Subject: Re: In review: substance abuse op-ed
From: "Ann O'Leary" <[email-masked]>
To: Kristina Costa <[email-masked]>
Cc: Nick Merrill <[email-masked]>, Jesse Ferguson <[email-masked]>, Mandy Grunwald <[email-masked]>, Karen Finney <[email-masked]>, Joel Benenson <[email-masked]>, Tony Carrk <[email-masked]>, Speech Drafts <[email-masked]>, Ian Sams <[email-masked]>, Dan Schwerin <[email-masked]>
Date: Sun, 16 Aug 2015 16:58:09 -0700
List-Id: <speechdrafts.hillaryclinton.com>

Hi all -

Sorry I was out of pocket for a few hours.  On a flight now to raise $$ for
all of us in Oklahoma - the things we do!!

Anyhow, here is the deal:

(1) The American Academy of Pediatrics came out with a strong policy
statement in 2011
<https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Recommends-Substance-Abuse-Screening-as-Part-of-Routine-Adolescent-Care.aspx>
that every child/teenager should be screened for substance abuse disorders
when they visit the doctor for their annual child check up or for an accute
care visit in which it might be suspected.  HRC has a long history of
working with AAP and supporting their efforts to do more screenings.  When
she was First Lady, she worked on the Newborn Hearing Screening to make
sure all babies get hearing screenings, and in the last several years she
has pushed for and supported the AAP's effort to screen young kids for
symptoms of "toxic stress."  This is not "mandatory," but it is part of
prevention and wellness and it is about supporting the AAP in making this
happen by raising awareness, making sure pediatricians get reimbursed for
their time in doing these screenings, etc.  I have tried to clarify with
edits to the speech, pasted below and attached.

(2) On Mandy's question about mental health parity, I have added a line.

(3) On Karen's question of whether we reached out to urban leaders, we
talked to a number of policy experts who serve urban communities. Maya is
going to work with political to be sure we do political outreach to leaders
in next 48 hours.

(4) On Karen's suggestion, that she alludes to problems in her own family -
I have modified accordingly.

(5) On Nick's question about specialized care, we are good with it as
Kristina noted - but let me know if you have further concerns.

I am also attaching our final fact sheet.  If all are good, we should get
her this draft op-ed together with the fact sheet.  Let me know if you have
more questions or concerns.

Thanks,
Ann

*DRAFT substance abuse op-ed*

WC: 822 words

I was on my first trip to New Hampshire this spring, in a Keene bakery,
when a retired doctor spoke up. I had just announced I was running for
president, and I had traveled to Iowa and New Hampshire to hear directly
from voters about their concerns, their hopes, and their vision for the
future. He said his biggest worry was the rising tide of heroin addiction
in the state, the result of a wave of prescription drug abuse. He said
hospitals were seeing more babies born addicted, that police officers were
responding to more overdoses, that families were being torn apart.

To be candid, I didn’t expect what came next. In several states, this issue
crept up again and again – from so many people, from all walks of life, in
small towns and big cities.

In Iowa, from Davenport to Council Bluffs, people spoke to me about meth
and prescription drugs, and scores of lives upended. In South Carolina, a
lawyer spoke movingly about the holes in the community left by generations
of black men who ended up imprisoned for non-violent drug offenses rather
than getting the treatment they needed.

These stories shine light on some harrowing statistics. Nearly 23 million
Americans suffer from addiction, but in 2014, only 2.5 million were able to
receive treatment at a specialized facility. Fifty-two million Americans
over the age of 12 have abused prescription drugs, including one in four
teenagers. In 2014, more Americans died from overdoses than car crashes.

Enough is enough. It’s time we recognize as a nation that we have a quiet
epidemic on our hands. Plain and simple, drug addiction is a disease, not a
moral failing—and we must treat it as such.

It’s time we recognize as a nation that there are gaps in our health care
system that allow too many sufferers to go without care—and invest
substantially more in prevention and treatment.

It’s time we recognize as a nation that our state and federal prisons,
where 65 percent of inmates meet the medical criteria for substance use
disorders, are no substitute for drug treatment—and reform our criminal
justice system.

That’s why I’m releasing a comprehensive strategy [LINK] to confront the
drug addiction crisis head-on. My plan sets four goals: first, ensuring
every American family has access to affordable and effective
treatments; second,
ensuring that we work with pediatricians to be sure that every child and
teenager is educated about and screened for substance use disorders as part
of their annual doctor’s visit, just as we do for hearing, eyesight,
developmental delays and so much more; third, ensuring all first responders
have access to naloxone, which stops overdoses from becoming fatal; and
fourth, requiring that all health-care providers receive training in
recognizing substance use disorders and consult a prescription drug
monitoring program before providing opiates.

Achieving these goals won’t be easy. It’s going to take real commitment
from all corners—law enforcement, doctors, insurance companies, schools,
and governments. That’s why my plan starts by increasing funding for the
Substance Abuse Prevention and Treatment Block Grant by 25 percent, so
states and localities have more resources to work with, and changing rules
that arbitrarily limit how many patients can be treated with medication
assisted treatment, a proven intervention for opiate addiction. I will also
direct the federal government to re-evaluate Medicare and Medicaid payment
practices, to remove obstacles to reimbursement for patients seeking help and
promote greater coordination of care. And I will make sure that our mental
health parity laws are fully enforced so that insurance practices are not a
barrier to substance abuse treatment.

