ONDCP Blog

  • FDA Takes Action on Prescription Drug Abuse

     

    Yesterday, the Food and Drug Administration (FDA) took an important step in addressing America’s prescription drug abuse epidemic.

    The FDA announced that it approved updated labeling for reformulated Oxycontin that describe the drug’s abuse-deterrent properties, the first time such a claim has been approved by the agency. FDA also said it will not accept or approve generics of the original OxyContin formulation, which lacks these properties.”

    For over a century, the FDA has applied the principles of science, evidence, and common sense to protect public health and safety in America. Yesterday’s action demonstrates yet again that when it comes to our Nation’s prescription drug abuse epidemic, there are significant and important steps we can take to save lives and protect public health.

    This announcement builds upon already unprecedented actions by the Administration to drive down the number of Americans affected by prescription drug abuse. Director Kerlikowske and ONDCP commend the FDA for its work to keep non abuse-deterrent formulations of this drug from reaching the marketplace while continuing to ensure access to powerful opioid analgesic drugs that – when properly used and prescribed –provide relief to those suffering from acute and serious illnesses.

    The Centers for Disease Control and Prevention has classified prescription drug overdoses as an epidemic. National data show that by 2010, drug overdose deaths were the second leading cause of injury death in America. Additionally, the overall drug overdose death rate in the United States roughly tripled between 1991 and 2011, and in 2007 about 100 people per day died from drug overdoses in the U.S.

    To address the threat of prescription drug abuse and diversion while also protecting legitimate access to these drugs for those suffering from pain, the Administration released Epidemic: Responding to America's Prescription Drug Abuse Crisis in 2011.  This action plan provides a national framework for reducing prescription drug diversion and abuse by supporting education for patients and healthcare providers, recommending more convenient and environmentally responsible disposal methods to remove unused medications from the home, supporting the expansion of state-based prescription drug monitoring programs, and reducing the prevalence of pill mills and doctor shopping through enforcement efforts.

  • Guest Post: Michael Banyard’s Story, Part 3

     

    In June 2012, National Drug Control Policy Director Gil Kerlikowske visited the Betty Ford Center, one of the Nation’s oldest and most recognized addiction treatment facilities. There he gave remarks to a crowd of leaders in the field of recovery. In the audience were two special guests—Michael Banyard and Federal District Court Judge Spencer Letts. In his remarks, Director Kerlikowske mentioned Banyard’s improbable—and inspirational—journey from crack cocaine dependence and homelessness, to prison, to a successful sentence appeal, to the chambers of a federal district court judge and completion of his GED.                     

    Read Part 1and Part 2 of Michael Banyard’s story.

    I was very successful and rose to the occasion. Things went so well that Kurt Streeter of the L.A. Times wrote a front page, two-part article that covered the judge’s and my friendship and the work we were doing with the youth at S.E.A. High School. 

    It was clear that, like Judge Letts, I too was a person who loved helping people. I was not a homeless drug addict who could never get it right, but someone who could really be happy if I continued to strive for perfection. I was happy I was making a difference in the life of these teens.

    I was so externally focused, when all was done and accomplished with the teens, I began to spend a lot of time alone. Even with my strong desire to do right, something was still missing, and I couldn't figure out what it was. After the students graduated, I went on a journey to find my value and esteem. There was still an unfulfilled emptiness. 

    Things got worse than they had ever been. I ended up going to four more drug programs trying to figure this thing out. Judge Letts still never gave up. He continued to encourage me and let me know that he believed in me, even at my lowest point. My experience taught me that reaching the bottom was not a process of spiraling down until you just splat...but rather, when you reach a real low place and get comfortable there. An ugly place where you feel you can never escape from.

    I was there and gave up totally but Judge Letts never gave up on me. He continued to be my friend through it all. 

    A time came when I knew for certain that I did not, nor could not, find the answer alone, and I called the Judge and told him I did not know what to do. I told him I was willing to do whatever he asked of me.

    The Judge reminded me of when his clerk Nancy Webb had mentioned to me that I should try going to a place called the Dream Center

    Nancy had seen Pastor Matthew Barnett on the Joyce Myers show talking the about the Dream Center's Discipleship Program and she felt it was a suitable place for me. So the Judge encouraged me to try what Nancy had already suggested and I did. 

