Pubdate: Tue, 11 Mar 2014
Source: Washington Post (DC)
Copyright: 2014 The Washington Post Company
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Website: http://www.washingtonpost.com/
Details: http://www.mapinc.org/media/491
Author: Jerry Markon

HOLDER: HEROIN CAUSING 'PUBLIC HEALTH CRISIS'

Attorney General Touts Federal Enforcement and Treatment Efforts

The Obama administration called attention on Monday to the nationwide 
surge in heroin abuse, with Attorney General Eric H. Holder Jr. 
saying a spike in overdoses from the deadly drug constitutes "an 
urgent and growing public health crisis."

In a video message posted on the Justice Department's Web site, 
Holder said the government is targeting violent traffickers who bring 
heroin into the United States while urging emergency personnel to 
carry an anti-overdose drug.

"Confronting this crisis will require a combination of enforcement 
and treatment. The Justice Department is committed to both," said 
Holder, who noted that the Drug Enforcement Administration has opened 
more than 4,500 heroin related investigations since 2011.

The message marked the first major public foray by the nation's top 
law enforcement officer into a debate over heroin that has escalated 
since the recent death of actor Philip Seymour Hoffman from heroin 
and other drugs. Heroin use rose 79 percent nationwide between 2007 
and 2012, federal data show, and Holder said heroin-related deaths 
are up 400 percent in areas such as Cleveland.

In response, he said, the government is "doing more than ever to keep 
illicit drugs off the streets" through a DEA strategy aimed at 
reducing the supply of heroin "at all levels of the supply chain." At 
the same time, Holder added, officials are partnering with police, 
doctors and others to increase prevention and treatment programs for 
heroin and prescription opioids such as OxyContin. Prescription drug 
abuse kills far more people each year than heroin, federal statistics show.

"It's clear that opiate addiction is an urgent - and growing - public 
health crisis," Holder said.

At times, the government has been slow to confront the problem. Gil 
Kerlikowske, who runs the Office of National Drug Control Policy as 
President Obama's "drug czar," recently said that he should have done 
more to raise awareness of heroin during much of the administration's 
first term but that heroin is now a much bigger priority.

Top drug policy officials in the Obama and George W. Bush 
administrations have said that for a long time they rarely discussed 
repeated warnings from inside the government that the crackdown on 
prescription drug abuse could help fuel a new heroin epidemic. Many 
prescription drug abusers have switched to cheaper heroin, since 
prescription pills and heroin provide a comparable, euphoric high. 
Experts say the government's actions in arresting doctors and 
shuttering "pill mills" contributed to the shift.

In the past few years, law enforcement has been aggressive in 
combating heroin. Federal data show that heroin trafficking cases 
rose 52 percent between 2008 and 2012. Federal officials say Mexican 
heroin production has increased, and traffickers are targeting areas 
of the United States hard hit by prescription drugs with a much 
cheaper product.

States are also increasingly confronting the spread of heroin use, 
usually by trying to prevent deaths. In recent years, 17 states and 
the District of Columbia have passed "good Samaritan" laws, offering 
some measure of immunity to those who seek medical help for an overdose victim.

Nearly 20 states and the District are also taking steps to allow more 
medical professionals to carry and administer naloxone, the drug 
Holder highlighted Monday, which reverses the effects of overdoses.

Even as his department has cracked down on heroin, Holder's personal 
efforts to use the power of his office to raise awareness have been 
sporadic, a review of his speeches and public statements shows. The 
attorney general speaks often, in deeply personal terms, about how he 
witnessed the impact of drugs as a father and former prosecutor and 
D.C. Superior Court judge.

In 2009, soon after taking office, Holder said at a congressional 
hearing that he recognized heroin as an emerging problem.

In recent years, however, Holder's drug-related efforts have focused 
more on matters such as reducing mandatory minimum prison terms for 
some low-level, nonviolent drug offenders and crafting a federal 
approach to state laws legalizing marijuana.

Speaking at a 2012 congressional hearing focusing on prescription 
drugs, the attorney general cited a variety of illicit substances. 
"People, when they hear drugs, they think of crack. They think about 
cocaine, methamphetamine," he said. He did not mention heroin.

John Carnevale, who worked for four drug czars in Republican and 
Democratic administrations, praised Holder's remarks on Monday, 
especially his focus on public health and treatment along with 
enforcement. "What the attorney general is saying makes perfect 
sense," Carnevale said.

But Theodore Cicero, an expert on addiction at Washington University 
in St. Louis, said the comments should have come much earlier. 
"Calling attention to heroin is a good thing, but there was a lot of 
dodging it for some time," he said. "It's too bad it took something 
like Philip Seymour Hoffman to have the country wake up."

A Justice Department official said Holder was reacting more to the 
broader national discussion about heroin than to the actor's death 
and wanted to invoke that to highlight the department's actions to 
combat it. "The attorney general wanted to have a voice in what has 
become a rising debate around the uptick in heroin-related deaths," 
said the official, who spoke on the condition of anonymity to discuss 
internal deliberations.

Alice Crites and Reid Wilson contributed to this report.
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