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Obama Seeks to Expand Opioid Addiction Treatment

Author: Brenda Goodman

2016-03-30

President Barack Obama traveled to Atlanta on Tuesday to shine a light on the nation’s opioid abuse epidemic, which continues to get worse.

More than 28,000 Americans accidentally overdosed on opioids in 2014, according to the National Center for Health Statistics. About half of those were prescription painkiller overdoses, officials said at the summit.

“When you look at the staggering statistics in terms of lives lost, productivity impacted, cost to communities, costs to families, it has to be something that has to be right up there at the top of our radar screen,” Obama told a town hall meeting at the National Rx Drug Abuse and Heroin Summit.

More people now die of narcotic drug overdoses than die in car accidents each year, Obama said.

Roughly 8 million Americans over the age of 12 need treatment for illicit drug use, according to the Office of National Drug Control Policy.

Meanwhile, 4 out of 5 addicts, 80%, can’t get treatment, even if they want it. That’s because there aren’t enough doctors who know how to treat substance abuse. The treatment programs that do exist have long waiting lists, according to speakers at the summit.

Along with the president’s appearance Tuesday, the White House announced a package of initiatives aimed at turning the tide on opioid addiction in the U.S.

Those included a new proposed rule from the Centers for Medicare & Medicaid Services that would raise the cap on the number of patients doctors can treat with buprenorphine, a controlled substance that helps wean addicts off the more potent drugs they’re abusing. That will allow more people to get this medication, which has been shown to help people recover from addiction.

There’s also more money -- $94 million -- coming for community health centers, and $11 million in new grants for communities that want to expand medication-assisted treatment programs.

That’s just a drop in the bucket compared to the $1.1 billion Obama has proposed “to help every American with an opioid-use disorder who wants treatment get the help they need,” according to a White House press release. Congress still has to approve that money.

Leana Wen, MD, Baltimore’s commissioner of health, drew cheers from the crowd of 2,000 people gathered to hear Obama speak.

She recounted a personal experience with a patient she'd gotten to know when she was working in a hospital ER. The woman, she said, was a competitive swimmer in her twenties. She’d started taking opioid pain medications to treat a back injury, became addicted to them, and switched to heroin. She came to the ER about once a week, Wen said.

“It’s one of the worst realizations for a doctor, it’s one of the most humbling things, is to know that you can’t help them,” Wen said.

The doctors would resuscitate the woman, and she would ask for treatment for her addiction. But they couldn’t get her into a treatment program. Her patient, she said, eventually overdosed and died.

“We would never say to someone who’s had a heart attack, ‘Go home. If you’re still alive in 3 months, come back, and we’ll get you treatment,’” she said, to enthusiastic applause. “We’re treating addiction different than any other disease.”

Wen issued a standing order in Baltimore so that anyone who takes a short amount of training can get a prescription for naloxone, or Narcan, a drug that can reverse an overdose.

“That’s what a solution looks like,” said the town hall moderator, CNN's Sanjay Gupta, MD.

A culture of overprescribing and overmedicating is at the heart of the opioid epidemic, both Obama and Wen said.

“We live in a society where we medicate a lot of problems and where we self-medicate a lot of problems,” the president said.

Gupta told the audience that Americans take 80% of the world’s pain medications. “We don’t have 80% of the world’s pain, I think,” he said.

Wen said she knows doctors aren’t trying to harm their patients when they prescribe pain medications.

“I know that doctors are trying to do the right thing. We’re not trying to get our patients addicted to medications,” she said.

But she said doctors are writing 30-day prescriptions for pain that may last a few days.

“This is the culture of excess that has to change,” she said.

SOURCES:

National Rx Drug Abuse and Heroin Summit, March 29, 2016, Atlanta.

Whitehouse.gov.

CMS.gov.

Medscape Medical News,

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