New York Times – Obama Steps Up U.S. Effort to Fight Abuse of Heroin and Painkillers

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.

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“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.”


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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.

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