Obama Administration Initiatives to Address Prescription Drug Abuse and Heroin Use

Joy Johnson Wilson and Rachel B. Morgan RN, BSN 10/22/2015

White House Announcement

The Obama administration issued a memorandum on Oct., 21, 2015, to federal departments and agencies directing two important steps to combat the prescription drug abuse and heroin epidemic:

  • Prescriber Training: First, to help ensure that health care professionals who prescribe opioids are properly trained in opioid prescribing and to establish the federal government as a model, the presidential memorandum requires federal departments and agencies to provide training on the prescribing of these medications to federal health care professionals who prescribe controlled substances as part of their federal responsibilities.
  • Improving Access to Treatment:  Second, to improve access to treatment for prescription drug abuse and heroin use, the presidential memorandum directs federal departments and agencies that directly provide, contract to provide, reimburse for, or otherwise facilitate access to health benefits, to conduct a review to identify barriers to medication-assisted treatment for opioid use disorders and develop action plans to address these barriers. 

The White House will host a Champions of Change event this spring to highlight individuals in communities across the country who are leading the fight to respond to prescription drug abuse and heroin use.

White House Fact Sheet on Public and Private Efforts to Combat Prescription Drug Abuse and Heroin Use

Additional Federal Actions

U.S. Department of Justice 
  • The Drug Enforcement Administration (DEA) announced that it will continue its National Prescription Drug Take-Back Day program events in the spring and fall of 2016.  As the president highlighted in a recent weekly address, Take-Back Day aims to provide a safe, convenient, and responsible means of disposing of unused prescription drugs, while educating the public about the dangers of misusing medications. DEA also finalized a new rule making it easier for communities to establish ongoing drug take-back programs. Read more about the DEA’s drug disposal information.
U.S. Department of Health and Human Services (HHS)
  • The Department of Health and Human Services (HHS) will undertake a review of how pain management is evaluated by patient satisfaction surveys used by hospitals and other health care providers, including review of how the questions these surveys use to assess pain management may relate to pain management practices and opioid prescribing. HHS also launched this site as a one-stop federal resource with tools and information for families, health care providers, law enforcement, and other stakeholders on prescription drug abuse and heroin use prevention, treatment, and response.
  • The Centers for Disease Control and Prevention (CDC) will invest $8.5 million on the development of tools and resources to help inform prescribers about appropriate opioid prescribing; track data on prescribing trends; research, develop, and evaluate clinical quality improvement measures and programs on opioid prescribing; and improve public understanding of the risks and benefits of opioid use. U.S. Surgeon General Vivek Murthy is developing an education campaign for doctors, dentists and other health care professionals who prescribe opioid pain medications. Earlier this month, Murthy also announced that work has begun on the first-ever surgeon general's report on substance use, addiction and health scheduled for publication in 2016.
  • Centers for Medicare and Medicaid Services (CMS) will release an information bulletin to states by the end of the year on steps states can take through their Medicaid preferred drug lists (PDLs) and other utilization management mechanisms to reduce the risk of overdose. This includes a recommendation that they consider removing methadone from their PDLs for pain management. The Centers for Disease Control and Prevention has found that the use of methadone in pain treatment is associated with a disproportionately high number of overdose deaths compared to other opioid pain relievers. This fall, CMS is testing three new Medicare prescription drug plan measures designed to identify potential opioid overutilization, with the goal of proposing publicly reportable measures for Part D drug plans next year. These measures are based on the work of the Pharmacy Quality Alliance.
The Department of Veterans Affairs 
  • The Department of Veterans Affairs will lead a research initiative to evaluate non-opioid alternative approaches to pain management. The Department of Defense (DoD) and VA are developing a standardized pain management curriculum for widespread use in education and training programs.
The Bureau of Indian Affairs (BIA) and the Indian Health Service
  • The Bureau of Indian Affairs (BIA) and the Indian Health Service (IHS) will provide BIA police officers and investigators the overdose reversal drug naloxone and training on its use. In 2016, the BIA, through the United States Indian Police Academy, will provide training to all BIA and tribal police officer cadets in recognizing opioid use disorders and overdose symptoms.

Moving Forward

In 2010, the president released his first National Drug Control Strategy, emphasizing the need for action to address opioid use disorders and overdose, while ensuring that individuals with pain receive safe, effective treatment. The next year, the White House released its national Prescription Drug Abuse Prevention Plan to outline its goals for addressing prescription drug abuse and overdose. This year the administration, through the CDC, launched the Prescription Drug Overdose: Prevention for States Program.

Prescription Drug Overdose: Prevention for States Program

The program provided $20 million to states to support strategies to improve prescribing practices and prevent opioid overdose deaths. Through a competitive application process, CDC selected 16 states to receive funds through the program: Arizona, California, Illinois, Kentucky, Nebraska, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Tennessee, Utah, Vermont and Wisconsin.

Map of the CDC Prevention for States ProgramOver the next four years, CDC plans to give states annual awards between $750,000 and $1 million each year, subject to the availability of funds, to advance prevention, including in these areas:

  1. Enhancing prescription drug monitoring programs (PDMPs).
  2. Putting prevention into action in communities nationwide and encouraging education of providers and patients about the risk of prescription drug overdose.
  3. Working with health systems, insurers, and professional providers to help them make informed decisions about prescribing pain medication.
  4. Responding to new and emerging drug overdose issues through innovative projects, including developing new surveillance systems or communications campaigns.

States can also use the funding to better understand and respond to the increase in heroin overdose deaths and investigate the connection between prescription opioid abuse and heroin use. The president's budget for 2016 includes a request from HHS Secretary Sylvia Mathews Burwell for the resources needed to expand CDC’s state efforts to all 50 states and launch a national program that will focus on prevention and prescription drug overdose surveillance.

Additional Resources