Health Policy$ense

President Obama Targets Opioid Abuse Epidemic

Major Initiative Announced

The White House announced this week a series of Administration actions aimed at slowing the opioid epidemic, in addition to President Obama’s $1.1 billion budget request. This new initiative comes amid a flurry of activity combating substance abuse. The Senate recently passed a bill targeting opioid abuse, the Centers for Disease Control and Prevention released its highly anticipated opioid prescribing guidelines for chronic pain, and the Food and Drug Administration announced it will require new warning labels on prescription opioids. 

A key component of the President’s plan aims to expand access to medication-assisted treatment by doubling the number of patients (from 100 to 200) a qualified physician can treat with buprenorphine, which can reduce withdrawal symptoms and cravings. Because the drug is itself an opiate, physicians are required to obtain a waiver to prescribe buprenorphine.  Certified physicians are currently capped at 30 patients the first year and can apply to increase the limit to 100 patients after that. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), nearly 10,500 physicians are certified to prescribe at the higher level, while the remainder, about 22,000 are limited to 30 patients.  In addition to increasing buprenorphine prescriptions, the plan includes $94 million in new funding for community health centers and $11 million for up to 11 states to expand medication-assisted treatment services. 

Beyond medication-assisted treatment, the initiative includes:

  • Creating an interagency Mental Health and Substance Use Disorder Parity Taskforce to increase access to mental health and substance use disorder treatment and promote compliance with federal standards requiring comparable insurance coverage of medical and mental health benefits.

  • Implementing Mental Health and Substance Use Disorder Parity in Medicaid to ensure these services are comparable to medical and surgical benefits provided in Medicaid and CHIP. 

  • $11 million in SAMHSA funding to states to purchase and distribute the opioid overdose reversal drug, naloxone, and to train first responders and others on its use along with other overdose prevention strategies.

  • $7 million in community policing strategies to investigate the distribution of heroin, unlawful distribution of prescription opioids and unlawful heroin and prescription opioid traffickers. 

  • a $1.4 million Rural Health and Safety Education Grant Program to address challenges related to substance use disorders in rural communities.

  • Guidance from the Department of Health and Human Services regarding the use of federal funds to implement or expand needle exchange programs. 

Along with the President’s announcement, more than 60 medical schools announced that they will require students to take a course in prescriber education based on the CDC’s opioid guidelines in order to graduate. 

The private sector is stepping in as well. Pharmacies, such as Rite Aid and Kroger, are expanding sites that can dispense naloxone without an individual prescription and training pharmacists on how to do so.   

According to the 2014 National Survey of Drug Abuse and Health, nearly 22 million people in the United States suffered from a substance abuse disorder. After decades of treating substance abuse as a law enforcement issue, policy is catching up with public health in treating substance abuse disorders as a disease. Albeit too late to save the thousands of lives lost to opioid addiction, the furious push we’re witnessing by public health officials and policymakers on the local, state, and federal level is encouraging.  President Obama’s Administration actions make strides in targeting the opioid epidemic, but Congress will have to do its part to provide the necessary resources to effect change on a significant level.