• Guest Post: Addressing Substance Abuse Requires Us All to Work Together

    This is a guest blog post from U.S. Representative Ben Ray Luján.

    Substance abuse is one of the most pressing public health concerns facing our Nation.  According to the 2010 National Survey on Drug Use and Health, an estimated 22.6 million Americans aged 12 and older had abused illegal drugs over the past month.  August 31st is International Overdose Awareness Day, a time to highlight the danger posed not only by illegal drugs but also by the abuse of prescription drugs.

    In New Mexico, our communities know the problem of substance abuse and overdose all too well.  For many years, New Mexico has been among the states with the highest rates of substance abuse.  At the national level, last year the CDC reported that drug overdose led to more than 37,000 deaths in 2009.  Of these, almost 21,000 deaths involved prescription drugs, and well over half of those involved opioid pain relievers—exceeding the number of overdose deaths involving heroin and cocaine.  While illegal drugs continue to plague our Nation, prescription drug overdose has become an epidemic.

    A strategy to address substance abuse must consist of a range of approaches that includes prevention, treatment, and law enforcement elements. Addressing substance abuse cannot be done in a top-down approach, but will instead require all of us to work together.  We cannot hope to lower substance abuse rates by working in a vacuum—we must coordinate our efforts at the Federal, state, county, and local government levels. We must work together with friends, families, communities, educators, and young people.

    One aspect of this problem that we understand particularly well in New Mexico is how drug abuse affects not only individuals but also our culture. Coming from small towns all across New Mexico, people in my district talk a lot about culture and tradition—and its importance to a strong and stable community. As I have joined the community in walks to raise awareness and held events in my district, one thing that I have consistently heard is the notion that we are losing our culture, tradition, heritage, and pride in our communities.  This is not unique to New Mexico, however, as drug abuse poses a threat to the fabric of communities across the country.

    As we mark today’s occasion and remember those who have been lost to substance abuse, we must realize that the equalizer in our fight against substance abuse is education.  Working as communities to raise awareness and spread education on the dangers of substance abuse—particularly the abuse of prescription drugs—will help to avert future tragedies.  We can also limit the availability of prescription drugs by locking medicine cabinets, properly disposing of prescription drugs, and supporting smart law enforcement efforts.  Government also has an important role to play, and now 49 out of 50 states have enacted legislation to establish prescription drug monitoring programs to prevent diversion and abuse.  By working together as part of a comprehensive strategy, we can rise to this challenge and reduce substance abuse and its often deadly consequences.

  • ONDCP Visits Detroit as Part of National Youth Initiative

    On August 8th, a team from the Domestic Policy Council, Office of National Drug Control Policy, Department of Justice, Department of Education, Department of Housing and Urban Development, and the Corporation for National and Community service visited Detroit, Michigan, as part of the National Forum on Youth Violence Prevention.

    The Forum, a White House-led initiative commissioned by President Obama in 2010, links cities and Federal agencies together to prevent youth and gang violence in the United States.

    The visit brought together city, state, and Federal officials, members of the business and philanthropic communities, law enforcement professionals, community leaders, and young people to discuss Detroit's efforts to reduce gang- and firearms-related violence.  ONDCP works closely with Federal agencies and national and local organizations to educate and empower young people to reject the negative influences surrounding them, including the influence to drink alcohol and use drugs.  Youth violence—particularly gang violence—is often linked to substance abuse and drug markets. 

    During the visit, ONDCP shared information on the agency’s youth drug prevention initiatives and the Drug Free Communities Support Program.  In the words of senior policy advisor Cynthia Caporizzo, “The Drug Free Communities Program helps to empower teens and young adults to make healthy decisions and to become leaders in their communities.  In that same spirit, this Forum brought adults and young people together to work on solutions that will make a difference for their community.”

    A Federal grant to support Detroit’s youth violence reduction efforts was announced by the Department of Justice, Office of Juvenile Justice Programs.  Detroit Mayor Dave Bing and Police Chief Ralph Godbee met with U.S. Attorney Barbara McQuade to discuss the city’s plans to sustain its efforts into the future. 

