The Opioid Drug Epidemic in America: Obama Proposes Relief

On Feb. 2, Obama unveiled a $1.1 billion funding proposal to help states fight the growing tide of drug abuse. The proposal includes $1 billion in new mandatory funding over two years to expand treatment access for substance abusers.

More than 90 percent of the $1 billion will support cooperative agreements with states to expand medication-assisted treatment options or to make already existing services more affordable. Federal funding will be allocated to states based on the severity of the crisis and the feasibility of the states’ plans for responding to it.

“Expansion of medication-assisted treatment options is critical to combatting the prescription drug and heroin epidemic,” Indiana Rep. Ed Clere said.

Medication-assisted treatment, or MAT, uses three FDA-approved medications—methadone, buprenorphine or naltrexone—prescribed and monitored by a health care provider, to assist individuals in overcoming addiction. Methadone and buprenorphine block the receptors in the brain that react to opioids. The person taking the medication feels normal, not high, and withdrawal does not occur. Methadone and buprenorphine also reduce cravings. Naltrexone blocks the effect of opioid drugs, taking away the feeling of getting high.

“Research shows MAT is highly effective, and government at all levels should act as quickly as possible to remove barriers and provide funding,” said Clere.

Clere’s district is just 30 minutes south of Scott County, Ind., which received international attention in 2015 because of an HIV outbreak caused by needle sharing for injecting prescription painkillers. In response to the HIV epidemic, Gov. Mike Pence declared an emergency that allowed Scott County to establish a needle-exchange program.

The president’s announcement also includes $500 million—an increase of more than 20 percent—for the U.S. Departments of Justice and Health and Human Services to continue their work to expand prescription drug overdose prevention strategies in states, increase access to medication-assisted treatments, improve access to the overdose-reversal drug naloxone and support enforcement activities. 

“We must take a multipronged approach with better prescribing and drug diversion practices as well as providing access to recovery programs,” said West Virginia Sen. Ron Stollings, a physician who practices in a small town.

“Pain is one of the most common reasons patients access the health care system,” said Stollings. “We, as physicians, have to be very judicious in how we treat pain.”

Over the past 15 years, nearly half a million Americans have died from drug overdose. It has become so prevalent in the U.S. that more people are dying from drug overdoses than from motor vehicle crashes, and the number of deaths is growing at unprecedented rates. The national death rate from drug overdoses rose from 13.8 per 100,000 in 2013 to 14.7 per 100,000 in 2014, a 6.5 percent increase. 

“The increasing number of deaths from opioid overdose is alarming,” said CDC Director Dr. Tom Frieden in a December 2015 press release. “The opioid epidemic is devastating American families and communities.”

On the same day Obama released his budget proposal, he met with Speaker of the House Paul Ryan of Wisconsin and Senate Majority Leader Mitch McConnell of Kentucky to discuss potential policy priorities that they could work on together. The president and congressional leaders agreed that something must be done to fight the rising tide of prescription opioid drug abuse and heroin use. The growing problem has been a major issue in the 2016 presidential primaries on both sides of the aisle.

There is also federal legislation moving through Congress that would address the opioid epidemic. Sen. McConnell has pointed to the Comprehensive Addiction and Recovery Act—or CARA—that has received bipartisan support in Congress. Introduced by Sens. Rob Portman of Ohio and Sheldon Whitehouse of Rhode Island, the legislation, if passed, would allocate nearly $80 million toward expanding access to opioid treatment and supporting current services in states.

In the end, the president’s budget proposal and congressional legislation would both provide funds and flexibility for states to take the lead role in combating opioid addiction and abuse.

The Partnership for Drug-Free Kids, whose executive vice president Sean Clarkin presented on the drug overdose epidemic to the 2015 CSG National Conference in December in Nashville, Tenn., applauded the president’s budget proposal.

“We know that when someone’s son or daughter is finally ready to enter treatment, only to find that there is no treatment bed available, there is a tragic, missed opportunity for a new and healthy future,” said Clarkin. “Greater access to treatment will, without question, help prevent heartache and loss for families and loved ones.”

Read the related CSG Capitol Research brief, Deaths from Drug Overdoses Rise Significantly, here.