     

  • The President’s FY 2014 Budget: Supporting A 21st Century Drug Policy

    Today, the President released a Budget that shows how we can invest in the things we need to grow our economy, create jobs, and strengthen the middle class while further reducing the deficit in a balanced way.  Everything the President does is geared toward strengthening the middle class by creating jobs and growing the economy. That’s his North Star, and that’s why today’s Budget details how we can invest to attract more jobs to our shores, equip our people with the skills they need, and ensure that hard work leads to a decent living—without adding a dime to the deficit.

    Across America, drug use and its consequences place obstacles in the way of the President’s plan to foster healthier, safer, and more prosperous communities.  In fact, in 2007 drug use cost American taxpayers $193 billion in lost productivity, healthcare, and criminal justice costs. There is also a connection between drug use and unemployment.  For example, research indicates that cocaine use tends to lower the likelihood of being employed by 23 to 32 percentage points, while marijuana use lowers it by 15 to 17 points.

    To reduce the significant burden of our Nation’s drug problem on our people and our economy, the President’s Budget supports a 21st century approach to drug policy that acknowledges drug use is a public health issue, not just a criminal justice one. Time and again, research has shown that prevention, treatment, early intervention in health settings, and smarter law enforcement efforts, working together, can make a real difference in saving lives and making our Nation safer and stronger. That’s why the Budget the President released today requests $25.4 billion in Fiscal Year 2014 to support evidence-based drug control programs – an increase of about $1 billion over FY 2012.

    Most notably, the President’s Budget includes a request for an increase of $1.5 billion over the FY 2012 level to fund drug treatment and prevention services in America – a 16 percent increase over FY 2012.  As a result, the President’s Budget requests more for treatment and prevention – $10.7 billion – than for Federally-funded domestic drug law enforcement and incarceration – $9.6 billion. This is what a 21st century approach to drug policy looks like.

    For more details on the President’s drug budget, click here

    To read more about the President’s 21st century approach to drug policy, click here.  

  • Director Kerlikowske Joins Secretary Napolitano on Southwest Border

    This afternoon, Director Kerlikowske joined Secretary of Homeland Security Janet Napolitano in Tucson, Arizona. They inspected border security operations at the Southwest border, met with state and local stakeholders, and highlighted the significant progress achieved at disrupting illegal drug trafficking and improving operations along the Southwest border. 

    As part of the visit, Director Kerlikowske released a progress update on Administration efforts to strengthen border security. Some of the highlights include:

    • Increased weapons and drugs seizures. During 2009-2012, the Department of Homeland Security (DHS) seized 39 percent more drugs, 71 percent more currency, and 189 percent more weapons along the Southwest border as compared to fiscal years (FY) 2005-2008.
    • More boots on the ground. DHS has increased the number of personnel on the ground from approximately 9,800 Border Patrol agents in 2001 to more than 21,000 today.
    • Technology and infrastructure. U.S. Customs and Border Protection (CBP) has expanded the use of Unmanned Aircraft Systems from California to Texas and has completed 651 miles of fencing along the key trafficking areas. 
    • Reducing drug demand. As part of its commitment to reduce the demand for drugs in the U.S., ONDCP has funded 18 Drug-Free Communities within 100 miles of the border in Arizona, California, New Mexico, and Texas. These coalitions provide outreach services to young people to prevent drug use before it begins.  
    President Obama announced in January of this year that strengthening border security is one of the key principles for common sense immigration reform. These principles will continue to build upon this progress by investing in the ports of entry; helping our officers and agents focus on public safety threats; making it harder for transnational criminal organizations to operate; encouraging immigrants to pursue a pathway to earned citizenship; holding employers accountable; and strengthening the integrity of the immigration system.

    The passage of the President’s proposal will help ensure that officers and agents along the border are better able to strengthen public safety and combat national security threats including drug trafficking.

    For more information on Obama Administration efforts to bolster border security and create an immigration system for the 21st century, go here. To read a fact sheet on strengthening border security, go here

  • Guest Post: Dr. Christian Thurstone, ONDCP Advocate for Action

     

    In the adolescent substance treatment program I run, 95 percent of the referrals are for marijuana, and in 2009 the number of referrals tripled. My young patients started telling me, "Doc, why would I stop using marijuana? It's medicine for my anger." I even heard parents say, "Maybe I should get my kid a medical marijuana card so they don't get in trouble for smoking pot."

    Meanwhile, new research was showing that marijuana was potentially more damaging to the developing adolescent brain than we previously thought. There are studies that show adolescents who use marijuana regularly may have an increased risk of developing psychosis[1] and may lower their IQ by up to 8 points.[2] Some people laugh at me when I explain these research findings. "That's just reefer madness," they say. But for families grappling with drug-using children, this is no laughing matter.