    The other cities that currently comprise the National Forum are Boston, Chicago, Memphis, Salinas, and San Jose. 

  • Director Kerlikowske Visits Missouri; Urges Adoption of Prescription Drug Monitoring Program

    In June, New Hampshire became the 49th state to enact a prescription drug monitoring program (PDMP), giving medical professionals a powerful tool for reducing the diversion and abuse of opioid painkillers and other prescription drugs.  The move left Missouri as the only state in the Nation that has not passed legislation to take advantage of this promising program.  On Wednesday, Director Kerlikowske joined Missouri State Senator Kevin Engler, Director of the Midwest High Intensity Drug Trafficking Area Program (HIDTA) David Barton, and Thomas Heard, the parent of an overdose victim, to discuss the importance of supporting efforts to monitor and track prescription drugs in Missouri and across the United States.  

    Rates of drug overdose deaths—driven primarily by prescription pain relievers—increased roughly five-fold between 1990 and 2007. The decade from 1998 to 2008 saw a more than four-fold increase in the proportion of substance abuse treatment admissions reporting any pain reliever abuse.

    These are just some of the concerns PDMPs can help address.  A PDMP is a database that helps track prescriptions and can act as an early warning system for prescribers to avoid dangerous drug interactions.  It is also a tool that can be used to intervene in the early stages of prescription drug abuse, as well as to identify pill mills and reduce doctor shopping.  PDMPs  can be used by state licensing boards as they seek to weed out prescribers with patterns of inappropriate prescribing and dispensing.

    Research supports the effectiveness of PDMPs.  A 2010 study at a Toledo, Ohio emergency department (ED), for example, found that ED physicians changed the prescriptions for 41 percent of ED patients after reviewing PDMP data.  Sixty-one percent of those patients received fewer or no opioid medications than were originally planned, and 39 percent received more opioid medication than previously planned, because the PDMP data made it clear the patients did not have a recent history of drug abuse.

    For years, ONDCP has worked with Federal, state, and non-governmental partners to encourage the development of PDMPs in every state.  We are pleased to be just one state shy of realizing this goal, and support those in Missouri working toward establishing a PDMP.

    More information about PDMPs is available from the PMP Alliance here.

  • Meeting with Congressman Steny Hoyer

    Today, Director Kerlikowske met with Congressman Steny Hoyer, House Democratic Whip, to co-host a roundtable discussion about drug policy in Maryland’s 5th congressional district. During the roundtable, which included leaders from the Maryland public health and safety systems, the Director emphasized the importance of a balanced approach to drug policy—one that emphasizes drug prevention, treatment, and recovery in conjunction with effective law enforcement.

    This roundtable also gave the Director an opportunity to discuss criminal justice reform. We know that we cannot arrest our way out of the Nation’s drug problem, and we must break the cycle of arrest, incarceration, and re-arrest when criminal behavior is driven by an underlying—and treatable—substance abuse problem.

    This Administration has an historic record of reforming the criminal justice system’s treatment of drug offenders. Here’s an overview of some of the criminal justice efforts we’re promoting:

    • Empowering communities to disrupt drug markets.Overt drug markets are major threats to the health and safety of the communities around them. They are magnets for crime, drug use, and addiction; draw local youth into the drug trade; and dramatically reduce the quality of life for area residents. One innovative, pre-arrest diversion strategy that shows promise in reducing the presence of drug markets is Drug Market Intervention (DMI). Read more about DMI here.
    • Smart probation. Started in 2004, Hawaii’s Opportunity Probation with Enforcement (HOPE) program uses drug testing and swift, certain sanctions to change a probationer’s drug using and criminal behavior. Since 2009, more than 1,500 probationers (one in every six felony probationers in Oahu) have been enrolled in HOPE. Read more here.
    • Alternatives to incarceration. Drug Courts, which combine treatment with incentives and escalating sanctions, mandatory and random drug testing, and aftercare, are a proven solution that reduces substance use, prevents crime, and maximizes limited financial resources.  Read more about Drug Courts here.

