Obama Plan for Opioid Abuse Stresses Prescriber Training

More physicians will receive training on prescribing opioid pain medications as part of a White House initiative against abuse of prescription drugs and heroin use.

President Barack Obama issued a memorandum yesterday requiring federal departments and agencies to provide opioid prescribing education to all “federal prescribers.” This group includes clinicians who are employees or contract workers of the departments of Defense, Health and Human Services (HHS), and Veterans Affairs, as well as residents who primarily work in federal facilities. A White House spokesperson told Medscape Medical News that the Obama administration has yet to come up with an exact head count of how many clinicians would be affected.

The required training must address such topics as principles of pain management, identification of potential substance abuse, and referral for further evaluation and treatment.

In addition, the memorandum orders federal agencies that either directly provide healthcare services or reimburse for them (HHS is an example) to identify barriers that individuals with opioid use disorder might encounter in receiving “medication-assisted treatment” (MAT) such as buprenorphine, which also is an opioid. Considered widely underused, MAT normalizes brain chemistry and relieves craving for opioids without the harmful effects of the abused drug, according to HHS.

The White House also announced that more than 40 provider groups ranging from the American Medical Association to the American Dental Association have committed themselves to get more than 540,000 clinicians trained in opioid prescribing during the next 2 years. Other voluntary goals these groups have set for themselves include:

doubling the number of physicians certified to prescribe buprenorphine from 30,000 to 60,000 during the next 3 years;

doubling the number of providers who prescribe naloxone, which can reverse an opioid overdose; and

doubling the number of providers registered with their state prescription drug monitoring program.

“We obviously need to work with the medical community,” Obama said yesterday at a community forum on opioid abuse and heroin addiction in Charleston, West Virginia, “They’re the front lines on prescribing this stuff. So there’s got to be a sense of responsibility and ownership and accountability there.”

The American Academy of Family Physicians, one of the provider groups involved in the Obama initiative, will do its part by promoting continuing medical education on opioid prescribing, a spokesperson told Medscape Medical News. The academy aims to train 10,000 of its members on how to prescribe the drugs and have another 600 complete overview training on MAT.

Treatment More Important Than Prison

The president’s latest sally against prescription drug abuse and heroin use enlists companies ranging from CBS Television Network to Google to donate airtime and advertising space for a media campaign by the Partnership for Drug-Free Kids. Likewise, the National Basketball Association and Major League Baseball will run public service announcements and the Dr Oz Show will encourage parents to talk with their children about the risks posed by prescription pain medications, heroin, and other drugs.

In one of many public sector actions, HHS will review how patient satisfaction surveys evaluate pain management and how they may influence current practices and opioid prescribing.

West Virginia was an apt setting for Obama to announce new efforts to combat abuse of prescription painkillers and heroin use. He noted that the state has the highest rate of fatal drug overdoses in the nation.

“More Americans now die from drug overdoses than they do from motor vehicle crashes,” he said. “This crisis is taking lives, destroying families, and shattering communities all across the country.”

Obama said fighting this epidemic depends more on getting people with a substance abuse problem into treatment than putting them in prison. That task will be easier, he said, when substance abuse is no longer stigmatized with terms such as “junkie.” Such pejorative language often deters from people from seeking help.

“Part of our goal today is to replace those words with father, daughter, son, friend, or sister, because then you understand there is a human element,” Obama said. “This could happen to any of us.”