The Senate just voted 92-2 to pass a piece of legislation, one already passed by the House 407-5. Can you remember the last time you saw a vote tally like that in Congress?
The President will now sign the Comprehensive Addiction and Recovery Act (CARA), a new law intended to stem the tide of drug misuse and abuse in this country. Given the ubiquitous and devastating nature of the epidemic, it's no wonder the vote was such a slam dunk. Better three hours too late than a minute too soon, I suppose, but this Congress after all.
And yet, this bill nearly died an ignominious death before reaching the President's desk. Even though we all agree that something must be done (and our representatives in Congress see it the same way, at least in principle), there remained the issue of how to pay for it. Obama asked for $1 billion. Lots of numbers were tossed around with respect to appropriations... $500 million... $300 million... $600 million. This surprised even those who watch the sausage making process as a full time profession (from thehill.com: "But the fight over funding threatened to doom the bill, surprising longtime policy watchers who expected the legislation to coast through both chambers as the country faces an epidemic of opioid overdose deaths.")
The final bill allows for $180 million per year for the programs it creates. The Department of Health and Human Services will dole out grants to treatment programs, law-enforcement assisted diversion, prisons, educational programs, and increase the number of patients able to receive medication assisted treatment (MAT).
So how far can we stretch $180 million? What can we expect the public health impact to be? Let's do some simple math.
If we just take the 16 million people in the US who suffer from some form of substance use disorder... that leaves us with about $11 per person per year.
If we just look at the most vulnerable subset of the substance use disorder population, those with concomitant mental health disorders - of which there are 8 million in the US - we're left with about $22 per person per year.
If we take the number of counties (the public health departments of which often compete for and implement these grants), of which there are about 3,000, we get $60,000 per county per year, probably enough to hire a single new public health worker to help those struggling with addiction.
And if we take the population of chronic, non-cancer pain patients in the US, a group at high risk for opioid dependence and addiction - of which there are approximately 38 million - well, that's a little less than $5 per person per year.
Think the math is unfair? Think my analysis isn't framed correctly? I'd love to see an alternative approach that shows this investment can and will make a difference. From my perspective, it's woefully insufficient.
But it's a start... which is why President Obama is going to sign it.
Michael
On Twitter @PRIUM1
Showing posts with label Obama. Show all posts
Showing posts with label Obama. Show all posts
Thursday, July 14, 2016
Tuesday, March 29, 2016
President Obama at the National Rx Drug and Heroin Abuse Summit
Imagine getting the chance to hear the President speak in person.
Now imagine he comes to your home town to offer some thoughts on a given topic.
Finally, imagine the topic of his remarks is the very center of your professional life and something you eat, sleep, and breathe every day.
That was my day today.
As my legendary 12th grade English teacher Ross Friedman would say: today was a 9.9 on the groovy scale (note: there are no 10s... so this was clearly a really great day).
President Obama came to Atlanta today to talk about prescription drug and heroin abuse. Rather than give a speech from a prepared text, he sat on a panel moderated by CNN's Dr. Sanjay Gupta along with two recovering addicts and an emergency room doctor who also serves as Baltimore City's Health Commissioner, Dr. Leana Wen (who, by the way, proved to be an incredible advocate for changing the way we view chronic pain and addiction... she issued a standing order in Baltimore so that any citizen in the city can secure a Naloxone prescription - an overdose antidote - under her name. Just walk into any pharmacy in Baltimore and pick it up. Beat that with a stick).
This format enabled President Obama to speak extemporaneously and candidly on a range of topics under the umbrella of prescription drug and heroin abuse. He talked about the Affordable Care Act, mental and behavioral health, criminal justice reform, patient and physician education, addiction prevention, treatment, and recovery. While I'm not supposed to betray my personal politics on the blog (at least according to my PR advisers), most people who know me know that I'm a fan of the president. Despite my admitted admiration for Obama, I expected today to be filled with presidential sounding platitudes like "we need more addiction treatment in this country" and other relatively obvious and safe statements. And he said most of the things I expected him to say along those lines.
But he said more than that. My impression is that President Obama understands both the policy nuance and personal tragedy of this issue at a level I honestly didn't expect. This is a guy fighting multiple battles against an array of terrorist organizations, he's steeped in a Supreme Court nomination fight, he's trying to figure out how and where to weigh in on the circus that has become the 2016 presidential election, and he's dealing with a hundred other issues on a daily basis. But he came to Atlanta today to talk about prescription drug and heroin abuse. And amidst all of the other issues on his desk, it's evident that he gets this. And it shows.
When asked by Sanjay Gupta what brought him to Atlanta this afternoon, President Obama offered this: "When I show up, the cameras usually do, too." He wasn't being arrogant. He was suggesting that his mere presence, regardless of what he said, helps bring needed attention to this critical issue. He was saying that he consciously chose to use the power of his office to shine a light on prescription drug and heroin abuse. And he's right - there certainly were a lot of cameras there today.