    The drug problem in Maryland and the U.S. is complex. It requires complex, evidence-based solutions. There’s no silver-bullet solution to reducing illegal drug use in this country, but we’re committed to working with our partners to implement smart, effective solutions that reduce undue burden on our already strained criminal justice system.

  • Video: Drugs in the Americas

    Watch Director Kerlikowske discuss drug policy with Stephen Johnson, Director, Americas Program, at the Center for Strategic and International Studies.

  • National Minority Mental Health Month

    ONDCP is proud to join partners in government to acknowledge July as National Minority Mental Health Month. Mental health is an important component of prevention, treatment and recovery from substance dependence, especially in minority communities. We must all work together to ensure access to mental health support services across the Nation. In honor of National Minority Mental Health Month, we’re pleased to share the Congressional Tri-Caucus’s statement on the meaning of this month. Please visit the statement here, or read it in full below.

    (Washington, DC) Today, Rep. Grace F. Napolitano, Congressional Mental Health Caucus Co-Chair, joined by the chairs of the Congressional Tri-Caucus, recognized July as National Minority Mental Health Month, to enhance public awareness about mental illness in diverse communities.

    “Mental health has long been ignored, and we must continue to de-stigmatize the issue and increase funding, elevating it as any other illness or conditions, such as diabetes, asthma, high blood pressure, and other physical illnesses,” Napolitano said. “Mental health does not discriminate: it affects all of us regardless of race, class, or gender. Mental wellness is just as important as physical wellness. We must all be part of the solution and work to invest in mental health services for those who need help.”

    Rep. Charles Gonzalez, Congressional Hispanic Caucus Chairman:“While mental illness does not discriminate, it disproportionately affects our minority communities. This month must be seen as an opportunity to not only increase awareness for mental illness, but also to promote long-term solutions that address the uniqueness of America’s minority communities.”

     Rep. Judy Chu, Congressional Asian Pacific American Caucus Chairwoman: “Mental health issues affect every community within our nation, but the effects of these disorders are especially challenging for minority communities where resource limitations and cultural stigmas make it much harder to address these problems. In the Asian American and Pacific Islander (AAPI) community, young AAPI women have the highest rates of depression and suicide ideation of any racial group, and nearly 40 percent of Southeast Asian refugees suffer from acute levels of depression and post-traumatic stress disorder. These problems are compounded by cultural and linguistic barriers to accessing mental health services, limited research on the unique mental health needs and challenges of the AAPI community, and the fact that AAPIs have the lowest rate of mental health care use among all populations.  National Minority Mental Health Awareness Month is a time to raise awareness of these critical issues, address systematic barriers to quality care, and ensure that our communities understand that saving lives is more important than saving face.”

    Rep. Emmanuel Cleaver, Congressional Black Caucus Chairman:“While the trend is getting better, far too little attention is paid to mental health and the racial and ethnic disparities that exist not only in mental health care, but in mental health status. For example, African Americans are 20% more likely than Whites to report psychological distress, yet are more than two times less likely than Whites to receive antidepressants, and a report from the Surgeon General found that the suicide rate among African Americans, aged 10 to 14 years, increased 233% from 1980 to 1995. Now that the Supreme Court has upheld the Affordable Care Act, we -- as a nation -- have never had a better opportunity to work to eliminate racial and ethnic mental health disparities, destigmatize mental health illnesses, improve our mental health screenings and diagnoses, expand access to needed mental health care services and treatments, and ensure that the mental health and wellness of every citizen in this nation is protected, preserved and improved.”  

    To honor a life-long advocate for mental health, Congress designated July as Bebe Moore Campbell National Minority Mental Health Awareness Month in 2008. Before her untimely death in 2006, Campbell was an author and co-founder of the National Alliance on Mental Illness Urban Los Angeles. The goal of National Minority Mental Health Month is to increase awareness of mental illness, prevention, treatment, and research in diverse communities.

