President Barack Obama on Wednesday announced a new initiative to train doctors who prescribe opioid pain medications and promote the use of medication-assisted therapy for treating addiction to prescription painkillers and heroin.
Speaking in Charleston, W.Va., which has been hard hit by the heroin epidemic, Obama said he wants to expand access to medicines like buprenorphine that treat opioid addiction, and naloxone, which can reverse an overdose.
Obama has instructed all federally employed healthcare providers who prescribe controlled medication to undergo training that addresses best practices for prescribing, principles of pain management and information on misuse.
Paul Gionfriddo, CEO of Mental Health America, said the number of providers and contractors for the federal government is large enough that the training mandate could mark an overall change in behavior and practice across the country.
Jeremiah Gardner, public affairs and advocacy manager for the Hazelden Betty Ford Foundation, said he thought training would have a ripple effect.
Doctors should be taught about addiction and instructed to consider alternative treatments for pain, limit the amount of opioids prescribed, involve family members in treatment, review risks with patients and then watch for signs of misuse, he added.
Obama noted Wednesday that addiction is not a new issue, but use and misuse of opioids has increased rapidly in the past several years.
“I don't have to tell you it's a terrible toll,” he said. “The numbers are big, but behind those numbers there is incredible pain for families.”
Heroin use among adults 18 to 25 has more than doubled in the past decade and the number of overdose deaths quadrupled between 2002 and 2013, according to the Centers for Disease Control and Prevention.
More than half of those who use heroin are addicted to prescription opioid painkillers and more than 90% of heroin users also use at least one other drug, according to the CDC.
Gionfriddo said the treatment community has been divided about medication-assisted therapy, but evidence shows it can help people in recovery. Obama's plan stresses that agencies must ensure their health benefits include access to those strategies.
Obama's plan also notes that the use of methadone as a first-line treatment for pain management has been recognized as inconsistent with goals to reduce opioid addiction. Being aware of what is the wrong medication and using data to determine best practices is helpful, Gionfriddo said.
Obama also announced Wednesday that broadcast networks have agreed to air public service announcements, and 40 medical organizations are coming together to promote awareness.
Robert Ashford, national program director at Young People in Recovery, was glad the campaign would use positive messaging and phrasing that reduces stigma and shame.
“It frames the conversation away from moral failure,” he said.
The administration has also recently pressured drug courts to include medication as part of their treatment options.
Gardner lauded the White House's goal of increasing the number of physicians who can prescribe buprenorphine from 30,000 to 60,000. Easing restrictions on prescribing buprenorphine is also part of Democratic presidential candidate Hillary Rodham Clinton's plan for combatting substance use disorder.
Clinton outlined a $10 billion plan in September in an op-ed published by the New Hampshire Union Leader. She called for a $7.5 billion fund to assist states that develop plans for fighting substance abuse and increasing funding for block grants.
