Obama to Announce Steps to Curb Increase in Overdose Deaths

WASHINGTON — President Obama is expected to announce steps on Wednesday that he hopes will reduce an alarming rise in deaths from drug overdoses, including mandating more training for federal doctors and requiring federal health insurance plans to provide treatment for addiction.

Mr. Obama will make an announcement at a forum in West Virginia, where addiction to prescription painkillers has devastated communities for more than a decade.

 

“Since the start of this administration and the president’s inaugural drug strategy, we identified prescription drug abuse and heroin abuse as crucial problems,” a senior White House official said in an interview on Tuesday, speaking on the condition of anonymity to preview Mr. Obama’s message.

In trying to address the epidemic, the Obama administration has gradually sought to curb out-of-control prescribing practices while ensuring that cancer patients and others in profound pain can get the treatment they need. Last year, the federal government tightened rules for prescribing hydrocodone, the most commonly prescribed painkiller, which is present in such drugs as Vicodin.

But the efforts that Mr. Obama is scheduled to announce are expected to have only modest effects. States, not the federal government, regulate the practice of medicine, and only 10 states, including West Virginia, require that doctors who prescribe opioids get specialized training.

Abuse of painkillers is one of the few major public health problems that have worsened significantly during Mr. Obama’s presidency. More than 20,000 people in the United States die from prescription drug abuse each year, a level that has risen fourfold since 1999, making it the nation’s leading cause of death by injury. Not coincidentally, opioid prescriptions during that time also quadrupled.

A recent federal survey found that 4.3 million Americans had engaged in nonmedical use of prescription painkillers, and 259 million prescriptions were written for opioids in 2012 — enough to give every adult American 75 pills.

West Virginia leads the country in overdose deaths, but other states have suffered as well. Last year, more than 1,000 babies in Tennessee were born addicted to painkillers.

In recent years, cheap and easily available heroin has added to the epidemic, with nearly half of heroin users also addicted to painkillers. The twin addictions have led to increases in diseases such as hepatitis. Austin, Ind., a small town near the Kentucky border, recently had one of the most concentrated outbreaks of H.I.V. in the world as addicts passed around needles.

For critics like Senator Joe Manchin III, Democrat of West Virginia, the efforts have been too little and too slow.

“I’ll be damned if I’m going to let them destroy a state and a country without putting up a fight,” said Mr. Manchin, who has demanded that the Food and Drug Administration stop approving for sale new opioid drugs.

Predatory sales practices by companies such as Purdue Pharma — which in 2007 pleaded guilty to criminal charges that it had misled doctors and patients when it claimed that its painkiller was less likely to be abused than traditional narcotics — have also contributed to the epidemic.

Dr. Thomas R. Frieden, the director of the Centers for Disease Control and Prevention, said in an interview that both doctors and patients had suffered from a series of misunderstandings that have worsened the epidemic.

“When I was in medical school, I got one lecture on pain, and the lecturer said if you give opiates for a patient on pain, they will not become addicted,” Dr. Frieden said. “That’s completely wrong.”

Similarly, many patients believe that if they get treatment for addiction, which can include prescriptions for drugs like methadone, their condition will only worsen.

The result? “Medically assisted treatment is seriously underutilized,” Dr. Frieden said.

Mr. Obama is also expected to announce commitments by more than 40 provider groups that 540,000 health care professionals will get opioid prescriber training in the next two years.

Mr. Manchin said that part of the problem was a lack of jobs in Appalachia, and he blamed the administration’s clean air and climate policies for dire effects on the local coal industry.

The senior White House official said that many issues were at play in West Virginia.

“There’s a broader point that the president fully understands, that there is a link between social conditions and addiction,” the official said. Making sure that people have access to health care, health insurance and meaningful employment, he added, were priorities of the administration.

Source: NY Times