Vilsack: Opioid epidemic has hit rural areas like N.H. especially hard

For the Monitor
Published: 5/10/2016 8:43:05 AM

In New Hampshire and across the country, opioid addiction is a fast-growing problem that disproportionately affects rural communities. Chances are, readers of this column have been directly affected by a loved one’s addiction, or know someone who has.

In fact, a new poll released this week by the Kaiser Family Foundation found that an astonishing 44 percent of Americans say they personally know someone who has been addicted to prescription pain killers. And new data from the Centers for Disease Control and Prevention shows opioids were involved in 28,648 deaths in 2014, meaning more Americans are dying from drug overdoses than in motor vehicle accidents each year.

A predominately rural state, New Hampshire has fared worse than most areas, with the third-highest drug-related death rate in the country. Tragically, 399 people in New Hampshire died of opioid overdoes last year. Already in 2016, another 66 lives have been cut short.

This is a health epidemic, and it is going to take serious action from all levels of government, the health community, law enforcement, and other stakeholders, to turn those numbers around.

In January, President Obama asked me to lead an interagency effort focused on heroin and prescription opioids in rural America, a role I was humbled to accept. This issue is very personal to me. Growing up with a mother who struggled with alcohol and prescription drug addiction for much of my childhood, it wasn’t until I saw her recover with treatment that I saw addiction for what it is: a disease, not a character flaw. This disease isn’t a personal choice, and it can’t be cured by willpower alone. It requires responses from whole communities, access to medical treatment, and an incredible amount of support.

The president’s fiscal year 2017 budget makes two requests of Congress to help reverse this problem.

First, the budget proposes $1.1 billion in funding to ensure treatment for opioid use disorder is available to everyone who seeks it. The bulk of the funding – more than $900 million – would help states expand access to medication-assisted treatment for opioid use disorders. States would receive funds based on the severity of the epidemic and on the strength of their strategy to respond to it. States, like New Hampshire, can use these funds to expand treatment capacity and make services more affordable.

Second, the president’s budget includes approximately $500 million – an increase of more than $90 million over existing levels – to continue and build on current efforts across the Departments of Justice and Health and Human Services to expand state-level prescription drug overdose prevention strategies, increase the availability of medication-assisted treatment programs and overdose-reversal drug naloxone, and support targeted enforcement activities. A portion of this funding is directed specifically to hard-hit rural areas.

Congress needs to approve these resources so we can put them to use fast. We can’t afford another year of increasing opioid abuse and fatalities.

In the meantime, as part of the interagency effort, Secretary of Health and Human Services Sylvia Burwell, Director of National Drug Control Policy Michael Botticelli, and I are directing our federal teams to put existing programs towards this effort. For example, USDA has invested heavily in telehealth, which allows doctors to provide expert advice in hard to reach areas that lack extensive medical personnel. Yesterday in Lebanon, I visited the Dartmouth-Hitchcock Center for Telehealth, a facility that has received $1 million in USDA grants to connect to rural hospitals and doctor’s offices and help bring opioid addiction treatment to the most rural corners of the state.

The Obama Administration has been promoting strategies including evidence-based prevention programs, prescription drug monitoring, and access to medication-assisted treatment and the overdose reversal drug naloxone. Under the Affordable Care Act, mental health and substance use disorder services are essential health benefits that are required to be covered by health plans, and insurers are required to treat them the same as they treat medical and surgical benefits. And in March, CDC issued the new CDC Guideline for Prescribing Opioids for Chronic Pain to help health care professionals provide safer and more effective care for patients dealing with chronic pain.

While these efforts can take us in the right direction, it is up to Congress to put real muscle behind this fight. By making real investments, expanding strategies that we know work, and mobilizing partnerships at every level across the country, we can turn the tide of this epidemic and save lives.

(Tom Vilsack is the U.S. secretary of agriculture and chairman of the White House Rural Council.)

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