseling and referral to treatment.
Other initiatives announced Tuesday aim to give addicts more access to substance abuse treatment.
A rule being finalized by HHS will strengthen substance abuse and mental health services for people enrolled in Medicaid and the Children’s Health Insurance Program by making sure they offered at “parity” with other types of medical care, benefiting about 24 million people, officials said. Meanwhile, a new task force will work to enforce existing parity protections for coverage people get on the job or through the Affordable Care Act.
Obama said such steps will ensure “Medicaid and Medicare start really taking care of this seriously so that now mental health issues and addiction issues are treated as a disease in the same way" as other medical problems.
Obama also unveiled two new $11 million grant programs for states — one to expand medication-assisted treatment and one to buy and distribute the fast-acting overdose rescue drug naloxone and train first responders how to use it. And he announced a proposed HHS rule to double the current patient limit of 100 for qualified doctors who prescribe buprenorphine treatment for opioid addicts.
Also Tuesday, administration officials announced that more than 60 medical schools will require students to take prescriber education in line with CDC guidelines released in mid-March. Those first-ever guidelines urge doctors to avoid prescribing opioid painkillers to patients with chronic pain — except for those undergoing cancer treatment or end-of-life-care — because the risks of these potentially addictive medications outweigh the benefits for most people.
“There’s no quick fix here, but (the guidelines) will help both patients and doctors,” said CDC Director Tom Frieden. “There’s less risk of overdose and death.”
Efforts under way
These are the latest of a wave of recent efforts by federal and state policymakers to fight opioid abuse.
In early February, Obama announced he was seeking an extra $1.1 billion in the fiscal year 2017 budget request to pay for drug treatment for people addicted to opioids. The biggest chunk of that — $920 million — would support cooperative agreements with states to expand access to medication-assisted treatment for opioid use disorders. States could use the money to expand treatment and make services more affordable, and they would receive funds based on the severity of the epidemic there and their strategies to address it.
“The problem we have right now is treatment is greatly under-funded,” Obama said.
This month, the Senate passed a bill that would bolster local drug task forces and target heroin, the synthetic opiate fentanyl and prescription opioid traffickers; enhance treatment and early intervention for addicts; and expand access to naloxone. The bill, pushed by Senate Majority Leader Mitch McConnell, R-Ky., and Sen. Joe Donnelly, D-Ind., must now gain approval in the House.
Diane Hague, director of the Jefferson Alcohol & Drug Abuse Center in Louisville, said she is glad to see the recent federal action surrounding the nation’s opioid epidemic and heartened by Obama’s concern about the issue. But she added that interest in tackling the ever-present problem of addiction waxes and wanes, to her dismay.
“Why is there not the steady interest to this as there is to cancer?” Hague asked. “Is this (concern) going to continue?”
April Rovero, executive director of the National Coalition Against Prescription Drug Abuse, said she’s hopeful it will. Rovero, of San Ramon, Calif., lost her 21-year-old son, Joseph John Rovero III, to a prescription drug overdose six years ago.
She said "it's wonderful” that Obama is proposing so many solutions to the scourge that devastated her family. “The only issue is, I would’ve loved to see it five years ago.”