Clinton details anti-addiction plan
Grant money for states that comply
States like Pennsylvania might have to strengthen opioid controls to tap a proposed $10 billion infusion of anti-addiction funding, an adviser to Democratic presidential nominee Hillary Clinton said Tuesday.
Among the strings attached to the proposed funding: States would have to compel doctors to check patients’ drug histories every time they prescribed a controlled substance. Pennsylvania doesn’t require that now, but the General Assembly may vote on such a rule this week.
“Pennsylvania, like other states, is seeing a serious epidemic of increased use of opioids and addictive drugs,” said campaign adviser Sara Solow, a Philadelphia native, in a conference call with reporters. The Clinton campaign, she said, “came at this from the orientation of addressing addiction as a health condition, as a disease.”
Last year 3,383 Pennsylvania residents died from overdoses, and 81 percent of those deaths involved heroin, fentanyl, prescription opioids or some combination of those.
Republican nominee Donald Trump has said that a proposed wall along the border with Mexico would help to keep out heroin, and better postal monitoring would stop illicit opioids from China.
Ms. Solow agreed that the nation needs “strong border enforcement” but added that “is not a solution to what we are seeing in community after community across this country.”
Ms. Clinton has said that her administration would add $4 for every $1 states spend on certain anti-addiction measures. The measures would include better education on drug dangers for everyone from schoolchildren to established physicians, an expanded network of rehabilitation providers and fair insurance coverage for their services, plus wider distribution of the antioverdose drug naloxone.
The former secretary of state would tell states that if they want the money, they must let their prescription databases communicate with each other, so doctors can see patients’ drug histories even if they cross borders.
“If you want to come forward and get all of this really generous grant money from the federal government, you should make your prescription drug monitoring program interoperable” with those in other states, said Ms. Solow. That would be a change for Pennsylvania, which in August became the second-to-last state to have a prescription drug monitoring program. It doesn’t yet communicate with other states’ databases.
Pennsylvania doctors must now check the database the first time they prescribe an opioid. Ms. Solow said that Ms. Clinton, if elected, would tell states that their doctors should check “upon every writing of a prescription” for a controlled substance.
The General Assembly is weighing such a measure this week. Prescription database checks are meant to keep patients from “doctor shopping” — getting painkiller prescriptions from multiple sources.
Mr. Trump has advocated more “drug courts” that often steer defendants in possession cases to treatment, plus more funding for treatment and better access to naloxone. The Trump campaign’s Pennsylvania spokesman did not immediately respond to a request for more details.
Ms. Clinton believes that low-level, nonviolent drug offenders should get treatment, not jail, Ms. Solow said.
“All of the stuff about treating this as a public health issue is right on point,” said Bob Twillman, executive director of the Academy of Integrative Pain Management, a doctor group. “We spent the last 40 years on this war on drugs, trying to control the supply of drugs, and it’s been an abject failure.”
He added that his doctors would like to see better reimbursement for nonopioid pain care, noting that many health care plans don’t adequately cover alternatives. “In some cases, you might as well be telling people to go pet a unicorn, because it’s about that accessible.”