The trajectory of opioid deaths in the United States is trending in the wrong direction and should be atop the federal government’s radar screen along with the threat of terrorism, responding to natural disasters and promoting a strong economy, President Barack Obama said Tuesday. Obama said more people are being killed from opioid overdoses than from traffic accidents. “I think the public doesn’t fully appreciate yet the scope of the problem,” Obama told about 2,000 people attending the National Rx Drug Abuse & Heroin Summit.
Obama’s appearance at the conference came as his administration issued proposed regulations and announced new funding for states to purchase and distribute the opioid overdose reversal drug, naloxone, and to train first responders and others on its use. The actions also coincide with a commitment from 60 medical schools to heighten training for prescribing opioids.
Opioids are highly addictive drugs that include both prescription painkillers like codeine and morphine, as well as illegal narcotics, primarily heroin. Deaths linked to opioids soared to more than 29,000 in 2014, the highest number on record. Congress is attempting to allocate more resources to the problem, one area where bipartisan agreement may be reached during the election year. But the White House is critical of a Senate bill it says lacks critical funding. Obama is seeking $1.1 billion in new money to expand treatment for opioid addiction, which is about triple current levels. “The problem we have right now is treatment is underfunded,” Obama said.
“Changes must start with us,” said Dr. Patrice Harris, chairman of an American Medical Association task force on the crisis.
Van Ingram, executive director of Kentucky Office of Drug Control Policy, said he was excited to see the problem getting more attention. “We are in the worst drug epidemic this country has ever seen and it is going to take a lot of resources to turn this around. This ship didn’t get this way overnight, and it’s not going to get turned around overnight,” Ingram said.
Republican senators note that the bill that almost passed the Senate unanimously in early March, along with $400 million appropriated earlier for opioid-specific programs, would still make important strides. Obama spoke during a panel discussion with doctors and recovered drug addicts. He said drug addiction in the past has been treated as a law enforcement problem, while the public often viewed it as a character flaw. Obama said the opioid epidemic shows that addiction touches everyone. He alluded to his drug use as a youth, saying he was lucky that addiction “didn’t get its claws in me,” except for nicotine. Obama is an ex-smoker.
Obama said the U.S. can cut opioid abuse in the same way it has lowered tobacco use and traffic fatalities. White House officials said most of the additional $1.1 billion that Obama seeks would fund agreements with states to expand medication-assisted treatment.
Along those lines, the Department of Health and Human Services issued a proposed rule allowing physicians who prescribe Buprenorphine to give it to more patients to help them reduce or quit their use of heroin or other opiates. The proposed rule would expand the limit from 100 patients to 200. The department also is issuing guidance to programs that allow intravenous drug addicts to trade dirty syringes for clean ones. Congress recently allowed federal money to be used for certain expenses, such as staff and equipment, but not for syringes themselves.
Officials also are focused on better educating prescribers. The Centers for Disease Control and Prevention recently issued new guidelines stating that physical therapy, exercise and over-the-counter pain medication should be used before turning to painkillers like morphine and oxycodone.
Health officials who addressed the conference earlier Tuesday said doctor training will be key. “Changes must start with us,” said Dr. Patrice Harris, chairman of an American Medical Association task force on the crisis. Harris noted that, for the past two years, the total number of prescriptions for opioids has decreased. But she said more must be done.
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