Why Obama is switching strategies on US heroin epidemic

The Obama administration is changing its approach to the surge in heroin use in the United States from a punishment-driven model to a treatment-driven one, following the release of data showing that heroin use and related deaths are rising rapidly.

The $2.5 million program, which the White House will announce Monday, unites law enforcement with public health officials in a year-long trial that will be implemented in 15 East Coast states, where the problem is seen as greatest, The Washington Post reported.

“Our approach needs to be broad and inclusive,” a senior White House official told the Post. “Law enforcement is only one part of what really needs to be a comprehensive public health, public safety approach.”

Thirty officials – a mix of drug intelligence officers and health policy analysts – will come together to collect data and find patterns, and study street-level law enforcement. Perhaps one of the team’s most proactive duties will be training first responders to administer the overdose-reversing drug naloxone.

The plan comes from the New York/New Jersey High Intensity Drug Trafficking Area Program, a federally-funded law enforcement initiative that is one of 28 nationwide.

The Center for Disease Control and Prevention released data last month revealing that addiction to the drug has become an “epidemic” in the United States. Between 2002 and 2013, heroin use increased across almost all demographics, especially among those in which use has historically been low. Over the same period of time, overdose deaths have almost quadrupled.

While heroin use is most common among young, poor men, the CDC says the biggest risk factor for addiction is opioid addiction. People who are addicted to prescription opioid painkillers are 40 times more likely to be addicted to heroin. Drugs like OxyContin are commonly prescribed and highly addictive, often paving the way for heroin use, which has similar effects but is cheaper and more easily obtained.

“We are priming people to addiction to heroin with overuse of prescription opiates,” CDC director Tom Frieden said at a news conference in July. “More people are primed for heroin addiction because they are addicted to prescription opiates, which are, after all, essentially the same chemical with the same impact on the brain.”

President Obama has acknowledged that painkillers are over-prescribed, the Post reported. This year, the administration proposed a $133 million plan to decrease opioid prescriptions and increase the use of Suboxone and methadone, two drugs often used to replace heroin during the withdrawal stages of overcoming addiction, though their effectiveness has been disputed since they can also be addictive.

“Heroin is killing people,” the enforcement official told the Post, “and too often, public health goes one way and law enforcement goes the other. Often, grants create silos in government. This program is designed not to create any new agency but to bring people together to break out of those silos.”