The poppy growers of Afghanistan and the drug cartels in Mexico may have their revenge on the United States. The U.S. may be fighting terrorism in Afghanistan, and President-elect Trump might be making plans to build a wall, but both Afghanistan and Mexico have won a battle with regard to drugs and opioids.
During the second part of his administration, Bill Clinton and Colombian President Andres Arango touted the "success" of "Plan Colombia," a strategy to eradicate cocaine production. But, right under America's nose (and arms), Afghanistan continued to grow poppies for opioids. Drug cartels were only happy to provide a route so Americans could obtain it. We have not been greatly successful at routing out terrorism or poppies from Afghanistan.
Back in my day, marijuana was the exotic drug that people used, and opioids, mainly in the form of heroin, were rare in the addiction recovery world. There were simply not a lot of people who had access to opioids or street heroin. Now, because of their availability from both overprescribing and the prices on the street, many communities both "red and blue" know they have a problem.
President Obama has only two months left in office, and he is trying to show what his administration has been doing to prevent addiction from opioids and to treat addiction once it is diagnosed. This week, there was an all-out push by the Obama administration to show what it has done to combat this very ugly addiction.
The White House put out some talking points showing that the president wants to use legislation in Congress to add of money for treatment. The White House said, "The president has made clear that addressing the prescription opioid and heroin epidemic is a priority for his administration and has called for $1.1 billion in new funding for states to expand access to treatment. This week, Congress is considering legislation to act on the president's request and provide $1.1 billion in new funding to combat the opioid epidemic. The president has made clear that addressing the prescription opioid and heroin epidemic is a priority for his administration and has called for $1.1 billion in new funding for states to expand access to treatment. … The administration's balanced public health and public safety approach to drug policy is built on the scientific research demonstrating that substance use disorder is a chronic disease of the brain that can be successfully prevented and treated, and from which people can recover."
Of course, no move is without its politics. Given that President-elect Trump has made a campaign promise to get rid of President Obama's signature program, the Affordable Care Act (ACA, or better known as Obamacare), the White House is touting how the ACA is necessary to helping to end the problem of opioid addiction.
There is a debate in the addiction treatment community about the use of buprenorphine (Suboxone)Â to treat addiction. Two of my friends have different views, one a physician who prescribes buprenorphine and believes it treats opioid addiction and another a physician who runs a drug treatment center and is opposed to its use.
Although, there is no promise that the debate about prescribing buprenorphine verses an abstinence approach will go away, the government under President Obama "finalized a rule in July 2016 that allows practitioners who have had a waiver to prescribe buprenorphine for up to 100 patients for a year or more, to now obtain a waiver to treat up to 275 patients. As of October 2016, 2,400 practitioners have applied for and been granted waivers to prescribe at the increased limit."
Although, President-elect Trump has had positive contact with Philippines President Rodrigo Duterte, who has been known to execute suspected drug traffickers without a trial, that is not the way our Constitution works. There is going to have to be a way to restrain drug traffickers as well as to help doctors to prescribe in ways that cuts down on people becoming addicted to prescription opioids. To this end, the Obama administration gets credit. It issued guidelines for pain management and has reached out to medical schools, nursing schools and pharmacy colleges to make sure students obtain training in reducing patient dependency on opioids.
The Obama administration has begun the necessary work. We hope the Trump administration understands that opioid addiction is a disease. Despite that fact that Duterte is shooting suspected dealers on the streets, the United States will need to continue to develop a policy that can address this growing problem where 7.7 million Americans use illicit drugs and are most likely addicted to them.
Media wishing to interview Ellen Ratner, please contact [email protected].
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