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Fact Sheet: Obama Administration Announces Prescription Opioid and Heroin Epidemic Awareness Week

September 19, 2016

Action from Congress urgently needed to provide $1.1 billion in new funding for treatment

"During Prescription Opioid and Heroin Epidemic Awareness Week, we pause to remember all those we have lost to opioid use disorder, we stand with the courageous individuals in recovery, and we recognize the importance of raising awareness of this epidemic."

--Proclamation by President Obama, September 16, 2016

As part of Prescription Opioid and Heroin Epidemic Awareness Week, Members of the President's Cabinet and Federal agencies are focusing on the work being done across the government and announcing new efforts to address the national prescription opioid and heroin epidemic.

Leading up to and during Awareness Week, Federal agencies are taking a number of actions, including:

•      Expanding substance use disorder treatment in the TRICARE system to include coverage of intensive outpatient programs and treatment of opioid use disorders with medication-assisted treatment.

•      Establishing enhanced measures in conjunction with the Chinese government to combat the supply of fentanyl and its analogues coming to the United States.

•      Increasing the patient limit from 100 to 275 for practitioners prescribing buprenorphine to treat opioid use disorders. Since July, 1,275 practitioners have applied for and been granted waivers to prescribe at the increased limit—improving access to medication-assisted treatment (MAT).

•      Supporting distance learning and telemedicine programs that expand access to healthcare, substance use disorder treatment, and educational opportunities in rural communities.

During Awareness Week, the White House will host a roundtable with parents affected by the epidemic. Attorney General Loretta Lynch and other Justice Department officials—as well as U.S. Attorney's Offices and Bureau of Prison facilities across the country—will participate in over 250 different events highlighting the importance of prevention, enforcement, and treatment. The Department of Agriculture will launch a series of State forums on the epidemic, starting in Connecticut and Colorado. Veterans Affairs Secretary Robert McDonald will lead a forum in Washington, DC, on treatment and support for veterans with opioid use disorder.

Departments across the Federal Government, including Justice, Agriculture, Defense, Veterans Affairs, and Health and Human Services, are using all available tools to combat this epidemic by expanding evidence-based prevention and treatment programs, increasing access to the overdose-reversal medicine naloxone, improving opioid prescribing practices, and supporting targeted enforcement activities. At the same time, with Federal support, State and community leaders are working together to combat the epidemic through innovative partnerships between public safety and public health.

Yet far too many Americans still do not get the treatment and care they need. That is why the President continues to call on Congress to provide $1.1 billion in new funding to make sure everyone who wants treatment for an opioid use disorder can get the treatment they need. Every day that passes without Congressional action to provide these additional resources is a missed opportunity to save lives.

Supporting Evidence-Based Prevention and Targeted Enforcement:

On Tuesday Attorney General Lynch will travel to Lexington, Kentucky, to hold a student town hall at a high school, meet with Heroin Education Action Team (H.E.A.T.) parents that have lost children to heroin overdose, and speak at the University of Kentucky on how the Administration is addressing the issue through prevention, enforcement, and treatment.

Also this week, the Department of Justice will issue a memorandum to Federal prosecutors to reinforce the Administration's prevention, enforcement, and treatment strategy and institutionalize best practices in combatting the epidemic. The memorandum will build on the work the Department of Justice has been undertaking around the country to address the issue.

At public events this week, the Department of Justice will be announcing funding to strengthen Prescription Drug Monitoring Programs across the country and grants to support State-level law enforcement investigations of drug manufacturing and drug distribution networks.

The Drug Enforcement Administration and the Department of Health and Human Services are releasing prevention PSAs for TV and radio. One set of PSAs was filmed in Scott County, Indiana—which experienced an HIV outbreak last year linked to injection opioid use—and will be launched there this week.

Also, as part of Awareness Week, Education Secretary John King will send letters to educators across the country on the important role that schools can play in preventing youth substance use and in supporting students who need treatment or are in recovery.

