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OBAMA MUST DO MORE TO FIGHT HEROIN

President Obama's administration has missed opportunities to stem the opioid overdose crisis, and therefore it's no great surprise that heroin overdose deaths have tripled since 2010.

The administration dragged its feet on requiring mental health and addiction treatment to have the same insurance coverage as physical ailments; inexplicably, it took five years to write the federal regulations needed to implement the 2008MentalHealth Parity and Addiction Equity Act.  Many insurance plans still ignore the need for parity, studies show.  The administration is only this month finalizing rules to implement parity for mental health and addiction treatment in Medicaid...

Still...  Obama has talked publicly about the opioid addiction epidemic and recently announced more money and a few federal actions to help quell the overdose crisis.  It's a welcome change, but it is also a sign that bodies are piling up like cordwood and becoming hard to ignore: 47,000 died of overdoses in 2014 alone, with 61 percent of the fatalities from prescription pain relievers and heroin....

Here are a few of Obama's proposals, with suggestions that he go further:

More treatment medication.  The likelihood that people will recover from hero in or painkiller addiction is vastly improved if they take medications such as Suboxone, which both blocks the euphoria of opioids and reduces craving....  Yet under federal law, doctors are limited to prescribing Suboxone to100 patients at any one time.  Obama advocates increasing that limit to 200 patients- a good move, but not good enough.

The president's budget this year proposed money for a pilot project to authorize nurse practitioners, and not just doctors, to prescribe Suboxone.  Why stop there? There's no reason why nurse practitioners, who can already prescribe medications in every state, should not have such prescribing authority...

Better medical education.  Obama also announced that more than 60 medical schools have agreed to include some form of training in prescribing opiates as a prerequisite to graduate.  Excellent.  But doctors should have broad training in addiction, which most medical schools skim if they cover it at all, not just prescription training.

Money.  Obama said he is releasing money to help curb opioid overdoses.  He included $1.1billion in his budget, but even if his budget passed, the money wouldn't be released until October.  Other proposals include $11million to purchase naloxone, or Narcan, the drug that helps reverse overdoses; $94 million to be spread across 271community health centers, or a little less than $300,000 each; another $11million to help states expand treatment.  None of this gives the sense that we are dealing with a public health emergency.

Of course, money is a stumbling block in Washington.  A case in point: In March, the Senate passed by a near-universal vote the Comprehensive Addiction and Recovery Act...  The Republicans who control the Senate successfully beat back a Democratic attempt to attach $600 million in emergency funding to the legislation, airily telling proponents that they could use $400 million meant for other programs that was passed last year in the omnibus spending bill....

The most honest assessment came from New Hampshire Democratic Sen.  Jeanne Shaheen.  She said, "There is simply no excuse for Congress providing emergency funding for the Ebola and swine flu epidemics while ignoring an opioid crisis that's killing a person a day in the Granite State."

And, she could have added, killing 130 a day nationwide.