[Pharmwaste] White House announces new steps to combat heroin, prescription drug abuse

Volkman, Jennifer (MPCA) jennifer.volkman at state.mn.us
Wed Oct 21 19:27:52 EDT 2015


I like what I read, but are they missing other sources of opioids? Do they all come from home medicine cabinets? Are prescribers really the problem and can it be trained out of them? What about pill mills, online sources, auto fills, or doctor shopping? Training prescribers can't hurt, but aren't prescribers and pharmacists are well aware of the overdose and addiction stats and wouldn't the vast majority act to minimize that potential where they can? Just seems like there is a gaping hole in the strategy, but maybe there isn't.  MN is one of the states that allows police officers, and I think even family members to administer naloxone. There is also a no penalty law of some sort where you can call the cops to administer naloxone and not get busted yourself for using. I have a bumper magnet that advertises it.

It does not seem wise to limit access to overdose prevention drugs.
https://www.naabt.org/reasons.cfm
http://www.theatlantic.com/health/archive/2014/12/the-fight-for-the-overdose-drug/383467/


From: pharmwaste-bounces at lists.dep.state.fl.us [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of DeBiasi, Deborah (DEQ)
Sent: Wednesday, October 21, 2015 2:16 PM
To: pharmwaste at lists.dep.state.fl.us
Subject: [Pharmwaste] White House announces new steps to combat heroin, prescription drug abuse

https://www.washingtonpost.com/politics/white-house-announces-new-steps-to-combat-heroin-prescription-drug-abuse/2015/10/21/e454f8fa-7800-11e5-a958-d889faf561dc_story.html

White House announces new steps to combat heroin, prescription drug abuse
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FILE: A kit with naloxone, also known by its brand name Narcan, is displayed at the South Jersey AIDS Alliance in Atlantic City, N.J. (AP Photo/Mel Evans) (Mel Evans/AP)
By Steven Mufson<http://www.washingtonpost.com/people/steven-mufson> and Katie Zezima<http://www.washingtonpost.com/people/katie-zezima> October 21 at 1:40 PM
CHARLESTON, W. Va. - Faced with a nationwide epidemic of heroin and prescription drug abuse, the Obama administration announced Wednesday it will take steps to increase access to drug treatment and the training of doctors who prescribe opiate painkillers.
The efforts, which President Obama will discuss at a forum here, are likely to have a modest effect on the steep increase in heroin and prescription drug overdoses, which now kill more people than car accidents each year, and the barriers to treatment that many addicts face.
The administration hopes to double the number of doctors who can prescribe buprenorphine, a drug used to treat opiate addiction, to 60,000 from 30,000 over the next three years. More than 40 medical provider groups have committed to training more than a half million doctors, dentists and others on the safe prescription of opiate medications.
Obama's announcement will "underscore his sense of urgency that we at the federal level can do more to address this issue," said Michael Botticelli, director of the White House Office of National Drug Control Policy.
[Drug czar approaches challenge from a different angle: As a recovering alcoholic<https://www.washingtonpost.com/politics/drug-czar-approaches-challenge-from-a-different-angle-as-a-recovering-alcoholic/2014/08/26/fa518dd0-2883-11e4-958c-268a320a60ce_story.html>]
Wednesday's announcement is part of a broader effort to try to fight opiate addiction and crack down on the overprescribing of powerful prescription drugs. There has been a steep increase in the number of heroin overdoses nationwide, with the number of deaths from the drug quadrupling in the past decade<https://www.washingtonpost.com/news/to-your-health/wp/2015/07/07/heroin-deaths-have-quadrupled-in-the-past-decade/>. Many who abuse heroin progressed to it after using prescription painkillers.
The administration this year proposed $133 million in new spending to curb overprescribing, increase the amount of overdose data collected and expand access to Naloxone, a drug that can reverse the effects of an opiate overdose. In August, the administration announced an initiative to pair drug enforcement officers with public health workers<https://www.washingtonpost.com/politics/in-heroin-fight-white-house-tries-to-break-down-walls-between-public-health-police/2015/08/16/f63d63c2-4425-11e5-8ab4-c73967a143d3_story.html> to trace the route of heroin, and it tightened prescribing rules for a popular powerful painkiller.
Wednesday's announcement will also double the number of providers that can prescribe Naloxone. Additionally, CVS will expand the number of states where its pharmacies will dispense Naloxone without a prescription, and Rite Aid will train 6,000 pharmacists on Naloxone use over the next year.
Despite the announcements, many barriers still remain to treatment, with many addicts unable to access the help they need because of insurance rejections or overburdened facilities.
The Affordable Care Act requires insurers to treat addiction like any other medical condition. But that portion of the law only went into effect for many insurance plans in January. In an interview earlier this year, Botticelli said the administration is investigating complaints of declined coverage, higher co-pays and reimbursement limits.
Botticelli is a champion of using opiate drugs including buprenorphine for medication-assisted treatment, a practice that is controversial. The drugs are prescribed by a doctor who monitors the patient and tapers the dosage of the drugs, eventually weaning the person off opiates.
The administration plans to expand a pilot program where medication-assisted treatment is offered to people in jail. The corrections system typically does not offer treatment, forcing people to detox in jail. They often relapse after being released. The White House has also made drug court funding contingent on the court offering medication-assisted treatment.
"That doesn't make sense to me, just sending out more medication-assisted treatment," Rep. Tim Murphy (R-Pa.) said in an interview earlier this year.
The Department of Health and Human Services plans to additionally change the rules on medication-assisted treatment; currently doctors can only prescribe to 30 patients in the first year after being approved to dispense the medications, and they are now capped at 100 patients.
The administration is working to take a federal approach to an issue that is often tackled at the state level. Many states have made it easier to access Naloxone as a way to curb the number of overdose deaths. The drug has saved many lives and some states have made it available without a prescription. But some treatment advocates are leery of relying too much on the drug, which saves lives but doesn't steer addicts away from heroin.
Here in West Virginia, a law passed earlier this year allows emergency responders, medical personnel and friends and family members of addicts to administer Naloxone. West Virginia - the home of Health and Human Services Secretary Sylvia Burwell - is the epicenter of America's opiate epidemic, where more than a decade ago people started getting hooked on prescription drugs.
According to the Trust for America's Health and the Robert Wood Johnson Foundation, West Virginia has the highest rate of drug overdose deaths in the country - 33.5 per 100,000 people - accounting for more than one-third of the state's overall injury deaths,
On a side street near the Roosevelt Neighborhood Center where Obama was scheduled to speak, the leaders of some local social service groups said they could use even more support from Washington.
Standing in front of a group of blue plastic kindergarten chairs on a grassy lawn, Carey Jo Grace, a community organizer with Our Children Our Future Campaign, said that at least one of the 30 chairs held a child who would eventually die of a drug overdose. Obama, she said, "has the power to do something about it with the stroke of a pen." She said that West Virginia needs more money for rehabilitation programs. West Virginia's Department of Health and Human Resources estimates that the state has about 60,000 people in need of treatment competing for just 750 beds.
"There are people who need to drive hours if their name comes up on a waiting list," she said.
"More funds for treatment is just critical," said the Rev. Jeff Allen, head of the West Virginia Council of Churches. But, he added, pastors had to do more to "change the culture of churches to take away any shame so people can turn to their pastors and congregations."
Marc Fisher in Washington contributed to this story.
Deborah L. DeBiasi
Email:   Deborah.DeBiasi at deq.virginia.gov<mailto:Deborah.DeBiasi at deq.virginia.gov>
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