    I decided there was an urgent need to get out the word that marijuana is definitely NOT safe for adolescents. So over the next 3 years, I gave more than 100 talks to any group that would listen – Boy Scouts, churches, colleges, news organizations, parent groups, policy makers, professional organizations, Rotary clubs, schools, students, prevention experts, and teachers, to name a few. I also developed written materials for the Colorado Department of Education and my personal website to provide up-to-date information. 

    At heart, I am a scientist and a physician, not a public speaker. However, in 2009 only a handful of people were speaking up to protect kids from bad information about marijuana. I figured someone had to do so, and I'm glad I did.

    Today, I see signs of hope. Parents frequently say to me, "Doc, I'm worried about what marijuana is doing to my kid's developing brain." They are getting the message, and I believe more and more kids are starting to understand as well.


    [1] Hall W, Degenhardt L., Adverse health effects of non-medical cannabis use, Lancet, 2009 Oct 17;374(9698):1383-91. doi: 10.1016/S0140-6736(09)61037-0.

    [2] Meier, Madeline et al, Persistent cannabis users show neuropsychological decline from childhood to midlife, PNAS Early Edition, 2012, www.pnas.org/cgi/doi/10.1073/pnas.1206820109

     

     

  • Cross Post: Celebrate National Public Health Week April 1-7

    This is a cross-post from the USA.gov blog. The original post can be found here

    What is the value of a strong public health system? The answers are quite literally all around us: in the air we breathe, the water we drink, the food we eat, and the places where we live, learn, work and play.

    Today marks the beginning of National Public Health Week, an annual celebration organized by the American Public Health Association every April. This year’s theme, “Public Health is ROI: Save Lives, Save Money,” highlights the return on investment, or ROI, that public health programs and services deliver in protecting our health and reducing medical costs from diseases that could be prevented.

    Did you know that investing $10 per person each year in community-based public health activities could save more than $16 billion within five years? That’s $5.60 returned for every dollar invested. And that’s just the tip of the iceberg:

    • Routine childhood immunizations save $9.9 million in direct health care costs, save 33,000 lives and prevent 14 million cases of disease.

    • Every $1 invested in the nation’s poison center system saves $13.39 in medical costs and lost productivity, saving a total of more than $1.8 billion every year.

    • From 1991 to 2006, investments in HIV prevention averted more than 350,000 infections and saved more than $125 billion in medical costs.

    • The benefits of tobacco cessation programs nearly always outweigh the costs, with a benefits-to-cost ratio reaching more than $2.50 for every $1 invested.

    • Substance abuse treatment has an ROI of $4-7 for every $1 invested.

    Lowering health care spending and curbing disease rates is possible — and opportunities to do so are all around us. But most people may not know what public health is and how it impacts their lives.

    National Public Health Week is an opportunity to raise awareness about the value of public health and its benefits on our lives and our pocketbooks. Each day carries a new theme, including health at home, at school, in the workplace, outdoors and in communities.
     
    You can make the key difference. Make your mark during National Public Health Week by:
    1. becoming a partner and making a difference;
    2. attending or organizing events that promote value of public health and prevention; or
    3. driving the conversation at NPHW activities including the national prevention road tour and Twitter chat (follow along at #nphwchat).
    Together, we can shape a healthier future for all.

  • National Drug Policy Director Meets with Newtown Group

    Newtown. Today, the name of the town itself immediately conjures many images and emotions for people throughout our country. After visiting Newtown myself yesterday I am left with the memory of two words specifically -- perseverance and character.

    I was privileged to visit the Newtown Prevention Council, a drug free communities coalition dedicated to reducing substance abuse in Newtown, Connecticut. The Council has been in existence since 1986 and seeks to help young people and families make decisions in support of healthy and substance-free lifestyles. But as with all prevention focused coalitions they also strengthen family and build resiliency and self-reliance for a community.

    I asked them if the presence of their Coalition had helped them since the tragedy that rocked their community on December 14. To a person, they agreed it had. Coalition members include faith leaders, the chief of the Newtown police department, public and private school principals, counselors, health care professionals including a school nurse and emergency room doctor, high school students and several other community members.

