Addressing the Heroin and Prescription Opioid Epidemic

Walk into any town in rural America, and ask someone if they know someone who is struggling or has struggled with addiction.  Chances are the answer will be yes.

In 2014, 28,648 Americans died of overdoses of opioids, a class of drugs that includes both prescription pain medications and heroin.  Heroin-related overdose deaths nearly doubled between 2011 and 2013.  In 2013, prescription opioid abuse or dependency affected 1.9 million Americans, and 517,000 Americans had abused heroin within the past year.

This is an epidemic, and it requires serious action from all levels of federal, state, and local government, the health community, law enforcement, and other stakeholders, in order to start turning those numbers around.

In January, President Obama asked me to lead an interagency effort focused on heroin and prescription opioids in rural America, a role I was humbled to accept.  This issue is very personal to me.  Growing up with a mother who struggled with alcohol and prescription drug addiction for much of my childhood, it wasn’t until I saw her recover with treatment that I saw addiction for what it is: a disease, not a character flaw.  This disease isn’t a personal choice, and it can’t be cured by willpower alone.  It requires responses from whole communities, access to medical treatment, and an incredible amount of support.

To me, our mandate is clear:  don’t judge, just help.  I feel especially fortunate to be able to leverage USDA’s special relationship with rural America, where rates of overdose and opioid use are particularly high, to better meet these communities’ unique needs.  Confronting the opioid crisis is part of the larger goal of creating economic opportunity and hope in rural areas, which are the heart and soul of this country.

On Monday, I spoke at the National Rx Drug Abuse & Heroin Summit in Atlanta, where more than a thousand leaders from across the country are currently gathered to discuss what we are doing, and what more we can do, to address this serious epidemic.  The Obama Administration has been promoting strategies including evidence-based prevention programs, prescription drug monitoring, and access to medication-assisted treatment and the overdose reversal drug naloxone.  Under the Affordable Care Act, mental health and substance use disorder services are essential health benefits that are required to be covered by health plans, and insurers are required to treat them the same as they treat medical and surgical benefits.  The President’s fiscal year 2017 budget proposes $1.1 billion in new funding to ensure treatment for opioid use disorder is available to everyone who seeks it.

Last week, Secretary of Health and Human Services Sylvia Burwell, Director of National Drug Control Policy Michael Botticelli, and I sent a joint letter to all governors to encourage them to use best practices that some states are already implementing, including requiring all prescribers to receive training on proper prescribing of opioids, and requiring prescribers and pharmacists to utilize prescription drug monitoring programs, a proven tool for reducing prescription drug abuse and diversion.  We are making great progress, but we need even more states to take action.

President Obama addressed the Summit yesterday and announced additional actions the Administration is taking right now to expand access to treatment, prevent overdose deaths, and increase community prevention strategies, as well as new commitments from the private sector.  In addition, I announced that I will hold a series of rural town halls in communities across the country in the coming months, in order to build support at the local, state, and regional levels for addressing addiction.  I also announced the availability of $1.4 million through USDA’s Rural Health and Safety Education (RHSE) grant program, which we are expanding this year to support outreach to prevent opioid abuse in rural communities.

These grants are an example of how USDA is utilizing existing programs to help.  As another example, our Rural Development Community Facilities programs can finance the construction of mental health and substance use disorder clinics in rural areas, which often lack access to treatment, and in 2013, I made a commitment to provide up to $50 million in Community Facilities funds for these types of facilities by the end of 2016.  As of November 2015, USDA had already more than quadrupled that commitment, providing more than $213 million to 80 projects in 34 States to develop or improve mental health and substance use disorder treatment facilities in rural areas.

We must continue to do more, and I urge Congress to approve the President’s budget request right away.  By making real investments, expanding strategies that we know work, and mobilizing partnerships at every level across the country, we can turn the tide of this epidemic and save lives.