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Trump administration calls for compassion for opioid addicts

September 20, 2018

The Trump administration on Thursday called for a “cultural shift” in how Americans talk about opioid addiction, saying too many people are still unwilling or unable to seek treatment and urging communities to adopt new strategies to combat the overdose epidemic.

Surgeon General Jerome P. Adams said companies could work to reduce work-related injuries that spur the need for addictive painkillers, and called on families to be supportive rather than judgmental in prodding relatives to get help for addictions.

He also said those with relatives struggling with addiction should carry overdose-reversing naloxone.

Dr. Adams has tried to lead by example by talking about his younger brother, who cycled in and out of prison due to opioid misuse.

“I tell my family’s story because far too many are facing the same worries for their loved ones. We all ask the same question: How can I contribute to ending the opioid crisis and helping those suffering with addiction?” Dr. Adams said. “The first step is understanding that opioid use disorder is a chronic but treatable brain disease, and not a moral failing or character flaw. Like many other chronic medical conditions, opioid use disorder is both treatable, and in many cases, preventable.”

Opioid use saw a slight drop in 2017, but fatal overdoses continued to rise, with painkillers involved in 48,000 of the 72,000 drug-overdose deaths in the U.S. last year.

Polling, though, suggests barely more than half of Americans consider the epidemic a “major concern.”

“We are still very much in the throes of the worst public health crisis of our times,” Brett P. Giroir, senior policy adviser for opioids at the Health and Human Services Department, told reporters.

HHS on Thursday defended its efforts to turn the tide, and pushed back on criticism. Health Secretary Alex M. Azar II, for example, said a recent move to reallocate up to $260 million to deal with children who entered the country illegally won’t take money away from the opioids effort.

He also said President Obama made similar agency-wide transfers when the number of children who entered the country illegally surged.

“We do not control the number of children that come into the country,” Mr. Azar said, noting opioids funding had been “walled off.”

He also said the administration’s moves on Obamacare, including allowing extended use of “short-term” health plans that are skimpier on benefits, won’t affect the addiction fight, since the people they expect to take advantage wouldn’t have been able to afford any coverage at all otherwise.

Mr. Azar said the opioids fight isn’t a “political issue,” and said both parties in Congress have rallied around legislation to expand treatment options and thwart potent synthetics from entering the country.

“Frankly, that’s a wonderful thing to see,” Mr. Azar said.

For its part, HHS said it is making two major changes to try and accelerate progress.

It will now let authorized doctors prescribe buprenorphine a common form of medication-assisted treatment for opioids misuse to people remotely through telemedicine technology.

The person receiving the medication must be supervised by a physician, though that doctor won’t need to have a waiver to prescribe buprenorphine. This way, people in underserved areas can get in touch with specialists in urban areas with more treatment options.

“This will make a tremendous impact in rural communities,” Mr. Azar said.

The National Institutes of Health, meanwhile, is offering six grants totaling over $9 million to communities that want to test new strategies for combatting opioid addiction. Officials hope the grants will slash opioids abuse by 40 percent in those communities.

“This is a very ambitious, aggressive goal, but we will accept nothing less,” Dr. Giroir said.

Capitol Hill Republicans, meanwhile, rolled out a bill Thursday that espouses Mr. Trump’s get-tough approach to kingpin traffickers.

The bill from Sen. Tom Cotton of Arkansas and Rep. Marsha Blackburn of Tennessee would require high-level fentanyl dealers to serve their full prison terms, saying they’re such a menace they don’t deserve a shot at earning early-release credits.

“Fentanyl traffickers, who killed more than 20,000 Americans last year, should not be eligible for reduced sentencing,” Mr. Cotton said.

Fentanyl, a synthetic opioid, has eclipsed prescription painkillers and heroin as the No. 1 killer in the U.S. opioid crisis. Often crafted in overseas labs, fentanyl and its analogs are being cut with the heroin supply and killing unsuspecting users.

Typically, prisoners can slice 15 percent off of their terms by earning 54 days of credit sentences for each year served. That means someone serving a 10-year term can get out in 8 1/2 years.

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