The President Joins a Community Forum on Prescription Drug Abuse

The President Joins a Community Forum on Prescription Drug Abuse


The President: Thank
you, everybody. Everybody, please
have a seat. Have a seat. Thank you so much. Well, hello, West Virginia! (applause) Go, Mountaineers! (applause) It is great to be
back in what is clearly one of the most beautiful states
in the United States of America. One of these days, I’m going
to finally try a Tudor’s Biscuit. (laughter) I want to begin by thanking
Jordan for sharing his extraordinary story with us. Jordan is living proof that,
when it comes to substance abuse, treatment
and recovery, those things are possible if
we work together and if we care about each other. And that’s what we’re
here to talk about today. We’ve got some outstanding
leaders who care deeply about this issue. I want to thank your
Governor, Earl Ray Tomblin, for being here. (applause) Your two fine
senators — Joe Manchin and Shelley Moore Capito. (applause) And Charleston
Mayor Danny Jones. (applause) We’ve also got
some outstanding members of my administration who are
here — first and foremost, our proud daughter
of West Virginia, HHS Secretary
Sylvia Burwell. (applause) We have the
Director of National Drug Control Policy,
Michael Botticelli. (applause) And we have the
head of the Drug Enforcement Administration,
Chuck Rosenberg. (applause) Where’s Chuck? He’s around here somewhere. And what I want to do is to
have a conversation with the panelists here today, take
some questions — because this is something that is
not a top-down solution type of problem alone. This is going to have to be
everybody working together. And we’ve got to understand
what families are going through, what law
enforcement is going through, what our health
systems are going through in order for us to wrap our
arms around this problem. So instead of giving
a long speech, I just want to offer some
initial thoughts to frame our discussion. When I came into office, I
started studying this issue — what’s called opioids. And I was stunned
by the statistics. More Americans now die every
year from drug overdoses than they do from
motor vehicle crashes. More than they do
from car accidents. The majority of those
overdoses involve legal prescription drugs. In 2013 alone, overdoses
from prescription pain medications killed more
than 16,000 Americans. One year. I don’t have to tell you,
this is a terrible toll. The numbers are big, but
behind those numbers are incredible pain
for families. And West Virginia
understands this better than anybody because this state
is home to the highest rate of overdose deaths
in the nation. Now, addiction is not new. But since 1999, sales of
powerful prescription pain medications have
skyrocketed by 300 percent. In 2012, 259 million
prescriptions were written for these drugs, which is
more than enough to give every American adult
their own bottle of pills. And as their use
has increased, so has the misuse. Some folks are prescribed
these medications for good reason but they become
addicted because they’re so powerful. At the same time, we’ve seen
a dramatic rise in the use of heroin, which belongs to
the same class of drugs as painkillers — this class
of drugs known as “opioids.” In fact, four in five heroin
users — new heroin users — started out by misusing
prescription drugs; then they switched
to heroin. So this really is a gateway
drug — that prescription drugs become a
gateway to heroin. As a consequence,
between 2002 and 2013, the number of heroin-related
deaths in America nearly quadrupled, although the
number of heroin-related overdoses is still far
exceeded by the number of legal prescription
drug overdoses. So this crisis
is taking lives. It’s destroying families. It’s shattering communities
all across the country. And that’s the thing about
substance abuse — it doesn’t discriminate. It touches everybody —
from celebrities to college students, to soccer
moms, to inner city kids. White, black, Hispanic,
young, old, rich, poor, urban, suburban,
men and women. It can happen
to a coal miner; it can happen to a
construction worker; a cop who is taking
a painkiller for a work-related injury. It could happen to the
doctor who writes him the prescription. Now, one of the problems we
have is too many families suffer in silence, feeling
like they were the only ones struggling to
help a loved one. And let’s face it, there’s
still fear and shame and stigma that too often
surrounds substance abuse — and often prevents people
from seeking the help that they deserve. Because when people loosely
throw around words like “junkie,” nobody wants to
be labeled in that way. And part of our goal here
I think today is to replace those words with words like
father, or daughter, or son, or friend, or sister. Because then you understand
there is a human element behind this. This could happen to any of
us in any of our families. What if we replaced a word
like “junkie” with recovery coaches and specialists
like Jordan? We can’t fight this epidemic
without eliminating stigma. That’s one of the reasons
why I’m so proud of Michael, who’s the first person in
the job of dealing with drugs in America who
actually knows what it’s like to recover
from an addiction. He shares his own story as
a way to encourage others to get the help that they
need before it’s too late. And I’m proud that there’s
some elected officials in this state who’ve told their
stories about what happened in their family and to
themselves in order for us to start lowering those
attitudes that keep people from getting help. So I’ve made this a priority
for my administration. And we’re not new to this. In 2010, we released our first National Drug Control Strategy. We followed that up in 2011
with a Prescription Drug Abuse Prevention Plan. We’re implementing
those plans. We’re partnering with
communities to prevent drug use, reduce overdose deaths,
help people get treatment. And under the
Affordable Care Act, more health plans have
to cover substance abuse disorders. The budget that I sent
Congress would invest in things like state overdose
prevention programs, preparing more first
responders to save more lives, and expanding
medication assisted treatment programs. So we have to make
those investments. Rather than spending
billions of dollars — taxpayer dollars — on
long prison sentences for nonviolent drug offenders,
we could save money and get better outcomes by getting
treatment to those who need it. (applause) And we could use