    In the face of unspeakable tragedy, the strength of this community has come through. Community members and members of this coalition support one another and cultivate the core characteristics of a town that will be known not just for the tragedy it has been through but for its resilience and character. The community coalition has done great work in Newtown to reduce underage drinking and substance use. Using evidence based techniques they work to give parents and young people the tools they need to lead healthy lives. And they build trusting relationships among the participants, relationships that pay huge dividends when tragedy strikes.

  • Good Samaritan Overdose Response Laws: Lessons Learned from Washington State

    Drug overdoses persist as a major cause of preventable death.  Calling 911 during an overdose can mean the difference between life and death, but witnesses sometimes do not call because they perceive that they may be arrested.  Proponents of drug overdose Good Samaritan laws aim to address this concern by providing limited immunity to overdose witnesses and victims.  Opponents argue that immunity will provide a “get-out-of-jail-free card” and interfere with the work of police and prosecutors.

    Drug overdose Good Samaritan laws are in effect in 10 states and the District of Columbia and are being actively considered by at least a half-dozen state legislatures as of March 2013.  In 2010, Washington State became the second state to pass a law incorporating a Good Samaritan provision providing immunity from drug possession charges; immunity applies to a person who seeks medical aid during an overdose (e.g., by calling 911 or taking someone to the ER), and to a person having an overdose.

    I evaluated the development and implementation of the law and remain involved in spreading awareness of the law, providing overdose education, researching interventions, and encouraging broader availability of the opioid antidote naloxone (Narcan).

    To date, there is no indication from police or prosecutors in Washington State that the Good Samaritan law is a serious impediment to the conduct of their work.  This may be because arrests at overdose scenes are quite rare. In Seattle, we found that while police, paramedics, and heroin users all agreed police were usually at the scene of an overdose, they also all agreed that arrests were rare.  This is in agreement with what we heard from representatives of statewide police/sheriffs and prosecutor associations during and subsequent to passage of the law.

    We have not been able to determine if there is a positive impact directly related to the law either on increasing calls to 911 or decreasing overdose deaths.  This is not because there is no effect, but rather because passage of the law facilitated the unfolding of a chain of events that was much broader than the simple legal immunity clause.  Like other states’ legislation, no funding for implementation was included and no state agency was designated to implement (or evaluate) the law.  However, during the course of our public health law research evaluation of the law, we surveyed Seattle police officers and found very low awareness of the law.  Only 16 percent had heard of the law, and only 8 percent knew it applied to both overdose witnesses who sought aid and overdose victims.  We shared these findings with police command staff, and they developed a training video that was shown to all patrol officers in the city.  The video features the narcotics captain, a county prosecutor, and the medical director for Public Health - Seattle & King County.  In my conversations with command staff and patrol officers, it appears that the video has dramatically increased awareness of the law among police in Seattle and has been shared with other Washington law enforcement agencies and at national conferences.  The fact that police have been trained about the law has also been shared with those receiving overdose education.  The video is publicly available and may be seen here:

    Immunity from a broader set of charges is often a point of contention; in Washington State, the 2009 legislation covered a broader set of drug charges and did not pass.  In 2010, the legislation was limited to drug possession, and it passed. Because of the social circumstances of substance use, there is interest by some in providing immunity for sharing controlled substances with others, and because of the personal histories of those with substance use, there is also interest in immunity for those on probation or parole. Immunity for these charges has not been implemented in Washington State but is under consideration in some other states.

    In summary, Washington’s Good Samaritan overdose law has coincided with a great deal of progress on overdose education efforts throughout the state without any major negative consequences. We have found that collaboration among diverse stakeholders is critical to spreading the word about overdose prevention and response.  The Good Samaritan law in Washington was an important catalyst for this progress, and we encourage other states to involve public health, law enforcement, medical and treatment professionals, and advocacy organizations in spreading the word about the need for overdose education and the protections provided by Good Samaritan overdose laws.  Other states also may wish to consider cost-neutral ways of explicitly identifying an agency or standing work group to convene a multi-agency task force to help implement overdose-related laws in their legislation.

    Dr. Caleb Banta-Green is a Research Scientist at the Alcohol & Drug Abuse Institute and served as a Senior Science Advisor at ONDCP in 2012. More information online at http://bit.ly/adaistaff_bantagreen

  • School Resource Officers

    In light of the tragedy in Newtown, Connecticut, families and local communities nationwide raised questions about the safety and security of our children.  Of course, the vast majority of schools are secure – and our children are safe at school.  However, the time is ripe to reassess  ways to improve the overall school climate and look beyond simply having more police officers in schools. President Obama’s Plan to Reduce Gun Violence includes tools to create a safer environment at schools across the country and includes a call to put as many as 1,000 new school resource officers and counselors on the job.

