As the nationwide epidemic of heroin and prescription drug abuse escalates, President Barack Obama's administration plans to take steps to expand access to drug abuse treatment and improve the training of physicians who prescribe opiate drugs for pain, according to The Washington Post.
From 2001 to 2013 there was a 3-fold increase in the total number of deaths resulting from overdoses of prescription opioid painkillers, and a 5-fold increase in deaths from heroin overdoses, according to data from the National Center for Health Statistics at the Centers for Disease Control and Prevention, last updated in Feb. 2015. Many of those who abuse heroin first abused prescription painkillers.
The current combined rates of death from heroin and prescription drug abuse now surpass those of fatal car accidents, according to the report.
The prevalence of heroin and prescription drug abuse in the U.S. is a national emergency, though clinicians, social workers and policymakers have voiced diverging opinions on the best way to address it.
Here are five things to know about the Obama administration's plan to fight opioid abuse, which was detailed Wednesday.
1. The administration wants to double the number of physicians who can prescribe buprenorphine — an opiate drug used to treat addiction — over the next three years. The drugs are prescribed by a physician who monitors the patient closely until he or she is weaned off the opiates. Currently, approximately 30,000 physicians can prescribe buprenorphine in the U.S.
However, medication-assisted treatment, including buprenorphine, is controversial. In an interview earlier this year, Rep. Tim Murphy (R-Pa.) said, "That doesn't make sense to me, just sending out more medication-assisted treatment."
Expanded education on prescribing painkillers is nother staple of the administration's plan on the clinical side. More than 40 medical provider groups have committed to train more than 500,000 physicians, dentists and other clinicians on the safe prescription of opioids.
2. More money will go into the fight. The Obama administration this year proposed $133 million in new spending to curb the epidemic. However, gaining support for drug treatment funding will likely be a new source of conflict in Congress, though President Obama repeatedly said this should not be a partisan issue.
The money will be aimed at reducing overprescription of opioid painkillers, increasing access to Naloxone — a drug that can reverse the effects of an opiate overdose — and expanding the amount of overdose data collected, according to The Washington Post.
President Obama's plan will double the number of providers that can prescribe Naloxone, and CVS plans to increase the number of states where its pharmacies can sell Naloxone without a prescription. Additionally, Rite Aid will train 6,000 pharmacists on Naloxone use in the next year, according to the report.
3. President Obama wants to take a federal solution. Prescription opioid and heroin abuse is usually fought at the state level. While many states have increased access to Naloxone — some making it available without a prescription — some treatment advocates are wary of depending on the drug too much, as it doesn't address the underlying addiction.
HHS also plans to change its rules on medication-assisted treatment. Currently, physicians can only prescribe such drugs to 30 patients in the first year after they are approved to prescribe them. After that, they are still capped at 100 patients, according to the report.
4. Drug abusers get treatment, not criminal punishment. The president's administration wants to shift people with drug problems toward treatment, not toward the criminal justice system. Both political parties have agreed on this, according to the report.
President Obama issued a memorandum Wednesday instructing federal agencies to train their employed physicians in proper practices for prescribing opioids, as well as on how to identify barriers to medication-assisted treatment for employees enrolled in their healthcare plans.
The administration plans to expand a pilot program that uses medication-assisted treatment to get people off drugs in federal prisons. Currently, no treatments are provided to prison inmates, forcing them to detox while in jail. The White House has also stipulated funding for drug trials must be contingent on the court offering medication-assisted treatments.
5. Barriers to treatment remain. The Affordable Care Act requires insurers to cover treatment for addiction the same as any other medical condition, but that component of the law only took effect in January for many insurers. President Obama urged the government to push insurance companies to expand their coverage.
"The notion that you're going to cover a broken leg but not going to cover an illness in which your child might die? That doesn't make sense," he said Wednesday, according to the report.
He added it's important to remove the shame and stigma of addiction. "We can't fight this epidemic without eliminating stigma," he said, according to the report. "With no other disease do we wait until people are a danger to themselves and others … This is an illness, and we've got to treat it as such."