some of the savings to make sure that law enforcement
has the resources to go after the hardened criminals
who are bringing hard drugs like heroin into
our country. So with no other disease
do we expect people to wait until they’re a danger to
themselves or others to self-diagnose and
seek treatment. Every other disease —
you got a broken leg, you got diabetes, you got
some sort of sickness, we understand that we
got to get you help. And we also understand when
it comes to other diseases that if we don’t
give you help, and let you suffer
by yourself, then other people
could get sick. Well, this is an illness. And we got to
treat it, as such. We have to change
our mindset. (applause) And this is one of the
reasons that the DEA declared a “National
Prescription Drug Take-Back Day” — a day when Americans
can safely and conveniently dispose of expired and
unwanted prescription drugs in their communities. Because most young
people who begin misusing prescription drugs don’t buy
them in some dark alley — they get them from Mom or
Dad’s medicine cabinet. And today, we’re also
announcing some new actions. First, we’re ensuring that
federal agencies train federal health care
providers who prescribe opioids. This is a common-sense
idea that you’re already implementing here
in West Virginia. Congress should follow
that lead and make this a national priority. And we look forward to
working with governors and the medical
community as well. Second — and we were
talking — Joe and I were talking on the flight over
here — there is evidence that shows that medication
assisted treatment, if done properly, in
combination with behavioral therapy and other support
and counseling and 12-step programs and things
like that, can work. It can be an effective
strategy to support recovery. But it can’t just be
replacing one drug with another. It’s got to be
part of a package. So we’re going to identify
any barriers that still exist that are keeping us
from creating more of these treatment facilities, and
incorporating them into our federal programs. Private sector partners are
helping out to help fight this epidemic, as well. And I want to give
them some credit. More than 40 medical groups,
from the American Medical Association to the American
Dental Association are committing to
concrete actions. And we need to, obviously,
work with the medical community — because
they’re the front lines on prescribing this stuff and
so there’s got to be a sense of responsibility and
ownership and accountability there. We’ve got to expand
prescriber training. Increasing the use of
naloxone — I wanted to make sure I was pronouncing
that right, so I talked to the expert
— naloxone — this is something that if first
responders have it can often save quickly the lives of
somebody who is having an overdose. So we want to make sure
that first responders have a supply of this. We want to make sure
that we’re getting more physicians certified to
provide medication assisted treatment. We then have broadcasters
like CBS that are providing airtime for education
and awareness. And groups like the NBA have
committed to running public service announcements
about drug abuse. So that’s just an example of
some of the private sector partnerships that
we’re forging here. The point is — and I’m
going to end with this — we’ve all got
a role to play. Because young
people like Jordan, they remind us
these are our kids. It’s not somebody else’s
kids; it’s our kids. It’s not somebody
else’s neighborhood; it’s our neighborhood. And they deserve
every chance. We’ve got to make sure that
we’re doing right by them, we’re taking this seriously. And the goal today is to
shine a spotlight on this, and then make sure that
we walk away out of here, all of us committed to
doing something about it. Whether we are
a faith leader, whether we are an
elected official, whether we’re in
law enforcement, whether we’re a private
citizen, a business, we’ve all got
a role to play. You understand that
here in West Virginia, and we want to make sure the
whole country understands how urgent this problem is. So with that, I’m going
to turn it over to our moderator, Michael
Botticelli. (applause) Director Botticelli: Well, good afternoon, everybody. Thank you for
being here today. I, too, want to thank Jordan
for his really stirring comments. I think it really
exemplifies for us the challenges that we have, but
also the success and hope that comes with recovery. It’s really astounding. We’re here in West Virginia
today to highlight the issue not just because of the
impact that it’s had on West Virginia, but the impact
that it’s had across the country. But also, West Virginia
is working together to implement strategies to
really deal with this addiction, and we’re proud
to be here to help support that. The President always gives
me a lot of credit for talking openly and honestly
about my recovery, but, candidly, I’m one of
millions of Americans who are in recovery today and
my story is not unique. Maybe this part is a
little bit unique, sir. (laughter) But I’m one of
millions of Americans who have been restored by
getting good care and treatment. And I know the President
wants what Jordan and I got, and that is a second chance
to be restored to productive members of our communities
and to give back what we’ve so freely been given. So, thank you, sir. So with that today, we have
a great panel of people who are really going to help
provide us with information and their insights about
what more we can do on the federal level. I’m really proud to be
a colleague of Secretary Silvia Burwell. And, Secretary, I’m going to
start — you can feel free to say anything you
would like, however. I know we’re here in your
home state of West Virginia. I know — we have talked
— you have been personally impacted by this. But you’ve also made this a
key priority for all of your HHS agencies. So may you could talk
a little bit about your experience and what HHS
is doing to deal with this issue. Secretary Burwell:
Absolutely. And first, I’ll just
say I love coming home. It’s great to be home. And it’s great to welcome
the President to the great state of West Virginia. And when I became Secretary,
this was a priority because it is something that I have
personally experienced. Everybody, I’m sure, in this
room knows people personally — friends that lost to the
addiction and what happens in terms of their children,
in terms of their family, in terms of the community. And what your experience
