Speaking on a panel at the National Prescription Drug Abuse and Heroin Summit today in Atlanta, President Barack Obama laid down some narcotics realness for the audience: Addiction to opioids like Vicodin, oxycontin, and heroin is not just a criminal problem, it’s a public health issue, and needs to be treated as such.
In February, Obama put in a request for Congress to allocate $1.1 billion to treating the prescription opioid abuse and heroin use epidemic, which killed over 28,600 Americans in 2014. As he explained during the summit, this money would be used to fund a multi-pronged public health approach to the opioid addiction epidemic. “What we have to recognize is that in this global economy of ours the most important thing we can do is reduce demand for drugs,” he said. “And the only way that we reduce demand is if we’re providing treatment and thinking about this as a public health problem and not just a criminal problem.”
Obama’s approach to tackling addiction can be split into two broad strategies: Treating those already suffering with addiction and preventing drug abuse from happening in the first place. Currently, treatment for addicts is scarce outside of major cities; 85 percent of counties in America, Obama said, have no mental health or drug treatment facilities. This point was illustrated by speakers from the organization Young People in Recovery, who recounted harrowing stories about the lack of support and the stigma young Americans still face when seeking treatment for drug abuse.
That support is needed in the criminal justice system as well. Drug treatment facilities are desperately needed for people in prison and just emerging from jail, Obama said; otherwise, he said, “They are going to get back in trouble. That’s just human nature.”
Part of increasing access to treatment is changing the way society — physicians included — unfairly stigmatizes drug use, panelist and Baltimore City Health commissioner Dr. Leana Wen argued. We live in a society where people question whether administering naloxone, a heroin overdose “antidote,” would make patients even more likely to use drugs; “We’d never say that about an epipen,” she said, asking, “Will it make them more likely to eat peanuts next time?” Baltimore’s public health approach to addiction was praised as an example of a city that does addiction right; its city-run needle exchange programs, for example, have led to a significant decline in HIV rate reduction.
And then there’s the question of preventing drug abuse altogether. Obama criticized American society — that includes pharmaceutical companies, consumers, physicians, and, crucially, parents — for encouraging the culture of access to pills, drawing a smart parallel with the ongoing antibiotic resistance crisis. A nation that’s become over dependent on pills is more likely to abuse them; as Wen later reiterated, “The culture of access has to change.”
The summit follows the release of new opioid prescription guidelines for primary care physicians from the Centers for Disease Control and Prevention last week; nearly half of the opioid prescriptions in the country are issued from their notepads, raising concerns that over-liberal drug prescription is fueling the addiction epidemic.
When asked how his new funding plans were going to help future recovering addicts, Obama did get in a final jab at his government: First of all, the 1.1 billion is not yet allocated by Congress, he said dryly, echoing his earlier jab accusing them of not expanding Medicaid “like they should’ve” under the Affordable Care Act.
“Without us collectively as a society making this commitment,” Obama said, “what we will repeatedly end up with is being penny wise and pound foolish. It’s just smarter for us to do the right thing on the front end.”