MANCHESTER, N.H., May 9, 2016 - In January 2016, President Obama tapped Agriculture Secretary Tom Vilsack to lead an interagency federal effort focused on the heroin and prescription opioid crisis. As Secretary of Agriculture and Chair of the White House Rural Council, Secretary Vilsack understands the unique needs of rural America, where rates of overdose and opioid abuse are particularly high. This summer, Secretary Vilsack will hold a series of rural town halls in communities across the country to build support at the local, state, and regional levels for addressing addiction. This week, he is visiting with stakeholders and leaders in New Hampshire to discuss the state's efforts to address the opioid epidemic.
Scope of the Crisis in New Hampshire
- Nearly one person dies from a drug overdose every day in NH.
- In 2014, 334 people in NH died of drug overdoses.
- Drug poisoning deaths in NH are increasing at an alarming rate.
- Age-adjusted drug poisoning death rate in 2014 was 26.2 per 100,000 population, up from 15.1 in 2013 (national rate in 2014: 13.5)
- NH had the third-highest rate in the nation in 2014, and it increased more dramatically from 2013-2014 than in all but one other state.
- Fentanyl was a factor in nearly two-thirds of opioid deaths in NH in 2015.
- The number of incidences of naloxone administration by EMS increased by 83% from 2013 to 2014, and there was a 70% increase in heroin-related emergency room visits.
- Young adults (18-25) in NH are using non-marijuana illicit drugs at a significantly higher rate (10.0%) than the rest of the nation (6.9%). They are also using prescription painkillers non-medically at a higher rate (10.5%, versus 9.5% nationally).
The Obama Administration's Response
- President Obama has made clear that addressing the opioid overdose epidemic is a priority for his Administration and has highlighted tools that are effective in reducing drug use and overdose, like evidence-based prevention programs, prescription drug monitoring, prescription drug take-back events, medication-assisted treatment and the overdose reversal drug naloxone.
- The President submitted a budget proposal and continues to call on Congress to provide $1.1 billion in new funding to help every American with an opioid use disorder who wants treatment get the help they need.
- Under the Affordable Care Act, substance use disorder services are essential health benefits that are required to be covered by health plans in the Health Insurance Marketplace. The law also requires that coverage of substance use disorder benefits must be comparable to coverage of medical and surgical benefits. President Obama has established a task force to ensure compliance with health coverage parity, which held its first meeting in April 2016.
- In October 2015, the President announced commitments by more than 40 provider groups that more than 540,000 health care providers will complete opioid prescriber training in the next two years. 75,000 providers have completed prescriber training to date, putting them on target to meet their goal. In response to a Presidential Memorandum, federal agencies are leading the way by making certain that their workforce is properly trained.
- The Office of National Drug Control Policy has worked with federal, state, and local government agencies and other stakeholders to expand access to the lifesaving opioid overdose reversal drug naloxone, including equipping first responders. In November 2015, FDA approved an easy-to-use nasal spray version of naloxone.
- In March 2016, HHS awarded $94 million in ACA funding to 271 health centers nationwide to improve and expand the delivery of substance use disorder services. These awards will increase the number of patients screened for substance abuse disorders and connected to treatment, increase the number of patients with access to medication-assisted treatment, and provide training and education resources to help health professionals make informed prescribing decisions. This investment is expected to help awardees hire approximately 800 providers to treat nearly 124,000 new patients nationwide, including 7 employees to treat over 550 patients in New Hampshire.
- In March 2016, CDC issued the new CDC Guideline for Prescribing Opioids for Chronic Pain to help health care professionals provide safer and more effective care for patients dealing with chronic pain.
- In March 2016, HHS issued a proposed rule to increase the current patient limit (from 100 to 200 patients) for qualified physicians who prescribe buprenorphine to treat opioid use disorders.
- Since 2010, DEA has held 11 National Prescription Drug Take-Back Days to provide a safe, convenient, and responsible means of disposing of unused prescription drugs. Take-Back Day events across the country have collected over 5.5 million pounds of drugs.
USDA Efforts
- As of November 2015, USDA had provided more than $213 million to 80 projects in 34 States to develop or improve mental health and substance use disorder facilities in rural areas. We have already more than quadrupled the commitment we made in 2013 to provide up to $50 million in Rural Development Community Facilities funds for mental health and substance use disorder facilities by the end of 2016.
- In March 2016, USDA announced the availability of $1.4 million through the Rural Health and Safety Education (RHSE) grant program. This year, the focus of these grants is being expanded to include extension work that addresses substance abuse.
- USDA's Distance Learning and Telemedicine program can be used to expand access to drug abuse treatment in hard to reach areas that lack extensive medical personnel. Since 2009, USDA has provided more than $213 million in loans and grants for 634 distance learning and telemedicine projects in rural areas nationwide. In 2014, USDA awarded $1 million in grants to the Dartmouth-Hitchcock Center for Telehealth to connect rural hospitals and doctors' offices and help bring opioid addiction treatment to the most rural corners of the state.
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