Pubdate: Wed, 30 Mar 2016
Source: New York Times (NY)
Copyright: 2016 The New York Times Company
Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Mark Landler

OBAMA TAKES CRUSADE AGAINST OPIOIDS ON ROAD

ATLANTA - President Obama, confronting a national epidemic of heroin 
and prescription drug abuse, met here Tuesday with recovering 
addicts, doctors and law enforcement officials to underscore his 
determination to tackle a problem some critics say he left until too 
late in his administration.

"We are seeing more people killed because of opioid overdose than 
from traffic accidents - I mean, think about that," Mr. Obama said at 
a meeting of the National Rx Drug Abuse and Heroin Summit. "It has to 
be something right up at the top of our radar screen."

The administration announced an array of new measures to expand drug 
treatment centers and increase the use of drugs, like naloxone, that 
reverse the effects of overdoses from opioids, ranging from illegal 
narcotics like heroin to brand-name painkillers like OxyContin and 
Percocet. These modest steps built on the $1.1 billion in additional 
funding that the White House requested this year to fight opioid addiction.

But the president said that "this is still an area that's grossly 
underresourced."

Mr. Obama cast the opioid scourge as having transcended economic and 
social boundaries. "If there's a market for heroin in an inner city 
in Baltimore," the president said, "it's not going to take that long 
before those drugs find their way to a wealthy suburb outside Baltimore."

The president listened as two fellow panelists recounted their 
struggles with drug addiction and a treatment process that often 
stigmatized them as criminals. Crystal Oertle, a 35-year-old mother 
of two from Ohio, described how she progressed from the recreational 
use of the painkiller Vicodin to OxyContin and then, finally, to heroin.

"They are pretty much like heroin," she said of Vicodin and 
OxyContin. "When it came to the point when I couldn't find those 
pills, I had to go to the street. That's how I got into using heroin 
after the pills."

Justin Riley, 28, said he had begun experimenting with painkillers in 
third grade to compensate for a feeling of emotional emptiness. "I 
used to take Benadryl to sleep through the night," he said. Mr. 
Riley, who has been in recovery since 2007, runs a nationwide 
organization that helps young people combat addiction.

Treating addiction, Mr. Obama said, has been hindered because the 
public has long viewed opioid use as a character flaw, common to 
people in poor and minority communities. That has changed, he said, 
because opioid addiction has spread so widely.

Mr. Obama again spoke about these drugs in starkly personal terms. 
"When I was a kid, I was-how would I put it? - not always as 
responsible as I am today," Mr. Obama said to laughs. "I was lucky 
because, for whatever reason, addiction didn't get its claws into me, 
with the exception of cigarettes."

Mr. Obama said he was not certain why he had not strayed into drug 
use. He referred to friends who had battled drug addiction and "were 
not more morally suspect than me."

The last time Mr. Obama traveled outside Washington to dramatize the 
scourge of opioid addiction - to West Virginia in October - his 
administration won praise for drawing attention to the problem but 
was criticized for not doing enough to combat a public health 
epidemic that worsened greatly during his presidency.

Since then, the federal government has published the first national 
guidelines for prescription painkillers, required new warning labels 
for certain kinds of opioid painkillers, and requested an additional 
$1.1 billion to expand treatment facilities and finance programs to 
prevent overdoses and crack down on illegal sales of drugs.

"The only thing I would fault them for is that they waited too long 
to do this," said Dr. Carl R. Sullivan, the director of addiction 
services at the West Virginia University School of Medicine. "This 
has been able to idle along for a long time."

In particular, Dr. Sullivan said, the national guidelines issued by 
the Centers for Disease Control and Prevention provide a "compass 
point" for the treatment of patients and the education of medical 
residents and even practicing doctors. "The situation is so dire that 
we had to do something," he said.

Josh Earnest, the White House press secretary, denied that the 
administration had waited too long to address the crisis. The 
Affordable Care Act, he noted, provides funding for expanded 
treatment of mental health problems, a key cause of drug abuse. By 
doing so, Mr. Earnest said, the president shifted the focus from 
purely law enforcement to medical treatment.

He said the coming presidential election had thrown a harsh spotlight 
on the extent of the problem. The Democratic front-runner, Hillary 
Clinton, after stressing that addiction was a recurring theme in her 
campaign swings, has proposed $7.5 billion in federal funding to help 
states expand treatment programs. Senator Ted Cruz, Republican of 
Texas, has spoken emotionally of the death of his older half sister, 
Miriam, from a drug overdose at 49.

Opioids played a part in 28,648 deaths in the United States in 2014, 
a record number, according to the C.D.C., and opioid painkillers like 
OxyContin, Percocet and Vicodin generate nearly $2 billion a year in sales.

Part of the problem for the Obama administration in combating these 
drugs is that the epidemic was fueled in part by doctors who 
prescribed the medicines indiscriminately, but regulating doctors has 
historically fallen to the states. Massachusetts, Vermont and Maine 
are among states that have moved in recent months to limit the 
ability of doctors to prescribe these pills. But patient and doctor 
groups, some funded by the pharmaceutical industry, have resisted 
state and federal efforts.

To underscore the role of the states, Mr. Obama invited two lawmakers 
to join him on the trip: Senator Edward Markey, Democrat of 
Massachusetts, and Representative Hank Johnson, Democrat of Georgia. 
Mr. Markey is pushing legislation that would remove all federal caps 
on the ability of doctors to prescribe buprenorphine, an opioid 
derivative that is used to treat people addicted to opioids.

"Coming from a state that is disproportionately impacted by this 
scourge," Mr. Markey said in a statement, "I believe we should do as 
much as we can, as soon as we can, to expand treatment to those who 
need it most." Correction: March 29, 2016

An earlier version of this article misspelled the surname of a 
recovering addict who met with President Obama. She is Crystal 
Oertle, not Oerle.

Gardiner Harris contributed reporting from Washington.
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MAP posted-by: Jay Bergstrom