is, personally, I think that is what
energizes you to act. And at the department, what
we focused on over the last year, figuring out an
evidence-based strategy — because we want
to get results, we want to change the kinds
of things that people have experienced personally
— and three things. Number one is changing
prescribing practices. When the President said the
259 million — that can’t be right. And so how do
we work on that. Second is working on
medication assisted treatment, getting people
the access we’ve talked about today being so
important to people. And third is that
access to naloxone. And I look at our colleagues
in law enforcement because they’re usually the front
line — and making sure that when something
does go wrong, in terms of that overdose,
that we can prevent those deaths, those deaths
that are so dramatically impacting the state. So those are the
three things. I’m going to stop because
we’re here to listen today. Thank you, Michael. Director Botticelli:
Cary Dixon, you’re a mom of a son who
is struggling with — in treatment now,
unfortunately in prison. But you’ve turned your
struggles into advocacy and action, and you provide
support for many, many parents here and around
the country for loved ones who are dealing with this. So what has your
experience been? What advice do
you give parents? What advice do you give us
as federal folks about how we can support parents
in this battle? Ms. Dixon: Well, I think
initially I want to thank President Obama for coming
here today to support this cause for our community
that has — substance abuse, it’s become an epidemic
in our community. And I thank you for coming
today, first and foremost. And I want to share just
briefly — I’ve been charged with being a representative
for families around our area and actually around the
nation who struggle with this. So if I could just share
some comments that we families have in common. The President: You
take your time. We want to hear from you. Ms. Dixon: Thank you. I spoke this morning to a
good friend of mine who was just calling me to wish me
well today and to encourage me in this endeavor. And this friend of mine lost
her daughter two and a half years ago to drugs. And so I don’t take this
charge of being here lightly. I realize that I’m here
to represent families, and I am grateful
for that opportunity. I do want to say that as I’m
speaking to you I’m sharing my story, but I’m sharing
the stories of so many other family members that are in
this community and in the nation that have this issue. And also it’s important
to know — for the sake of time, I’ve really tried
to make this concise, but this is the tip of the
iceberg of what families experience and endure when
they love someone and care so much about someone
with an addiction. We raise our children
in loving homes. We teach them
morals and values. We teach them the difference
between right and wrong. We wonder what is happening
when the grade starts slipping, when things that
used to be enjoyable for our loved ones no longer
interest them. We’re confused as to the
cause of the personality changes that we see
in our loved ones. We’re shocked when we
hear of that first DUI. And we’re fearful when our
loved ones are taken to jail for the first time. We’re embarrassed when
holidays approach and family members are coming
in from out of town, and our loved ones can’t
interact because they’re under the
influence of drugs. We dread the
next phone call. We can’t sleep because we
haven’t received a phone call. We don’t take vacations for
fear of the next crisis. We come back from vacations
because there’s a crisis. We’re sad and angry
when valuable, but most importantly,
sentimental items are missing from our homes, only
to find out that they’re at a pawn shop, or that
they’re in the hands of drug dealers. We’re relieved when our
loved ones acknowledge that they have a serious problem
and understand that they need help. And then we’re devastated
when we help them seek treatment only to find out
that there is a month-long waiting list, or that
there’s no insurance coverage, or that there’s a
big requirement for money up front for treatment. We are sad and uncomfortable
when acquaintances ask us about our loved ones. And we’re even more sad
when they ask us about every other member of our family
and don’t mention our loved ones. We neglect our marriages. We neglect other children
in our home who are thriving because all of our attention
is focused on addiction and substance abuse. We disagree endlessly about
the right way to handle this problem. And after experiencing
years of turmoil, we rest better at night
when our loved ones are incarcerated, because the
place that you never dreamed that your loved one
would ever even see, a jail or a prison, is
safer than them being on the street, interacting
with drug dealers, or pushing a needle
into their arm. The ones of us
who are fortunate, we lay awake at night and
we plan our loved ones’ funerals in our mind. The ones of us who aren’t
fortunate actually do plan the funerals, in reality,
of our loved ones. And this is where
addiction has taken us. This is where substance
abuse has taken us. Now, all that being
said, there is hope. And that’s probably the most
important thing to remember here. We’re so grateful to
Recovery Point and Matt Ball and people in recovery
that are helping others. We’re grateful to our mayor,
the mayor of Huntington, Steve Williams, who has so
tirelessly and endlessly spearheaded programs to
help our community recover. Don Purdue who has
made it possible for people to receive treatment
in our communities. I think education
is important. And I was fortunate to find
a group called The Loved Ones Group, developed by
a man named Ed Hughes. It’s a series that helps
provide education and information and support for
family members or those who care about someone
with an addiction. The final week of this
program we get to speak to people in recovery. They come and speak to
our group of people there. And it inspires us because
we know that recovery is possible and that
it can happen. For too long,
we’ve been silent. And I think is going to
answer your question as parents and family members,
because of the stigma of this disease and the
shame that we feel, we’ve been silent. And I think that
is holding us back. We need to open our voices
so that people don’t feel ashamed. This is a disease. It is a sickness. But education, educating
