President Obama Requests $1.1 Billion to Combat the Opioid Abuse Epidemic

Barack Obama, substance abuse, Lynn R Webster, MD President Barack Obama’s request that Congress earmark $1.1 billion to combat the U.S. opioid abuse epidemic has turned out to be controversial. That’s not surprising, since controversy infiltrates everything related to every president and every Congress. Nothing any president does is viewed by everyone as the right thing to do.

But, to me, there is no controversy here.

The request that President Obama made to Congress is wonderful news, in my estimation. I applaud the president for making it.

The country has a serious crisis with opioid addiction that must receive priority attention and funding. What the president proposes is largely focused on treatment, and we sure need better access to affordable treatment.

I have conducted many clinical trials with drugs that have been approved to treat opioid addiction. What I learned from these trials was that, although there were drugs available to treat addiction, most people with addictions could not afford the medication.

So, for them, it was as if the drugs were never developed. They were simply unreachable for most people who needed them, and they were only available to the elite — generally, to the middle and upper class folks — who needed them less often.

The other disturbing fact was that most of the heroin addicts who participated in my clinical trials were polysubstance abusers with serious mental health problems. We realized that just giving them a drug to treat heroin addiction wasn’t really meeting the needs of these people. They needed so much more than that.

The disease of opioid addiction is complex, and it requires a interdisciplinary approach. It’s not just a matter of detoxing and giving addicts a substitution drug they can take for just a few weeks. This is a long-term problem that requires a long-term, multi-faceted solution.

I also realized that it was relatively easy to enroll subjects in the trials because these people had no other options. They were poor and had no health insurance. Once the clinical trial was over, the subjects would be discharged to the street without the ability to continue to receive treatment. They would likely return to using without the substitution drug. It broke my heart to know, at that point, their fate and well-being were beyond my control.

If President Obama can help make available treatment that is affordable, or free, to those with opioid addiction, it would be wonderful.

However, the larger public health challenge is to prevent addictions and not just treat them. Being able to treat addictions with drugs, or rescue an overdose with naloxone is important, but we need to focus on prevention.

It is like using gastric bypass surgery as the only option to treat obesity. Just as it is important to prevent obesity in the first place so that you won’t have to resort to dangerous surgery to correct the problem, it is important to prevent addictions.

To do this means we need to understand what leads to addictions and treat the causes. This is hard work. It is not sexy work, but it’s necessary work. It is not something that can be captured in a sound bite. And it’s far more likely to produce better long-term public health benefits than managing addiction, or rescuing addicts from an overdose.


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