He said "we need to think about this [drug abuse issue] as a public health problem, not a criminal justice problem." Many of us close to this issue agree with that statement, but when the President of the United States says it out loud, it reshapes the broader public dialogue and helps further the aims of those of us who have been thinking that way for years. Such a public statement will help reshuffle the priorities of agencies like the FBI, DEA, ATF, CDC, and NIH.
He said he was "shocked to learn how little education medical residents receive in pain management." And as a result, 60 medical schools announced today their intention to significantly enhance pain management training in medical school residency programs. The bully pulpit is real.
Finally, he said "we medicate... self-medicate... a lot of problems in this country." I was floored when he said that. We know that's true, he knows that's true, but for the president to say it out loud is to acknowledge the fundamental need for cultural change necessary to truly stem the tide of prescription drug and heroin abuse. Perhaps the most deeply rooted of all the root cause issues behind prescription drug abuse is the notion that Americans expect to be pain free, stress free, anxiety free. Opioids aren't ragingly popular simply because they help manage pain. Opioids also have psychoactive attributes that make the slings and arrows of our difficult and complicated lives seem easier to handle. And President Obama said it. And that matters.
Today was a great day for me, personally and professionally. I think today might also turn out to be a great day in the broader fight against prescription drug misuse and abuse. And that's a great day for all of us.
Michael
On Twitter @PRIUM1
Now imagine he comes to your home town to offer some thoughts on a given topic.
Finally, imagine the topic of his remarks is the very center of your professional life and something you eat, sleep, and breathe every day.
That was my day today.
As my legendary 12th grade English teacher Ross Friedman would say: today was a 9.9 on the groovy scale (note: there are no 10s... so this was clearly a really great day).
President Obama came to Atlanta today to talk about prescription drug and heroin abuse. Rather than give a speech from a prepared text, he sat on a panel moderated by CNN's Dr. Sanjay Gupta along with two recovering addicts and an emergency room doctor who also serves as Baltimore City's Health Commissioner, Dr. Leana Wen (who, by the way, proved to be an incredible advocate for changing the way we view chronic pain and addiction... she issued a standing order in Baltimore so that any citizen in the city can secure a Naloxone prescription - an overdose antidote - under her name. Just walk into any pharmacy in Baltimore and pick it up. Beat that with a stick).
This format enabled President Obama to speak extemporaneously and candidly on a range of topics under the umbrella of prescription drug and heroin abuse. He talked about the Affordable Care Act, mental and behavioral health, criminal justice reform, patient and physician education, addiction prevention, treatment, and recovery. While I'm not supposed to betray my personal politics on the blog (at least according to my PR advisers), most people who know me know that I'm a fan of the president. Despite my admitted admiration for Obama, I expected today to be filled with presidential sounding platitudes like "we need more addiction treatment in this country" and other relatively obvious and safe statements. And he said most of the things I expected him to say along those lines.
But he said more than that. My impression is that President Obama understands both the policy nuance and personal tragedy of this issue at a level I honestly didn't expect. This is a guy fighting multiple battles against an array of terrorist organizations, he's steeped in a Supreme Court nomination fight, he's trying to figure out how and where to weigh in on the circus that has become the 2016 presidential election, and he's dealing with a hundred other issues on a daily basis. But he came to Atlanta today to talk about prescription drug and heroin abuse. And amidst all of the other issues on his desk, it's evident that he gets this. And it shows.
When asked by Sanjay Gupta what brought him to Atlanta this afternoon, President Obama offered this: "When I show up, the cameras usually do, too." He wasn't being arrogant. He was suggesting that his mere presence, regardless of what he said, helps bring needed attention to this critical issue. He was saying that he consciously chose to use the power of his office to shine a light on prescription drug and heroin abuse. And he's right - there certainly were a lot of cameras there today.
He said "we need to think about this [drug abuse issue] as a public health problem, not a criminal justice problem." Many of us close to this issue agree with that statement, but when the President of the United States says it out loud, it reshapes the broader public dialogue and helps further the aims of those of us who have been thinking that way for years. Such a public statement will help reshuffle the priorities of agencies like the FBI, DEA, ATF, CDC, and NIH.
He said he was "shocked to learn how little education medical residents receive in pain management." And as a result, 60 medical schools announced today their intention to significantly enhance pain management training in medical school residency programs. The bully pulpit is real.
Finally, he said "we medicate... self-medicate... a lot of problems in this country." I was floored when he said that. We know that's true, he knows that's true, but for the president to say it out loud is to acknowledge the fundamental need for cultural change necessary to truly stem the tide of prescription drug and heroin abuse. Perhaps the most deeply rooted of all the root cause issues behind prescription drug abuse is the notion that Americans expect to be pain free, stress free, anxiety free. Opioids aren't ragingly popular simply because they help manage pain. Opioids also have psychoactive attributes that make the slings and arrows of our difficult and complicated lives seem easier to handle. And President Obama said it. And that matters.
Today was a great day for me, personally and professionally. I think today might also turn out to be a great day in the broader fight against prescription drug misuse and abuse. And that's a great day for all of us.
Michael
On Twitter @PRIUM1
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