More than 2 million Americans are plagued with opioid addiction. When those afflicted make a decision to turn their lives around, U.S. Secretary of Agriculture Tom Vilsack wants to make sure that help is available. Nicole Erwin spoke with the Secretary on the lack of support in rural communities.
For those wondering, what does the U.S. Department of Ag have to do with combating opioid addiction; Secretary Vilsack, you were recently appointed by President Obama to lead an interagency initiative to combat substance abuse. My understanding is this issue runs deep for you, would you mind expressing what growing up in a home with a parent who suffers from an addiction is like and how substance abuse is not just a personal issue, but in fact something that does involve a community? |
Well, that's a really important question and probably everyone has a slightly different story to tell but in my case, my mom when I was in grade school struggled mightily with prescription drug addiction and alcoholism. She would separate herself from our family for extended periods of time in a drunken stupor she at times she became violent. It was a scary proposition for a little fellow like myself to deal with a parent like that. And she unfortunately and tragically attempted suicide a couple of times, once in my presence. So it stays with you, those memories. Now fortunately for me, my mom was a courageous and gutsy woman who basically decided she needed to go in a different direction and fortunately for her there was a community of support. There was a facility a long term treatment facility that she went to that provided her with a good start. There was a community of support with frequent AA meetings with mentors and sponsors who had gone through the same challenges that she faced that would get her through the tough periods. There was a support of family, my mother and father separated for a period of time but they got back together and she spent the last 14 years of her life sober and provided an incredible example to me of courage and faith and tenacity.
Not every story has that kind of ending and that's one of the reasons I am involved in this is because there are far too many families in America today, particularly in rural areas and they are having a tough time. They are either having a tough time acknowledging that they've got a problem because of living in a small town and having a value system that rewards self reliance and independence and toughness and toughen things out. Or they maybe at a point where they need help and they have searched for help but a shortage of facilities and professionals they can't get the help they need when they need it. They may even get the immediate help they need but then look around for that long term support system that community support that my mom had and have a hard time finding frequent AA meetings or convenient AA meetings and they can lapse. So our challenge I think is to make sure that rural folks have the same opportunities for recovery that folks in the cities have. The President has asked me to really focus on this and make sure we are using all the tools of the federal government in creative ways to make a difference.
Years ago, we were having this same conversation about Meth. There was a huge effort in combating it, and the effort worked in some ways in that we hear about less meth cases, but now we are hearing about heroin and opioid addiction. What is going on? Is it a replacement? Why are we seeing such high rates now?
Well we've seen since 1999 a 300 percent increase in the number prescription opioids, and we are seeing more than 2 million Americans who are basically abusing opioids, they are using them for purposes for which they weren't intended. It's a complicated problem, the methamphetamine problem was also complicated but easier to deal with because you could essentially make it much more difficult to make meth by moving pseudo ephedrine from in front of the counter to behind the counter in terms of pharmacy and that really made a big difference in the ability to produce methamphetamine. I think this is a comprehensive problem that we face with opioids.
- We have to focus on prevention which means we have to do a better job training our docs and our dentists to be able to use opioids when it is appropriate and in the amount that is appropriate for the circumstance so not to over-prescribe.
- We have to have monitoring systems that allow pharmacists and physicians to know if someone is doctor shopping so we can get those people help, immediately.
- We have to have access to reversal drugs when there is an overdose situation to avoid the tragedy of death. There are ways in which we can prevent death but we have to have our first responders equipped to provide naloxone and narcan to be able to reverse an overdose.
- We have to have treatment facilities and that is why the President has focused on increasing the resources committed to treatment. Congress right now is considering a lot of bills to authorize programs, much of which is already taking place. Authorizing a program is just simply giving permission to set something up, if you don't have the resource to set it up, it's meaningless and that's why the President's budget in providing additional resources is so critically important to this process.
Recently, the House passed H.R. 4641, H.R. 5046, and related bills, what do these bills do to address substance abuse and what more could they do?
Well they basically authorize an expansion of existing programs they basically reaffirm the work that is already being done in prevention and treatment and support. The problem is they just simply give permission to do more, they don't give the resources to do more. That's why the budget becomes so important. The critical component here is not authorizing legislation it is in fact the resources to expand treatment facilities in remote areas. It is in fact the resources to expand treatment facilities in remote areas. It is in fact resources to expand telemedicine opportunities in very remote areas. It is the resources to make sure that every first responder has naloxone and narcan available if they are confronted with an overdose circumstance. It is the resources to be able to expand drug courts so that you don't incarcerate the problem but that you basically treat it as the mental illness and substance abuse challenges they present.
So the bills are great they certainly sound good, they certainly allow folks who are in congress to say they are doing something, but in order for them to do something that really matters they have to address the fiscal part of this and if they don't we are going to continue to do what we can but we wont be able to do as much as we ought to be doing.
The President’s Fiscal Year 17 budget includes $1 billion in new mandatory funding over two years to expand access to treatment for prescription drug abuse and heroin use. Kentucky's Attorney General Andy Beshear announced yesterday that he would be allocating $700,000 dollars to Recovery Kentucky, a substance abuse center selected by the state for their 'proven track record in putting men and women afflicted with addiction on the road to recovery. In the centers online program description, step two states:
"They become aware of the self-centered disease problem and the spiritual solution."
Kentucky is a part of the bible belt, there are churches at every corner at some four way stops, so a spiritual solution makes sense for some, but what about those seeking help that don't believe in a higher power?
Even if you do believe in a higher power, and my mom’s circumstance, going back to my personal circumstance, there was a religious component to this and it was an important aspect to her recovery, but without the treatment facility that she went to for 30 to 60 days, without the repeated AA meetings that she went to, without the sponsors, without the supportive family, it would have been a much more difficult road to hoe and I'm not sure she would have been able to turn her life around.Whether you believe or you don't believe, once you reach that point in life where you have a decision to make whether you are going to continue with the addiction or whether you are going to seek help, it is really important that once you decide to seek help that the help is there. And help cant be there if you live in rural remote area and there are not treatment facilities or telemedicine option to be able to visit with a professional to get services, there is no help if you are the unfortunate consumer of heroin laced with fentanyl and you are confronted with an overdose circumstance and your first responders aren't equipped to deal with that situation. So that's why its important, incredibly important that we look at additional funding. The President has proposed mandatory funding so we don't have to go through this process every year to justify the resources.
We have 2 million Americans who are addicted. We have 84 Americans every single day dying from heroin and opioid abuse. This is a problem that impacts and affects an incredibly number of families in this country. There is hardly anyone that doesn't know someone close to them that hasn't been touched by this and so its just incredibly important. I think the spiritual piece is incredibly important for many people but that alone may not be enough for many people. So you are going to have to have treatment facilities, professionals trained to provide medications to assist treatment, you are going to have to have better trained physicians and nurses and expansion of treatment and services in rural areas, that's what this is all about.
That's all we have time for today, there is certainly much more to discuss and we thank you for your time here. Is there anything else you would like to add?
I just want folks to know that we are focused on this and particularly focused on making sure that regardless of what your zip code might be or where you might be located if you are someone who is dealing with an addiction or you have a loved one dealing with an addiction and you are searching for help, we want to make sure that we are there to provide the help when it is needed and we think we can save lives and we can turn this process around significantly.
