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Obama Administration’s New Approach To Combat Heroin Epidemic Prioritizes Public Health Over Punishment

heroin deaths

The Obama administration announced a new strategy to combat heroin abuse on Monday, pledging $2.5 million in additional funds to target five of the nation’s “high intensity drug trafficking areas.” The plan, which aims to pair law enforcement officials with health experts, marks a major shift in U.S. drug policy, emphasizing treatment and harm-reduction rather than jail time.

In the 15 states participating in the pilot program, a public health official will coordinate “heroin response teams” and help track the number of overdoses in their region. Funding will also go toward training more first responders on how to deal with heroin and prescription opioid-related incidents, including in the use of naloxone—also known as Narcan — a life-saving medication that can reverse the effects of opioid overdose within minutes. The Obama administration will work with local law enforcement to increase access to treatment for addicts and try to trace the sources of heroin trafficking.

“The new Heroin Response Strategy demonstrates a strong commitment to address the heroin and prescription opioid epidemic as both a public health and a public safety issue,” said Michael Botticelli, director of the White House’s National Drug Control Policy (NDCP). “This Administration will continue to expand community-based efforts to prevent drug use, pursue ‘smart on crime’ approaches to drug enforcement, increase access to treatment, work to reduce overdose deaths, and support the millions of Americans in recovery.”

The move comes in response to a sharp rise in the rates of heroin abuse and deaths that has been linked to a recent nationwide crackdown on painkillers. As prescription drugs have become more tightly controlled, experts say that some opioid abusers have turned to heroin instead. Increased availability of cheap heroin has only fueled the surge. The epidemic is particularly serious in rural parts of New England, but the problem is on the rise across the U.S.

According to the Centers for Disease Control and Prevention, the death rate from heroin overdoses has quadrupled over the past decade — a growing trend that caught many Americans’ attention after the death of prominent actor Philip Seymour Hoffman last year.

Beyond the increase in deaths, the rise in heroin use also presents serious public health risks. Without regulation or standard dosing, users of heroin face an extremely high risk of accidental overdose due to unexpectedly potent “batches” of the drug. Even more troubling, however, is that injection heroin use is associated with a wide range of communicable diseases, including hepatitis, tuberculosis, and HIV/AIDS. According to the CDC, injection drug users account for about one in ten new HIV cases in the U.S.

Health officials have already started reporting clusters of hepatitis C and HIV linked to opioid injection — including the largest-ever HIV outbreak in the state of Indiana, which was declared a public health emergency in March after more than 150 new HIV cases were confirmed in the first three months of 2015. All cases were tied to intravenous drug use.

This issue has been on the administration’s radar for a while. Last year, former Attorney General Eric Holder called heroin addiction an “urgent and growing public health threat,” and the administration has repeatedly urged states to make it easier for cops to carry naloxone to prevent overdose deaths, rather than focusing on arresting users.

Pairing cops with docs on drug-use efforts has shown some success. A May 2015 study by funded by the National Institute of Drug Abuse and published in The Lancet, a leading medical journal, found that people who were incarcerated for six months or fewer and who underwent methadone maintenance, a common treatment method for drug addiction, while imprisoned were more likely to get additional treatment after their release.

Some criminal justice experts have recently pointed out that the national response to this ongoing epidemic — one that’s focused on addiction treatment, health solutions, and “Good Samaritan” laws that shield people from prosecution if they’re seeking medical attention — stands in stark contrast to the country’s strategy to combat previous spikes in drug use, which were greeted with harsh prison sentences during the failed War on Drugs.

“The response to the rise in heroin use follows patterns we’ve seen over decades of drug scares. When the perception of the user population is primarily people of color, then the response is to demonize and punish. When it’s white, then we search for answers,” Marc Mauer, the executive director of the Sentencing Project, an organization that works to close racial disparities in the criminal justice system, told the Marshall Project last week.

As opposed to the rise in heroin use in the 1960s, which was mainly seen as an “urban problem,” the current heroin epidemic is hitting mostly white towns in New England states like Vermont and New Hampshire. According to one 2014 study, almost 90 percent of the people who are trying heroin for the first time are white.

Mauer suggested that’s perhaps partly why approaching heroin as a public health issue has gained such bipartisan support. Indeed, even Obama’s most ardent opponents don’t have many objections to the White House’s new plan. Senate Majority Leader Mitch McConnell (R-KY) applauded the effort as “a positive development for Kentucky’s efforts to fight the use of heroin that is hitting the commonwealth particularly hard.” And at least one Republican presidential candidate, Ohio Gov. John Kasich (R), is on board with expanding access to naloxone without a prescription.



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