State Medicaid programs for the poor would have to cover treatment for drug abuse under a rule the Obama administration will issue today, as the U.S. government grapples with an epidemic of painkiller and heroin abuse that kills tens of thousands of Americans a year.
President Barack Obama will travel to Atlanta today to participate in the National Rx Drug Abuse & Heroin Summit to discuss the opiate abuse epidemic, a rising issue in U.S. politics that has found its way into the presidential campaign. The Obama administration will also propose today allowing doctors who prescribe medicine to treat opiate addiction to accept as many as 200 patients, twice as many as currently allowed.
Congress increased federal spending to combat the epidemic by about $100 million this year, to $400 million, and Obama has requested $1.1 billion more in his fiscal 2017 budget. Overdose deaths continue apace, though, and partisan divides have begun to emerge over how to confront the problem. The White House earlier this monthcriticized a Senate bill aimed at stemming the epidemic because it lacked funding, and the two leading candidates for the presidency, Hillary Clinton and Donald Trump, diverge widely in their approach to the issue. Advocates for addicts and their families have been frustrated by the government’s slow response.
“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 for addiction sufferers, said in an interview. “This is like two Vietnam Wars of people dying.”
More than 47,000 Americans died of drug overdoses in 2014, more than were killed in car accidents, according to the Centers for Disease Control and Prevention. Sixty-one percent of the deaths involved opioids, mainly prescription pain killers and heroin. The rate of deaths from overdoses grew 6.5 percent from 2013 and 137 percent since 2000.
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 opiates 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 opiate 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 opiate 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 theBoston 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.