Reducing the Supply of Fentanyl:

Many of the recent overdoses and deaths in Indiana, Kentucky, Ohio, and West Virginia have been attributed to synthetic opioids like fentanyl or its analogues, which include carfentanil, being mixed into heroin. Earlier this month, the Administration announced enhanced measures in conjunction with the Chinese government to combat the supply of fentanyl and its analogues to the United States. The majority of fentanyl and its analogues brought to the United States by drug traffickers originates in China. China committed to targeting U.S.-bound exports of substances controlled in the United States, but not in China. Additionally, the U.S. and China agreed to increase the exchange of law enforcement and scientific information with a view towards coordinated actions to control substances and chemicals of concern. The Administration will continue to work with China bilaterally and multilaterally to tighten international scheduling and improve capacity to monitor and analyze illicit synthetic drugs.

Preventing Overdose Deaths with Naloxone:

Today the Food and Drug Administration (FDA) announced the 2016 Naloxone App Competition, a public contest focused on developing innovative technologies to help combat the rising epidemic of opioid overdose. The goal of this competition is to develop a low-cost, scalable, crowd-sourced mobile phone application that helps increase the likelihood that opioid users, their immediate networks, and first responders are able to identify and quickly react to an overdose. A panel of judges from the Department of Health and Human Services will evaluate submissions and the highest-scoring entrant will receive an award of $40,000. Following the competition, all eligible entrants also may apply for National Institute of Drug Abuse Small Business Innovation Research grants to further develop their concepts and to develop data to evaluate their real world impact.

DEA has now trained 1,033 employees in DEA Field Divisions on how to administer the overdose-reversal medicine naloxone. In early 2016, DEA's Training Division coordinated two Train-the-Trainer programs for 65 DEA Emergency Medical Technicians (EMTs). These 65 EMTs were then certified to conduct a four-hour class on naloxone, CPR, and Automated External Defibrillator (AED) use for employees.

Expanding Access to Treatment:

The Substance Abuse and Mental Health Services Administration (SAMHSA) at the U.S. Department of Health and Human Services published the final rule to increase the patient limit from 100 to 275 for practitioners prescribing buprenorphine in July. Since that time, 1,275 practitioners have applied for and been granted waivers to prescribe at the increased limit—improving access to buprenorphine, which is prescribed along with behavioral health services as part of medication-assisted treatment (MAT). In addition, SAMHSA plans to publish this week the final rule outlining annual reporting requirements for practitioners who increase their patient limits from 100 to 275 for prescribing buprenorphine.

This week, VA Secretary Robert McDonald, Associate Attorney General Bill Baer, and National Drug Control Policy Director Michael Botticelli will host a forum in Washington, DC, on the Administration's efforts to assist veterans suffering from opioid use disorder. Funding to support Veterans Drug Courts will be announced as part of the forum.

Medicare and Medicaid are implementing person-centered and population-based strategies to reduce the risk of opioid use disorders, overdoses, inappropriate prescribing, and drug diversion. This includes the use and distribution of naloxone and increasing access to medication-assisted treatment. The programs are also encouraging the use of evidence-based practices for acute and chronic pain management.

Improving Mental Health and Substance Use Disorder Treatment for TRICARE Beneficiaries:

In coordination with the Mental Health and Substance Use Disorder Parity Task Force established by the President, the Department of Defense issued a final rule this month to reduce barriers to mental health benefit coverage and to improve access to substance use disorder treatment for TRICARE beneficiaries, including coverage of intensive outpatient programs and treatment of opioid use disorders with medication-assisted treatment. TRICARE currently has an estimated 15,000 to 20,000 beneficiaries with opioid use disorder who previously could not access medication-assisted treatment. The changes include:

o      Eliminating prohibitions on substance use disorder (SUD) care and applying the same benefit coverage rules as other medical and surgical benefits.

o      Expanding covered SUD treatment under TRICARE, to include coverage of intensive outpatient programs (IOPs) and additional venues for Medication-Assisted Treatment (MAT) for opioid use disorder, including Office-Based Opioid Treatment and Opioid Treatment Programs.

o      Streamlining the process for SUD treatment facilities to become TRICARE authorized providers.

o      Developing TRICARE payment policies for newly recognized SUD treatments, Opioid Treatment Programs, and Office-Based Opioid Treatment.