    According to the Office of Minority Health:

    • The death rate from suicide for African American men was almost six times that for African American women, in 2008.
    • African Americans are 20% more likely to report having serious psychological distress than Non-Hispanic Whites.
    • Older Asian American women have the highest suicide rate of all women over age 65 in the United States.
    • Suicide attempts for Hispanic girls, grades 9-12, were 70% higher than for White girls in the same age group, in 2011.
    • While the overall death rate from suicide for American Indian/Alaska Natives is comparable to the White population, adolescent American Indian/Alaska Natives have death rates at twice the rate for Whites in the same age groups.
    • National Native Hawaiian/Pacific Islander mental health data is limited at this time. Data will be published as it is released in reports published by the CDC.

    National Mental Health Crisis Hotline: 1-800-273-TALK

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  • Detecting Substance Use Problems Before Addiction Develops

    Preventing the development of substance use disorders is fundamental to the Obama Administration’s approach to drug policy. If problematic substance use can be detected, interrupted, and treated before it reaches the “tipping point” to become a serious health problem, then the consequences of substance dependence can be avoided. By intervening early, we can reduce the harmful consequences of substance use.

    This common-sense approach is the principle behind Screening, Brief Intervention, and Referral to Treatment (SBIRT), an innovative program supported by grants from the Department of Health and Human Services (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA).The goal of the program is to deliver early intervention and treatment services in traditional healthcare settings to people with, or at risk of developing, substance use disorders.

    With today’s announcement of $22 million in new SAMHSA funding to expand the program, the promise of SBIRT to prevent substance use disorders moved closer to reality for many Americans. The awards went to three states – New Jersey, Arizona, and Iowa – each of which will receive up to $7.5 million for as many as 5 years to implement SBIRT.

    The SBIRT program equips primary care centers, hospital emergency rooms, trauma centers, and other community settings with the ability to intervene early with at-risk substance users before more severe consequences occur. Healthcare providers using SBIRT screen patients by asking patients about their substance use during routine medical visits. They provide medical advice and, if appropriate, refer patients who are deemed to be at risk of substance use problems to treatment. In this way, SBIRT helps identify people with underlying substance abuse problems that might otherwise go unnoticed and untreated, then puts them on the road to recovery before their drug use becomes a life-threatening or criminal justice issue.

    SBIRT exemplifies the medical, prevention-based approach to the drug problem outlined in the 2012 National Drug Control Strategy.  It’s part of our “third way” forward in drug policy—a path defined by evidence-based strategies and a public health approach to America’s drug problem.

    We can be proud of the progress we have made in reducing substance use in America. The rate of overall drug use in the United States has plunged by roughly 30 percent since 1979, with a 40 percent decline in the rate of cocaine use just within the past four years. SBIRT represents the future of this continued progress, and we look forward to working with partners in government and in the health communities to implement this innovative program.

  • A Collaborative Approach to Reduce Drug Use and Prevent HIV Transmission

    Today, Director Kerlikowske participated in a preconference hosted by the International AIDS Society to help kick off the 2012 International AIDS Conference in Washington D.C. Director Kerlikowske underscored the Obama Administration’s commitment to preventing drug use and its consequences, particularly the transmission of HIV. Injection drug use is a leading cause of HIV in the United States.

    Director Kerlikowske made clear that the Administration and ONDCP recognize and acknowledge the connection between drug use and the spread of HIV/AIDS. The National Drug Control Strategy, the federal government’s primary blueprint for drug policy in the United States, includes an action item from the Administration to help reduce drug use and the attendant spread of HIV. The Strategy explores all avenues for curbing the drug problem in America, including areas not emphasized in past drug policies: treatment, prevention, and recovery.

    The Administration’s policy recognizes drug addiction not as a moral failing but as a chronic disease of the brain, a disease that can be treated and managed. The policy encourages and applauds those who have overcome the disease of addiction, and it supports former users who are now living healthy, productive lives in recovery.