ourselves as much as we can as family members, and
speaking out to raise awareness is, I think,
critical in helping the situation. I’m almost finished. People in 12-step recovery
groups and different groups rely on a higher power. I’m a person of faith,
and my faith has helped me navigate this journey
that we’ve been on. And I just want to share
with you a verse that I hold dear for my own family
member who is sick, but also offer it to others. Jeremiah 29:11 — For I know
the plans I have for you, declares the Lord, plans to
prosper you and not to harm you, plans to give
you hope and a future. And I believe that every
person in the throes of addiction and the disease of
substance abuse needs hope in a future. And I believe this for
their families as well. Thank you so much. (applause) Mr. Botticelli: Cary, thank
you so much for sharing your story. It obviously touched
everybody here in terms of not only your struggles, but
articulating the hope that’s on the other side. And we will continue to
work with parents as we deal together with this epidemic. I go to Dr. Michael Brumage. You have been involved in
this work for many years. You’re here at
the local level, so love to hear your
experience and share what you think are both some
successes and challenges in dealing with this issue. Dr. Brumage: Certainly. And thank you very much. Welcome to West Virginia,
Mr. President and Mr. Botticelli. Welcome home,
Secretary Burwell. I’ve been on the job
actually only 79 days here in Charleston. I came back home after
being 29 years away. And I knew what I was coming
into when I came home. I knew there was a heroin
and opioid abuse epidemic in the state. I knew we had the highest
rates of Hepatitis B and the second highest rates of
Hepatitis C in the nation, largely due to needle
sharing among addicts. But I also knew that coming
home that Mountaineers would take this kind of
challenge head on. That’s the kind of people
that there are in the state of West Virginia. And so I wanted to be part
of the solution here in the state. And I knew it would require
patience, persistence, and people — lots
of good people here. With the help of so
many community partners, and my good friend
and colleague over at Cabell-Huntington
Health Department, Dr. Mike Kilkenney, we’ve
been able to get some programs off the ground,
working together. And I think we’re moving
in the right direction. In about six weeks, we’re
going to begin our own harm reduction program
here in Charleston. We’re going to have syringe
exchange as part of that. We’ll be testing for
Hepatitis B, Hepatitis C, HIV. We don’t want to become
another Scott County, Indiana, where they had an
outbreak of HIV — almost 200 cases in a small
rural community there. We’d also like to offer
contraceptive services to women of the reproductive
age who are addicted to drugs to prevent neonatal
abstinence syndrome as well. (applause) And more
than anything else, what I think we’d like to do
is to treat the people who come through our doors for
this program with dignity and respect and the kind
of love that they deserve, because the ultimate disease
underlying every addiction, from my perspective, is
disconnection and alienation from themselves and from
everybody else around them. Two weekends ago, I began
working with West Virginia University researchers on a
program of mindfulness-based relapse prevention with
opioid addicts in recovery. This is based off of the
pioneering work done at the University of Washington. And one of the more pleasant
surprises that I’ve seen since I’ve been here on the
job is the close connection between public health
and public safety. Our law enforcement
community has just been outstanding and we’ve been
really privileged to work with them. Finally, I was able to also
sit together with delegate, Dr. Chris Stansbury from
Kanawha County to sponsor legislation — he’s going to
sponsor legislation to make naloxone an
over-the-counter medication, the way it is in
14 other states. (applause) And then, as
you’ve said, Mr. President, this is a
multifaceted issue. It requires a lot of
different people to come together to fix this. It’s not a quick fix; it
requires a collaborative, multiagency approach
with public health, mental health, primary care,
schools and school nurses, law enforcement. our own judiciary community. And finally, I’d be remiss
if I left out our business and industry, because jobs
provide not only an income, they provide a sense of
purpose and meaning in the lives of people. And so I’m hoping that by
the end of your visit today, Mr. President, that you’ll
be impressed with some of the things that are going on
and how much West Virginians are really digging in to
try to address this issue. Thank you. (applause) Mr. Botticelli:
Thank you, Doctor. Chief Webster, Dr. Brumage
gave you the perfect lead-in and segue to talk about the
importance of public health and public safety
collaboration. So love to hear your
thoughts and what you’re doing here. Chief Webster: Sure. First of all, I’d
like to, again, thank the President of the
United States for making this a focus, coming to
Charleston, West Virginia, and also providing me an
opportunity to represent Charleston and all law
enforcement, effectively. I think this is where most
people probably look at the person in uniform and
they probably say, okay, this is the guy who is now
going to tell us we need to build more jails and
make tougher laws. And that’s not me. This is such an epidemic and
we cannot arrest our way out of this mess. (applause) And I think the President
touched on it briefly. What the President
said earlier is true, because we want to arrest
the violent drug dealers that are creating havoc
in our communities. We have our share
of violent crime. And we are very fortunate
— our drug task force, we have a great partnership
with (inaudible.) They fund so many of our efforts. So, on a daily basis,
the bad guy get arrested. We made a significant
seizure yesterday. So we feel in
law enforcement, as I’m sure our
counterparts do, we really attack the supply
side of this issue very well. And so we’re not going to
back down from that and we’re going to keep trying
to remove people that are dangerous from society. But what’s nice about this,
and what I want to talk about, though, is attacking
as a strategy the demand side. And that’s what I think is
very nice about this panel and this gathering, because
we’ve got a lot of things we can really talk about. We basically have a
