ATLANTA — During an emotional and often intensely personal panel discussion, President Obama listened Tuesday as a 35-year-old mother of two described her descent from prescription drugs into heroin addiction.
“It slowly happened,” said Crystal Oertle of Ohio as she sat beside the president. “It is crazy to think of the things I did, but it was necessary for me to function.… I’ve had to steal. I have stolen from department stores to feed my habit. I have been involved in drug busts a couple of times.” She has now marked a year of recovery.
A Baltimore doctor described her feeling of helplessness as she watched one patient spiral downward and overdose because no treatment options were immediately available. And a 28-year-old father described how he had been in and out of recovery seven times.
The president came to Atlanta to participate in the National Rx Drug Abuse and Heroin Summit at a time when Americans are overdosing from prescription opioids and heroin in record numbers. Obama has made the nation’s heroin and prescription drug epidemic a priority in his second term, and the scourge has been one of the few areas in which the White House has been able to draw bipartisan support from Congress.
Obama spoke of the problem of drug addiction in unusually personal terms. He made reference to his own drug use as a young man, which he described in a memoir before he became a politician. “When I was a kid I was — how would I put it? — not always as responsible as I am today, and in many ways I was lucky because for whatever reason addiction didn’t get its claws in me,” he said.
A few minutes later, he repeated himself: “I was lucky, and I don’t know why,” Obama said.
Even as he promised to fight the drug cartels, Obama was insistent that addiction was a medical problem that requires more help from the government. “This is a straightforward proposition of how do we save lives,” he said. “It doesn’t do us good to talk recovery after people are dead.”
He has proposed $1.1 billion in new funding to battle heroin addiction — more than double last year’s budget — with the vast majority of that money going to expand access to medications designed to help addicts struggling with severe withdrawal. Drugs like buprenorphine combined with therapy have proven to be the most effective treatment for addicts, but major shortages of physicians trained to administer it make progress difficult, especially in rural areas, Obama said. Today as many as 1 million Americans need treatment for opioid addiction but are unable to get it.
That issue is one of the few for which Obama has been able to muster support, if not funding, from Republican lawmakers. Obama was introduced Tuesday by Republican Rep. Harold Rogers, who played a key role in the summit and whose district in eastern Kentucky coal country has been ravaged by drugs.
The president used his appearance to make the case for a big budget increase to expand treatment for addiction, particularly in rural communities, where he traditionally has not won much support.
“The $1.1 billion is not allocated by Congress,” Obama said of his budget request. “I want to be very clear about that. This is still an area that is grossly under-resourced.”
The White House on Tuesday announced modest measures that don’t require congressional backing and are designed to make treatment more available to those suffering addiction. To address the physician shortfall, the Department of Health and Human Services said it would double the patient limit for doctors prescribing buprenorphine to 200.
“This change has taken far too long,” said Sen. Rob Portman (R-Ohio), who has called for expanding that cap to 500 patients.
The White House also plans to spend $94 million to help 271 community health centers increase their services to addicts, a move that could open up treatment to as many as 124,000 new patients. It also would direct $11 million to help states purchase and distribute naloxone, which is injected to block or reverse an overdose.
The panelists' stories are "heartbreaking,” Obama said. “And the fact is that for too long we have viewed the problem of drug addiction in our society through the lens of law enforcement.”
In today’s global economy, Obama emphasized that the most effective counter-drug policy is one that prioritizes reducing the demand for drugs at home. “The only way we reduce demand is if we are providing treatment and thinking of this as a public health problem and not just a criminal problem,” he said.
Public health officials have said the current heroin epidemic was triggered by a spike in prescriptions for short-acting opioid pain medications starting a decade ago. “We arrived here on a path that was paved with good intentions,” U.S. Surgeon General Vivek H. Murthy said at the summit. But "the results have been devastating. We have nearly 250 million prescriptions for opioids written every year. That’s enough for every person in America to have a bottle of pills and then some.”
The Food and Drug Administration recently said it would begin requiring new warnings about the risk of addiction for these medications, which are often prescribed after surgery, and the Centers for Disease Control and Prevention has called for a “culture shift for patients and doctors” away from the highly addictive painkillers. Only this month did the CDC issue its first national recommendations on prescription opioids, urging doctors to use more caution and consider alternatives before they prescribe the highly addictive narcotic painkillers.
Obama insisted that real solutions would require more money, as well as a change of approach in communities across the country.
“Today we are seeing more people killed because of opioid overdose than traffic accidents,” he said. “This is not something that is restricted to a small set of communities. This is affecting everybody.”