    School resource officers, or SROs, are members of the law enforcement community who teach, counsel, and protect the school community. When SROs are integrated into a school system, the benefits go beyond reduced violence in schools. The officers often build relationships with students while serving as a resource to students, teachers, and administrators to help solve problems.

    For students with a mental illness, use of drugs or alcohol can be a key risk factor for committing acts of violence. Recent research shows that those with a severe mental illness and a substance use disorder have a greatly increased relative risk for violence (more than 11 times) compared to those with neither diagnosis.  Since SROs can help infuse substance abuse and violence-prevention messaging in schools and throughout school systems, they can play an important role in school safety plans.

    In March, I met with school resource officers in Chantilly, Virginia, to discuss school safety and substance abuse.  It was clear from this discussion that we need to look beyond the law enforcement function of SROs and recognize their value in cultivating a safe, supportive environment for our young people.

    School resource officers are not armed guards standing sentry at school entrances. These men and women receive training in counseling and other skills that help them be effective in a school setting. Part of a school resource officer’s job is building relationships with students and faculty, and the job often doesn’t end at the close of the school day. They can be present at extracurricular activities and in school hallways, building trust with the students. School resource officers can get involved if they believe a young person may pose a danger to the school community. They can even visit students at home and speak with parents and family.

    Keeping our young people safe and healthy is a prime motivator for all of us.  And properly trained school resource officers can play an important role in creating a school community where young people thrive and are prepared to meet the challenges of the 21st century.

    For more information on SROs, please visit the National Association of School Resource Officers at www.nasro.org.

  • Guest Post: Michael Banyard’s Story, Part 2.

     

    In June 2012, National Drug Control Policy Director Gil Kerlikowske visited the Betty Ford Center, one of the Nation’s oldest and most recognized addiction treatment facilities. There he gave remarks to a crowd of leaders in the field of recovery. In the audience were two special guests—Michael Banyard and Federal District Court Judge Spencer Letts. In his remarks, Director Kerlikowske mentioned Banyard’s improbable—and inspirational—journey from crack cocaine dependence and homelessness, to prison, to a successful sentence appeal, to the chambers of a federal district court judge and completion of his GED.                     

    Read Part 1 of Michael Banyard’s story here.

    Although I had no idea what I was doing, studying law brought this inner peace that made me feel that everything was going to be alright.

    I filed petitions for a writ of habeas corpus, a writ of coram nobis, and a writ of coram vobis.

    I somehow never doubted that God would deliver me, and I continued to pray for approximately nine years before my petition made it through the state courts and to the federal court, where Senior Federal Judge J. Spencer Letts of the California Central District Court ruled in my favor and GRANTED my writ of habeas corpus, ruling and writing an opinion on all four of claims (see Banyard vs. Duncan opinion here.)

    Shortly after I was released from prison, around the beginning of 2005, I received what was probably the first email in my life. It was from the Federal Court. They gave me a phone number to call Judge Letts’ chambers. I was nervous when I called, but his clerk, Nancy Webb, made sure I understood that nothing had changed, and I was not in trouble.

    On the day I arrived and walked into the chambers of Senior Judge Letts, he and his staff gave me a warm and friendly welcome. I knew I was around people who loved to help people. We talked for some time, and before I left, Judge Letts asked me how I felt about going with him to speak to the teens at L.A. High School to share my experiences in a way that would encourage them to go down the right path in their lives and not make some of the choices that I did.

    I said, "Yes." 

    I had never done anything like that in my life, but it felt more than right, and I never felt so sure about anything before in my life. It felt like all that I had went through in my life, being shot and partially paralyzed, going head first through car windshields, and more, was all for this purpose—to help others avoid being blinded by the outcome of poor choices. 

    I went to L.A. High with Judge Letts and spoke at the assembly. It was at this event that I first met Kurt Streeter of the L.A. Times.

    Michael Banyard and Kurt Streeter

    I had some struggles after that. I really could not understand how I could not just stay on the right path, as much as I wanted to do right. I really did not know what my life would become, but I knew I wanted something different. As I would stumble, Judge Letts would encourage me to stand back up, and he would remind me that he would never give up on me and would always be my friend. He would tell me that he could see a man in me who would find his place in life.

    Things got better and I began to work with the youth at the Long Beach Soledad Enrichment Action Charter High School.