community of zombies, for lack of a better
word, walking around. They need treatment
very badly. And they’re coming up to our
officers — they actually are — some don’t
want help yet, but at some point
they do want help. And we want to
get them help. And a couple of the
strategies that we’ve worked on that we want to
attack the demand side, not so much the supply
in this conversation, is that we have trained
our officers in naloxone. And that’s been
traditionally, up until very recently,
just something that our fire department– and they do
more of the — they can do the nasal and the IV. We trained all
of our officers, regardless of
their assignment, to be able to save
somebody’s life — administer the nasal and the
rescue breathing mask that’s accompanied. And again, that’s paid for
with Appalachian — and such great partnership. They recognize that
it’s supply and demand. Interestingly, though, when
I went to the roll call to start talking about this
to the officers, first, they’re kind of like, that
might be more of a fire department role. That might be more — but
as we talked more and I went down the line
and said, well, has anybody have anybody
affected by an addiction, and I’ve yet to go to one
roll call — I’ve been to numerous, but I’ve yet to
one where someone said no. Someone has said, yes,
my sister, my aunt. And we’ve just got them
mounted to our cars in the last week, so we don’t have
any success stories — and we don’t want to have
any stories, really, unless they’re — we want
them all to be positive. But we know the fire
department will continue to administer most of
them in our camp. But we want to be in a
position to save a life — much like a child drowning
and we can administer CPR. Another thing that we’re
doing that we’re real proud of and it’s working with
the United States Attorney, which is the LEAD program,
the Law enforcement assisted diversion program. And basically, since 2014,
we’ve had 39 I’d call them low-level users that were
selling drugs to support their habits. And basically they’re hit
with a stark decision right at the arrest gate: You
have an opportunity to go to jail, or you can seek
immediate treatment. And of the 39 people that
have taken us up on that, since 2014, just one
has been rearrested. (applause) I think
that’s pretty impressive. And that’s a partnership
with the U.S. Attorney’s Office and
something that our officers are coming around to
understanding what kind of problem we have. And I would just
say, finally, because we do support
everything Dr. Brumage and the Kanawha County Health
Department is doing with his harm reduction plan, and how
we factor into that with the needle exchange
program — finally, we have a Handle With Care
program that we piloted in 2013 in one school
on the West Side, then a second school, and
now we do it for the whole city. I see some smiles in the
crowd because there are teachers in here. But what we realized had
been lost is when police officers go to crime scenes,
what are they there for? They’re there to take
witness statements. They’re there to arrest
the so-called bad guy. And then they leave. But who is looking
out for the children, the collateral damage? Who’s looking out for the
child that maybe is just trying to do his homework,
mom and dad are fighting. We come in, arrest dad. Mom cries. She’s got to go
to the hospital. And so that child gets left
behind many, many times. And so we started a
notification system to where the next day, our officers
that are on the scene will send a notification to
the principal or to the counselor basically to say,
handle that child with care today. Maybe that child needs
an extra day before — (applause.) Those are ways that we
realize that we’re not going to arrest our
way out of this. We have our place and we can
always use additional law enforcement resources. I’m not going to lie to you. (laughter) But we’re all
in this together and it’s affecting all of us. (applause) Mr. Botticelli:
Thank you, Chief. I think that’s an
extraordinary example of your willingness and
your partnership. I’m now going to turn to
Susan Shumate from the Charleston Gazette, who
I believe is going to ask questions of the panel that
come from the community. Ms. Shumate: Thank you for
coming to West Virginia, Mr. President, Secretary
Burwell and Secretary Botticelli and the rest of
the panel to address the chronic issue of
opioid addiction. The Charleston Gazette now
has done numerous stories over lots of years about
this issue facing West Virginia, and we were able
to solicit hundreds of questions from our readers
over the last five days for the President and the panel. And with us here is David
and Kate Grubb with their question for the President. Male Speaker: First of all,
mom — Cary — there isn’t a parent here who had a
dry eye when you spoke. From your heart, you
expressed exactly what we feel. And Danny knows this, too. Mr. President, I want to say
that it is — and I’m going to take this opportunity —
it is wonderful to have an intelligent, caring,
thoughtful person in your position. (applause) The President: Thank you. Male Speaker: Thank
you so much for coming. This issue — my wife and
I, we have five daughters. Mr. President, you might
relate a little bit to that. The President: I
can relate to that. (laughter) I don’t know how you did five. (laughter) Two keeps me busy. Male Speaker: And we live
here in the East End. My second oldest
daughter, Jessica, has been battling heroin
addiction for seven years. Ironically, the last time we
were in this room was when our daughter was in the 8th
grade here at Roosevelt and was a cheerleader. She made good grades. She was socially involved. Her future was bright. But as Jordan mentioned, her
life got put on hold for a long time. Last month, the
middle of August, our daughter overdosed. We found her in her bedroom,
tourniquet on her arm, syringe next to her. She was already
turning blue. My wife administered CPR. We called 911. While we were waiting
I held her and said, don’t leave us yet. Fortunately — I want to
say this to the Chief — the response was amazing. Less than five minutes, the
EMTs and the police officers were there. The police officers
were sympathetic. They were helpful. The EMTs
administering Narcan, coupled with the CPR,
saved our daughter’s life. And she’s now in recovery. (applause) This is her fourth time. It usually takes
more than one time. And we think this
one will be the one. We are full of hope. But we understand the pain