    In recent years ONDCP has worked collaboratively with the Office of National AIDS Policy and the Department of Health and Human Services to develop the National HIV/AIDS Strategy, which calls for the coupling of HIV screening with traditional substance abuse treatment programs. The Nation’s first-ever comprehensive HIV/AIDS roadmap, the Strategy urges more medical facilities to employ rapid HIV screenings and, thus, give more people the opportunity to be tested in a variety of settings.

    Working together with our partners in and out of government, we are committed to “turning the tide together” while building a healthier, safer America. For more information on this year’s International AIDS Conference, please visit the event page on AIDS.gov.

  • New Safety Measures for Opioid Medications

    Today, the Food and Drug Administration (FDA) approved a plan designed to increase the number of health care professionals who are trained on how to properly prescribe certain types of painkillersand help patients use prescribed medications safely. The Risk Evaluation and Mitigation Strategy (REMS) targets extended-release (ER) and long-acting (LA) opioid drugs, including prescription medications containing oxycodone hydrochloride.

    The new FDA plan is the latest step in a multi-agency Federal effort to address prescription drug abuse, a major public health problem in the United States. These drugs, used for treating patients with severe, persistent pain, provide needed relief for millions but also pose a serious risk of abuse, overdose, and death. Nearly 15,000 Americans died from unintended consequences of pain reliever use in 2008, according to the Center for Disease Control.

    The REMS plan will affect more than 20 companies that manufacture opioid analgesics, requiring them to make continuing education programs available for prescribers based on models developed by the FDA. These programs will help prescribers weigh the risks and benefits of opioid therapy, manage and monitor patients correctly, and counsel patients more effectively. Opioid manufacturers must also provide prescribers and patients with information regarding the safe use of these drugs and the risks involved.

    In April, 2011, as part of its comprehensive plan to address the epidemic of prescription drug abuse, the Obama Administration called for training prescribers in proper use of ER and LA opioid analgesics. The FDA continues to support this approach by including company and prescriber compliance as part of its REMS plan.

  • Working to Make Our Roadways Safer

    Thermometers across the country have made it clear that summer is upon us. In conjunction with summer holidays, we often see campaigns designed to heighten our awareness of the dangers of alcohol-impaired drivers. However, there is an equally dangerous driver: the drugged driver. These drivers crash, and those crashes may not only result in injuries, but deaths.

    According to a survey by the National Highway Traffic Safety Administration, one in eight nighttime weekend drivers test positive for illegal drugs.  More alarming – one in three drivers with known test results who were killed in accidents tested positive for an illegal drug.  Young people are also at risk.  According to another study by the National Institute on Drug Abuse, one in eight high school seniors admit to smoking marijuana before driving.

    The research is clear – driving high slows reaction time, impacts judgment, and all too often leads to deadly consequences.  So when people drive high, they don’t just pose a threat to themselves, but to others with whom they share the road.

    Our agencies are committed to reducing drugged driving. The Office of National Drug Control Policy is working with states to help them pass zero tolerance laws when it comes to drugged driving.  Already, 17 states have established per se laws, which means that any presence of an illegally used drug is a violation of the law.  We are also working with law enforcement agencies to increase the number of law enforcement officers who are trained to detect the signs of drugged driving and are properly trained to identify impaired drivers.

    But our efforts don’t end there.  Last month, the National Transportation Safety Board hosted its first-ever forum examining the substance-impaired driving problem. Over the next several months, NTSB will be reviewing the information obtained during the forum and conducting additional research to identify the best recommendations for preventing future drug-related highway crashes, injuries, and deaths.


    Americans deserve fewer risks when taking to the roads and highways; parents should not have to fear that their children will become another teenage drugged driving statistic. We at the Office of National Drug Control Policy and the National Transportation Safety Board are steadfast in our mission to reduce this threat, and we hope that Americans will join us in raising public awareness regarding this challenge.