In conjunction with his trip to Charleston, President Barack Obama will announce new steps to help stem the flow of prescription painkillers and ease the path to treatment for people fighting opioid addiction.
Obama will issue a memorandum this morning to federal departments and agencies with two directives:
n The president will require federal agencies to provide training to doctors and nurses who work for the federal government on how to properly prescribe opioid medications, like oxycodone.
n Federal agencies that provide health insurance will have to review their health plans to see if there are barriers or restrictions that prevent patients from accessing medication-assisted treatments for opioid abuse, like Suboxone. If there are restrictions preventing people from getting those treatments, agencies will have to address those.
The directives apply only to federal agencies — not private doctors or insurance plans — but the White House wants to set an example for private providers.
“These are two effective strategies,” Michael Botticelli, the White House’s director of National Drug Control Policy, said in a phone interview. “We want to ensure that the federal government is doing all it can to minimize the magnitude of the epidemic, but also kind of model what we think are good practices.”
Botticelli will moderate the discussion in Charleston, which, in addition to the president, will feature U.S. Health and Human Services Secretary Sylvia Mathews Burwell (a native of Hinton) and about 150 invited guests who work with or have been affected by substance abuse.
Today, Obama also will announce commitments from more than 40 health care groups — including the American Medical Association and the American Nurses Association — to help make treatment more available and to train more doctors in properly prescribing opioids. There also are new agreements with media companies, including CBS, ABC and Google, to provide millions of dollars in free ad space for public service announcements about prescription drug abuse.
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West Virginia is one of only 10 states that already require additional training for doctors and nurses who prescribe opioid painkillers.
“Many of the issues that we see around prescription drug misuse, and subsequent heroin use, stem from the over-prescribing of prescription pain medication,” said Botticelli, who has been in recovery from substance abuse issues himself for 26 years. “We believe that this is a model for other prescribers.”
The 40 health care organizations have committed to providing training in opioid prescribing for 540,000 doctors and nurses nationwide in the next two years.
They also have agreed to double the number of providers that can prescribe naloxone, a drug that can reverse the effects of opioid overdoses. CVS and Rite Aid also have committed to increasing the availability of naloxone. The national Fraternal Order of Police will give its 300,000 members cards to instruct them on how to respond to overdoses.
The groups have committed to doubling the number of doctors, over the next three years, certified to prescribe buprenorphine products — like Suboxone and Subutex — that are used to treat opioid abuse.
There are about 30,000 doctors nationwide, and about 190 doctors in West Virginia, who have the special federal certification necessary to prescribe buprenorphine, or “bupe.” Each one of those doctors is limited in how many patients he or she may prescribe buprenorphine to, either 30 patients or 100, depending on the experience of the doctor.
“No other disease, no other specialty and no other medication are limited in this manner,” the American Society of Addiction Medicine wrote last year, objecting to the longstanding restrictions.
Burwell announced last month that the federal government would be revising those regulations to increase access to buprenorphine treatment.
The president’s new memorandum and the announcement last month are “two separate pieces of the same puzzle” to increase access to medically assisted opioid treatment, Botticelli said.
“One is, you need a benefit plan that pays for it; second, you need someone to do it,” he said. “We know we have too few physicians who are trained to administer these medications.”
The Affordable Care Act designated substance-abuse treatment as an “essential health benefit” that insurance plans are required to cover. However, just because insurance has to cover it doesn’t mean there are enough facilities to offer it.
The dearth of available treatment is particularly acute in West Virginia, with those suffering from addiction often having to go out of state for help.
Dr. Carl “Rolly” Sullivan runs the Addiction Program at West Virginia University Hospitals, where the average patient is in nonresidential treatment — a combination of buprenorphine and counseling — for 33 months.
“If you’ve got a gall bladder attack or you’ve got heart disease, you’ll be seen within a week or two, at most,” Sullivan said. “If you have opioid addiction it’s going to be months, if ever. The need for treatment providers in West Virginia completely and spectacularly outstrips our ability to provide treatment.”
Among the attendees at this afternoon’s event on the East End will be Gov. Earl Ray Tomblin and U.S. Sens. Joe Manchin and Shelley Moore Capito.
Rep. Alex Mooney, who represents Charleston, declined an invitation because the House is in session.
“President Obama’s trip to Charleston to discuss the ongoing drug epidemic in West Virginia goes beyond party lines,” Mooney said in a prepared statement. “Hopefully this meeting will help our local, state and national officials’ efforts to coordinate ways to fight back against the drug epidemic.”
Mingo County native Carrie Dean will be at the discussion with Obama today. Her father died, within the past year, from issues related to substance abuse. Dean, 25, is a doctoral student in clinical psychology at Marshall University.
“Rural and Southern West Virginia are really lacking in mental health resources,” Dean said. “I’m hoping this visit brings awareness to the people outside of West Virginia that this is such a serious problem in our state.”
Lori McComas Chaffins runs the West Virginia Nurses Association and will be at the Obama event. Chaffins has been sober for nearly six years — since Jan. 3, 2010 — but has struggled with addiction in the past.
She was homeless. She lost custody of her four children for a stretch.
“I essentially destroyed every single relationship in my life,” she said.
She said she’d like to see an increased national awareness of the epidemic, but she also wants to see more than just dialogue. She wants to see increased federal funding for drug treatment.
“There is hope, it’s just at this point we need some help,” Chaffins said. “People do recover and they can recover . . . if they have the resources available to them.”
Because of the president’s visit, police have asked people not to park their vehicles on several East End streets near the Roosevelt Center, where Obama is speaking, between 9 a.m. and at least 5 p.m. Those include the 400 and 500 blocks of Ruffner Avenue, the 1400 and 1500 blocks of Jackson and Lewis streets and Chamberlain Court. Those streets will be closed before the president’s arrival and until after his departure, according to a letter from the Charleston Police Department.
Reach David Gutman at david.gutman@wvgazettemail.com, 304-348-5119 or follow @davidlgutman on Twitter.