— the pain in this room, the pain the families feel. The concern we have is
access — where do you get the treatment? How do you get
the treatment? And, Cary, you mentioned it. As soon as this
overdose happened, we called hotlines and we
got numbers to call and we called those numbers,
and they said, well, there’s a three-month
wait — or, well, we don’t take
Medicaid cards — or, this wasn’t really the
facility that could handle your type of problem. The other problem with
Medicaid cards and things of that nature is you can’t
always go out of state. What if the facility
is across the river? We’re a border state — we
need to be able to have that ability to go to the
facility that may be best for our children. The bottom line is we need
resources and we need to find a way to put those
resources into effect so that we have the facilities. Because there’s so many
people that want help, like our daughter, but it
took forever to find a place for her. Right now she’s in Michigan. That was the
best we could do. Why can’t we have lots of
these types of facilities with trained staff
here in West Virginia, close to home? (applause) And lastly, I
want to say one of the best provisions of the Affordable
Care Act is that it does require coverage
for drug treatment. And thank you for that. (applause) But one of the
concerns is that if there aren’t facilities available,
then the treatment coverage can be illusory. So we have to
close that gap. And I think the biggest
issue there is are you concerned, as sometimes
we get concerned given the current political climate
that the Affordable Care Act will be weakened or repealed
either before the end of your term or in
the next term? What are your feelings
about our commitment to that program and to the drug
rehabilitation part of that program? (applause) The President:
Well, first of all, as with Cary, I just want to
thank you and your wife for sharing your story. And you’re right,
if you are a parent, then listening to Cary
or listening to you, you can relate. I told somebody one of my
favorite sayings I ever heard about having children
is it’s like having your heart walking around
outside your body. All you care about is
making sure they’re okay. But they’re so vulnerable. And you’re just, as a
parent always navigating, just trying to figure out
how do I make sure they’re going to be okay. And when something like this
happens — and I think it’s something that you
sharing your story, Cary, and your sharing
your story, sir, really emphasizes this
is happening in families everywhere with great
parents who love their kids. Obviously there are a lot of
kids who are in less stable homes and are
more vulnerable. But the way this kind of
phenomenon is penetrating all communities means that
we have to understand that there is no “us”
and “they” here. There is no “us” and “them.” This is all of us in every
school, in every community, in every neighborhood. And it could be your child. So I think the first
thing to do — and this conversation has been so
helpful — is to understand that this is an American
problem that cuts across groups and political
affiliations. Because once we
understand that, then I think we’re in a
position to deal with it together as opposed to
turning it into another political football. That’s point number one. Point number two: One of
my goals when I came into office was for us to restore
a sense of balance when it came to dealing with drugs. And this was true
for illegal drugs, but it was true for legal
but over-prescribed drugs. For a long time our goal has
been to deal with the supply side. And as the Chief said,
we’re very aggressive. I promise you, there’s no
backing off us trying to make sure that some Mexican
heroin cartel is not getting heroin into West Virginia
or anyplace else in this country. And we’ve got a lot of
terrific agents and border patrols and officials. We have ramped
up aggressively, under my administration
and under previous administrations,
interdiction efforts. So we don’t stop that, and
we don’t make apologies for that. And if there is somebody who
is out there systematically making millions or hundreds
of millions of dollars off the destruction of our kids,
we’re going to go after them. (applause) We don’t
apologize for that. But we were under-investing
and — even with the changes we’ve made — continue to
under-invest in the demand side, in the prevention and
the treatment that is so necessary. And this is a
real opportunity. It’s an important moment for
us because if we can start thinking intelligently about
treatment on the opioids and prescription drug side,
then people start making the connection, well, we should
have treatment when it comes to heroin — and then maybe
they start thinking, well, we should have treatment
when it comes to other narcotics and drugs that are
affecting and devastating families potentially
in different ways. But for a long time I think
treatment was seen as a second-class citizen to
interdiction and arrest and incarceration. And that mindset
needs to change. The good news is we’re
seeing that mindset changing, and it is on a
bipartisan basis — which I think is really interesting. To go back because I want
to make sure that people understand we’re putting an
end to the old politics on this. Democrats and Republicans
were both responsible for wanting to look tough on the
War on Drugs and ramping up incarceration. It wasn’t just one
side or another. And now both at the
same time are realizing, you know what, what
are we doing here? Why is it that we’re
willing to invest $20, 000 a year in incarcerating
a young person when we might have spent a few thousand
dollars on the front end to avoid them going to
prison in the first place? And that mindset means that
resources hopefully will start channeling
in a new direction. But we’ve got to make sure
that the money is following the insight. I think we’re at the
stage now where people are starting to realize that
we need more treatment. But the budgets are not
yet reflective of that awareness. And that’s going to
require Congress. So in our budget,
for example, we’re proposing an
additional $133 million for enhanced treatment and
prevention programs. But it’s also going
to involve states, state legislatures,
counties, local governments, all also recognizing this
is something that every community needs. And we can’t be
stigmatizing this. Having a treatment facility
is just like having a health clinic for any other illness
