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
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