Remarks by White House Drug Policy Director Michael Botticelli at the First Meeting of Heroin Task Force

WASHINGTON -- This morning, Michael Botticelli, Director of National Drug Control Policy, and Acting Deputy Attorney General Sally Yates and gave opening remarks at the first meeting of the federal Heroin Task Force.

The multi-agency Task Force was created to help address the growing heroin crisis in America. The Attorney General has asked David Hickton, U.S. Attorney for the Western District of Pennsylvania, and Mary Lou Leary, Deputy Director for State, Local, and Tribal Affairs at the Office of National Drug Control Policy (ONDCP) to Co-Chair the Task Force. The meeting will bring together federal agency experts from law enforcement, medicine, public health, and educational fields to help develop a coordinated response.

The Task Force will create a strategic plan that will be submitted to Congress and the President by end of 2015. This plan will provide a framework for national, regional and local efforts to both restrict the heroin supply and reduce heroin use and its consequences.  The Task Force will build on the Administration’s ongoing public health and safety approach to combatting the opioid epidemic, which includes heroin and prescription drugs. The President’s FY 2016 budget proposed critical investments to intensify efforts to reduce opioid misuse and abuse, including $133 million in new funding.

Remarks by Director Botticelli:

Thank you for that kind introduction.

Thanks also to each of you for taking on the work of this Task Force. Our Nation is facing a growing heroin and opioid crisis, and Congress is calling on us to provide the roadmap to address this crisis.  I know that many of you have been working on this issue for the past several years but it is important that we adapt our strategies to address the evolving opioid epidemic and help local communities address it as well.

In 2009, drug poisoning deaths surpassed the historically most lethal cause of preventable injury – traffic crashes – and rates continue to escalate.

The 2013 drug overdose mortality data from the Centers for Disease Control and Prevention (CDC) show a 6 percent increase in all drug poisoning deaths from 2012 and a 1 percent increase in deaths involving opioid medicines. 

A pressing reason for concern and ultimately the reason this task force exists, is that deaths involving heroin had the largest upsurge overall, with a 39 percent increase from 2012.

As we will learn from the data presentation, heroin is striking a younger and more rural and suburban population, affecting strained criminal justice systems and in areas with scant access to treatment.

Prescription Drug Abuse Prevention Plan

To address this issue, the Administration released a Prescription Drug Abuse Prevention Plan in 2011. Since then, we have made substantial progress towards accomplishing many of the goals established under each of the Plan’s four pillars – education, monitoring, drug disposal, and enforcement.

Education

The majority of prescribers do not receive any training in medical school on identification or treatment of substance use disorders.  We have therefore developed continuing education training programs that teach prescribers skills such as how to start a conversation with patients about substance use; managing pain appropriately; and treating patients using opioids more safely. 

Monitoring

Prescription drug monitoring programs are another part of our plan to address prescription drug overdose deaths.  All but one state – the state of Missouri – have a database that allows prescribers to check on drug-drug interactions as well as to alert them to early signs of dependence on opioids.

Disposal

The third element of our plan is disposal.  Since the majority of individuals who begin misusing prescription drugs get them from family and friends, we must make it easy to dispose of the drugs.

The Drug Enforcement Administration (DEA) published the final regulations on controlled substance disposal in September 2014. Now ONDCP and our Federal partners and stakeholders are beginning to inform the public about the regulations and looking at ways to stimulate local disposal programs in partnership with pharmacies and law enforcement.

Enforcement

Finally, work on enforcement and strengthening existing laws is ongoing at the Federal, state, and local levels.  And those engaged in fraud across the drug-control supply chain are being investigated and prosecuted.

We have made great progress, but overdose rates are still much too high.  And there are too many people with opioid use disorders who cannot access treatment.

In addition to the Prescription Drug Abuse Prevention Plan, the Administration is emphasizing naloxone distribution and access to evidence based treatment for opioid use disorders. 

Over the past year, we have made incredible strides with respect to naloxone, a quick-acting prescription medication that rapidly blocks the effects of opioids and restores breathing.

• The Department of Justice created a Naloxone Toolkit for law enforcement. [The toolkit is available from the Bureau of Justice Assistance at www.bjatraining.org.]

SAMHSA also has released an Opioid Overdose Toolkit for community members as well as public health professionals.  It is  available for downloading from the SAMHSA.gov website.

https://store.samhsa.gov/shin/content/SMA13-4742/Overdose_Toolkit_2014_Jan.pdf

• The Veteran’s Health Administration added naloxone to its formulary and created a policy for naloxone co-prescription.
• The President’s FY 2016 Budget directs SAMHSA to permit the use of block grant funds for naloxone purchase. It also provides funding specifically for law enforcement to purchase naloxone.

I recently had the opportunity to do a ride along with Corporal Nicholas Tackett, a police officer from Anne Arundel County in Maryland. Corporal Tackett has witnessed about 50 drug related overdoses in his law enforcement career.

He knows the signs of overdose, the looks on their faces. Now, with naloxone, he has a tool that allows him to save lives. Corporal Tackett brought me to the locations where his use of naloxone saved the lives of two people who were suffering heroin overdoses. Naloxone works, and it is an incredibly important tool.

But our goal must be to prevent a substance use disorder from ever developing into a chronic condition.  We do this by promoting drug use prevention at a young age.  And by working with the medical community to make sure that treatment becomes a regular part of our health care system.

The standard of care for individuals with opioid use disorders is treatment that includes both behavioral therapies and medication assisted treatment.  Medication-assisted treatment is provided under the care of a physician and includes the use of an FDA-approved medication such as methadone, naltrexone, and buprenorphine.

Medication-assisted treatment involves using one of these medications along with a full array of counseling, adherence, diversion-prevention efforts, and recovery-support services. Sometimes recovery support goes on for years, so patients learn the skills they need to function in recovery.

There is a lot that we can do in this area but I’d like to provide a caveat - that we be careful not to stigmatize people with substance use disorders, this includes being aware of the language we use and not criminalizing behavior when we need to provide treatment. 

This Task Force will bring your collective wisdom and experience together to address these issues and many others

I am excited that the work of this Task Force is beginning, and I look forward to working with each of you.

Thank you.

# # #

For more information on National efforts to reduce drug use and its consequences, visit: http://obamawhitehouse.archives.gov/ONDCP