because it’s affecting people just as much. And we know how to do this
when we do it smartly. Think about smoking — and I
can say this as an ex-smoker who still chews on
Nicorette — which is okay, it’s expensive, but
I can afford it. (laughter) Better
not starting, though, young people. (laughter) If you look at
how drastically we’ve been able to reduce
the smoking rates, despite the fact that we
never outlawed smoking — but what we did was we
just enhanced education, made it more difficult
for kids to access it, stopped peddling it,
stopped advertising it, took some of the
money out of it. And over time, a public
health model had a drastic impact on smoking. And Nicorette is — or
nicotine is as addictive as any of the drugs
we’re talking about. So if we could do on that
with the public health model, there’s no reason we
can’t do it here, as well. But it does require
a change in mindset. And as you pointed out, it
requires additional money. Last point I’ll make —
on the insurance side. You are absolutely right
that insurance coverage is not enough if there is no
treatment center for you to apply that insurance. So we’re going to have to
build and fund and support more treatment
centers locally. (applause) On the other hand, if there is a treatment
center and you don’t have any insurance, then you
might have to mortgage your house. And I am very proud of the
fact that the Affordable Care Act — also known as
Obamacare — (applause) — which I — I mean I won’t
get on a soapbox here, but there’s 17 million
people who have health insurance who
didn’t have it. And by the way, our overall
costs for health care have been going up at the slowest
rate in my lifetime after we passed the law. So it’s not bankrupting
the government, not bankrupting states. (applause) But one of the
things that it does is it requires that insurance —
private insurance that’s sold on the marketplaces
that are subsidized by the federal government have
to provide coverage for substance abuse programs. And given the prevalence
of what’s happening to our children and our schools,
the notion that we would not have our insurance policies
cover this — they’re going to cover a broken leg, but
they’re not going to cover a situation where your
child might die? That doesn’t make any sense. And so I think that we’re
trying to nudge that along through the marketplaces. But I think one of the
things that we need to do is to have consumer groups and
our medical associations and others really push a little
bit more on the insurance companies to say that this
is something that is vital, and that everybody
should have coverage. Because you don’t know if
it’s going to be your child. And that’s the most
important point here. Cary, is carrying a
particular burden. And I was most touched when
Cary talked about her other children. But I thought about
Malia and Sasha. They’re wonderful girls,
but they’re teenagers. They do some things. (laughter) And I remember me
being a teenager — and I’ve written about this,
I did some stuff. (laughter) And I’ve been
very honest about it. So what I think about is
there but for the grace of God, and that’s what we
all have to remember. And when we do, then I think
we’ve got a chance to make a real change. But thank you for
sharing your story. (applause) Ms. Shumat: This
was from Natalie Laliberty, who is a principal at
Ruthlawn Elementary School. And she says, as the
principal of an elementary school, I see the harm being
done to kids who are born addicted or live in
traumatic and chaotic drug environment. Many of the kids have any
number of learning and behavioral problems upon
entering preschool and kindergarten. How can the community at
large and schools work together to intervene in
these children’s lives during their early years
when brain growth stimuli is most critical? Thank you. The President: Well, I’ll
make sure to get the doctor involved in this
one, as well. And I know that Sylvia and
others through HHS were working on this a lot. I’ll just make two
quick comments. Number one, we know that you
learn more between the time you’re born and three years
old than you will ever learn the reset of your life. You are a sponge
at that age. And so the more we can
invest in early childhood education, prenatal
education for parents, home visitation
with at-risk moms. And we know who they are. If you’re a poor teenage
single mom who maybe doesn’t have a lot of support,
then you are just much more likely to not know how to
express the love you have for your child effectively,
even if you love them just as much as we love our kids. But you just don’t
have the tools. So that has got to be an
emphasis at the state and local levels. That’s where we can
really make a difference. But us being able to
target at-risk parents, new parents, young parents,
that can be extraordinarily helpful. The second thing that I’ll
just say — and then maybe, Doctor, you might want to
chime in on this — and here I’m going to be a
little controversial, but I’m in my last term,
I only got a year left. (laughter) And it’s not like
my poll numbers are that high. (laughter) I figure I
can go ahead and say it. I think one of the benefits
of conversation like this is to highlight the fact that
income and race make a difference here. The truth of the matter is,
is that poor communities are more vulnerable. One of the useful things
about this forum is we’re all vulnerable, but it’s
almost like if you’re healthy and you get sick,
you have more antibodies and resistance. And if you’re poor — or if
you’re already weakened and you get sick, then you’re
more vulnerable, right? There are some communities
we know that are more vulnerable, and the kids
there are more vulnerable. And part of what I hope this
discussion does is to remind us that just as it
could be Malia or Sasha, or Cary’s kids, or
any of our kids, those kids who don’t always
look like us and don’t live in the same
neighborhood as us, they’re just as precious. (applause) And their parents
are much less equipped than you, sir, or I would be in
terms of dealing with this stuff. And we got to get
them help, too. So I think the doctor
earlier talked about the importance of jobs and
economic development and broad-based approaches so
that growth helps everybody. There is some connection
to substance abuse and the vulnerabilities that
communities have. And we’ve got —
and let’s face it, part of the reason West
Virginia probably has more cases partly has to do with