Assisting Rural and Tribal Communities:

Today the Department of Agriculture (USDA) announced it is investing $4.7 million in Distance Learning and Telemedicine (DLT) program grants to support 18 projects in 16 States for rural communities to use communications technology to expand access to healthcare, substance use treatment, and advanced educational opportunities. These projects join 80 DLT projects announced in July. DLT grants can be used to connect rural hospitals to larger healthcare facilities through telemedicine in order to better diagnose and treat substance use disorders.

To continue the important conversations happening in rural communities devastated by the opioid crisis, leaders from USDA's Farm Service Agency and Rural Development offices in key affected States will host opioid epidemic awareness forums to bring together government officials, medical professionals, law enforcement, and other stakeholders to raise awareness of the issue, forge partnerships, identify possible solutions, and highlight the need for more treatment resources in rural communities. The series will kick off with four forums in September, with more to follow in the coming months:

•      September 19: Tolland, Connecticut

•      September 20: Brighton, Colorado

•      September 26: Grants Pass, Oregon

•      September 29: Fayetteville, North Carolina

Also today, USDA provided Red Lake Band of Chippewa a direct loan through USDA's Community Facilities program for the construction of a new, 16-bed Chemical Dependency Treatment Center. The new center will provide a safe, sanitary facility to treat men and women suffering from drug and alcohol use disorders.

Engaging Health Care Professionals:

In response to the President's call to action last year, more than 40 health care provider groups announced a commitment to ensure that more than 540,000 health care providers would complete training on appropriate opioid prescribing in two years. To date, the provider coalition reports that 280,433 providers have completed prescriber training. In addition, 11,461 physicians have completed training to prescribe buprenorphine to treat opioid use disorder as part of the coalition's effort to double the number of buprenorphine prescribers in three years. This puts the coalition on track to meet or exceed their goals.

In August, the Surgeon General sent a letter to 2.3 million American health care professionals asking them to pledge to educate themselves to treat pain safely and effectively and to screen patients for opioid use disorder and provide or connect them with evidence-based treatment (TurnTheTideRx.org). The Surgeon General's office today is announcing that more than 17,000 people have signed the pledge to date and many more are joining their colleagues each day.

Safely Disposing of Unneeded Prescription Opioids:

The Drug Enforcement Administration (DEA) will hold its 12th National Prescription Drug Take-Back Day on Saturday, October 22, providing a safe, convenient, and responsible way of disposing of unneeded prescription drugs. More than 6.4 million pounds of medication have been collected over the last eleven Take Back Days. Local communities and some pharmacies are also establishing ongoing drug take-back programs.

Additional information on recent Administration actions to address the opioid epidemic:

Aug 31, 2016: HHS Awards $53 Million to Help Address Opioid Epidemic

August 17, 2016: Obama Administration Funds New Projects to Disrupt Prescription Opioid, Fentanyl and Heroin Trafficking

August 5, 2016: White House Hosts Panel on Effective Treatment for Overdose Survivors for More Than 600 Medical Providers and First Responders

July 6, 2016: Obama Administration Takes More Actions to Address the Prescription Opioid and Heroin Epidemic

June 29, 2016: White House Releases Estimated State Opioid Treatment Funding Levels under President's Budget Proposal

April 8, 2016: White House Director of Drug Policy Joins National and Local Leaders in Announcing Medication-Assisted Treatment Trainings

March 28, 2016: Obama Administration Announces Additional Actions to Address the Prescription Opioid Abuse and Heroin Epidemic

Barack Obama, Fact Sheet: Obama Administration Announces Prescription Opioid and Heroin Epidemic Awareness Week Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/322364

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