the economics that have been taking place in some
of these communities, which is why it’s so
important for us to also push on that front, as well. Doctor, any thoughts on
that question about the vulnerability of children
and how we can get to them quicker, more effectively? Dr. Brumage: Yes,
Mr. President. One of the things that I’m
hoping to kick off here next week is a discussion about
probably one of the most important studies that most
people have never heard of called the Adverse
Childhood Experiences Study. The baseline study
was done with 17, 000 people at Kaiser
Permanente in San Diego, California. And what they found out was
that when people score high on a scale of 10 questions
— everybody has a score from zero to 10, the higher
you are on that scale, the more likely you are to
have problems with addiction with IV drug use, with
smoking, with obesity, with all the public health
problems that we’re really seeing right now. I think a trauma-informed
community and an open discussion about where these
problems are going is the first step in addressing why
people are using drugs in the first place. And, Mr. President,
you’re absolutely right. What happens in those early
years and reaching out to those families who we know
are at risk and devoting the kind of resources that we
would need to is really the first step I think in
really truncating this. Because if we don’t, what
we’re going to be doing 25, 30 years from now is having
the same discussion about why these kids are
abusing drugs, obese, and so on and so forth. So I think that that’s a
really important part and to have that sort of open
discussion about that. Because it happens
in good families, as well as in families
who are disadvantaged. But I agree with you it
happens probably more often in families that
are disadvantaged. And it perpetuates the
cycle of poverty, as well. The President: And for
those of us who are more advantaged, the
disadvantaged communities create the markets that
then seep into the more advantaged
communities, right? So the reason we have a fire
department is because if your neighbor’s house
is burning down, you don’t want to just leave
it to the neighbor to figure out whether or not he can
afford to put out the fire. You have an interest in
making sure that fire gets put out before it
burns your house. Well, the same is
true with drugs. That child who is poor,
you may think, well, I don’t have to
worry about that kid. That’s not my kid. My kid is going to be okay. But if you start seeing more
and more kids who are more and more involved
in the drug trade, over time that migrates
into every community. And that’s part of the
reason why we got to care about every kid out here
and make sure they’re vulnerable. Chief. Chief Webster: And if I can
add also on that issue to the question, that Handle
With Care Program — Ruthlawn Elementary is — I
don’t believe — it’s not in the city of Charleston. But the Handle With Care is
about to go statewide if it hasn’t. But the Handle With Care
Program will fix some of those issues. I know we’re talking about
addiction and maybe some others that are
born with addiction. Well, the Handle With
Care may not fix that, but it will at least alert
the proper authorities that child is struggling because
of some trauma or substance abuse in the home. The President: I think it’s
a really smart program. I got to tell you, before
I came down I hadn’t heard about it. And I’d really like to
see us advertise this more across the country and adopt
this as a best practice. (applause) Mr. Botticelli:
I want to thank everyone for coming today. And I want to particularly
thank our incredible panel here — been sharing
their experience, but I think also
giving us some ideas. And your innovation I
think can really help spur replication around
the country. So I really want to
thank you for doing that. And just for
closing comments, I’ll ask the President
to say a few things. The President: Well, I’ve
been talking too much. I want to say three things. One is we’re just talking
about the Handle With Care Program and the gentleman
here talked about his daughters’ lives being
saved by an EMT and police officers on the spot. Our law enforcement officers
sometimes get a lot of attention when
something bad happens. They don’t get enough
attention every single day when they’re out
there saving lives, doing the right thing,
looking out for people. And when I’ve talked
to law enforcement, there is an incredible sense
of compassion and empathy. And most folks aren’t in
there just to try to be hardnosed. Most of the time, they’re
just trying to help folks. And so, number one,
they deserve our thanks. But number two, the more
we’re supporting innovative policing that isn’t
just thinking, my job is to clean up a
mess after it happens, but rather, I’m part of the
community and I need to be part of preventing crime and
stuff from happening in the first place — I think
we have to encourage that mindset in a lot
of law enforcement. I’m really proud of them, so
they deserve some applause for that. (applause) Second thing
I want to emphasize, we live in a time when our
politics gets so polarized. We got talk radio and
we got the Internet. And it seems
like every year, sort of the rhetoric
ratchets up about how this party is destroying
the country, or those folks
are unpatriotic, or they’re evil,
or what have you. And I am deeply encouraged
by the fact that on this issue, we’re seeing
bipartisanship and we haven’t seen some
of that rhetoric. And I hope that that
continues because that’s how we’ll solve this problem. And the elected
officials who are here, they represent I think
that best tradition. And I just want to
commend them for that, because that’s how we’ll be
able to get stuff done — both at the congressional
level and at the state and local levels, as well. And then, finally, I just
want to once again thank Cary, the parents who
we heard from here. We are just so grateful that
you’re willing to share your story. It will save lives. And we want you to know that
you’re in our thoughts and prayers. And we want to just give you
all the encouragement in the world. But just as importantly,
or more importantly, we want to give your
children encouragement, because they got great
parents and these things could happen to any of us,
but we want them to know that we love them and
are looking out for them, as well. Thank you, everybody. (applause)

Danny Hutson

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