But we can't stop there. As President, I will do everything I can to
partner with states and communities across America to meet the four
goals—treatment, prevention, overdose intervention, and improved prescriber
practices. We’ll ask states to design ambitious plans for tackling these
four goals using the programs that make most sense for their citizens’
needs and challenges. In return for strong plans to address the substance
abuse crisis, the federal government will draw on a new $5 billion fund to
help states meet their goals.

Every town I’ve visited so far in this campaign has stories of families
upended by drug addiction. But across the country, I’ve also heard about
second chances. The young mother who overcame addictions to alcohol and
heroin so her son would never see her with a drink or a drug in her hand.
The man who served 11 years in prison who is now serving others through a
prison ministry.

They all say the same thing: no matter how much time has passed, no matter
how different their lives are today, they’re all still in recovery. It’s a
process—one that began when a family member, a friend, a doctor, a police
officer extended a hand to help. As one New Hampshire woman said, “We're
not bad people trying to get good, we're sick people who deserve to get
well.”

There are 23 million Americans suffering from addiction. There are untold
millions more. No one is untouched – we all have family and friends who are
affected. We can’t afford to stay on the sidelines any longer—because when
families are strong, America is strong. Through improved treatment,
prevention, and training, we can end this quiet epidemic once and for all.

On Sun, Aug 16, 2015 at 3:57 PM, Kristina Costa <[email-masked]>
wrote:

> On the screening point, will let policy get into details, but it's the
> major pillar of the 'prevention' goal. Would folks be more comfortable if
> it said something like [CAPS=ADDITION]  "ensuring every child and teenager
> is annually screened for substance use DISORDERS, JUST AS THEY ARE ALREADY
> SCREENED FOR OTHER ILLNESSES"?
>
> schools and doctors regularly screen for all sorts of diseases, and
> substance abuse screening /= random drug testing.
>
> On the "specialized facilities," the stat comes from the NIH's National
> Institute on Drug Abuse and includes all facilities licensed or certified
> by state substance abuse agencies to provide treatment. So think it's easy
> to answer Politifact when they try to get cute.
>
> + Ann, per Maya's add
>
>
> On Sun, Aug 16, 2015 at 6:45 PM, Nick Merrill <[email-masked]
> > wrote:
>
>> I'm piling on at this point, but without knowing the background or the
>> particulars, the mandatory testing piece is troubling to me.  Not to
>> mention I probably wouldn't have passed at times in my younger
>> years...I bet I'm not the only one.*
>>
>> And on the statistic about 2.5 million people receiving treatment at a
>> "specialized facility," can someone explain what that means?  Just
>> want to make sure we're not trying to be too cute, that there aren't
>> perfectly viable treatment alternatives that lie outside of the term.
>> Our friends from PolitiFact as always in the back of my mind.
>>
>>
>> *(Joel?)
>>
>> On Aug 16, 2015, at 6:13 PM, Jesse Ferguson
>> <[email-masked]> wrote:
>>
>> Flagging - goal had been to get this to HRC on Saturday night but it has
>> been held till tonight as the other elements of the rollout (video, etc.)
>> are debated.
>>
>> AKA - ideally would like to send it in tonight for her review so we can
>> have final on Monday for Wednesday AM placement.
>>
>> -----Original Message-----
>> From: Mandy Grunwald [mailto:[email-masked]]
>> Sent: Sunday, August 16, 2015 5:47 PM
>> To: Karen Finney <[email-masked]>
>> Cc: Joel Benenson <[email-masked]>; Kristina Costa
>> <[email-masked]>; Tony Carrk <[email-masked]>;
>> Speech Drafts <[email-masked]>; Ian Sams
>> <[email-masked]>; Dan Schwerin <[email-masked]>;
>> Jesse Ferguson <[email-masked]>
>> Subject: Re: In review: substance abuse op-ed
>>
>>
>> And one more thing.  Should we mention the growing problem of synthetics?
>>
>> Mandy Grunwald
>> Grunwald Communications
>> 202 973-9400
>>
>>
>> >> On Aug 16, 2015, at 5:18 PM, Karen Finney <[email-masked]>
>> > wrote:
>> >
>> > Last question/comment I promise - did we engage urban leaders in the
>> > development of the plan?
>> >
>> > Sent from my iPhone
>> >
>> >> On Aug 16, 2015, at 5:15 PM, Joel Benenson <[email-masked]>
>> wrote:
>> >>
>> >> Democrats are going to have a field day with it. It is also probably
>> unconstitutional violation of 4th amendment, isn't it?
>> >>
>> >> Sent from my iPad
>> >>
>> >>> On Aug 16, 2015, at 3:10 PM, Karen Finney <[email-masked]
>> >
>> wrote:
>> >>>
>> >>> The only thing that stood out to me was annual drug screening for
>> >>> children and teenagers, could see the GOP having a field day. Can we
>> >>> explain that one a little more?
>> >>>
>> >>> Sent from my iPhone
>> >>>
>> >>>> On Aug 15, 2015, at 6:42 PM, Kristina Costa
>> <[email-masked]> wrote:
>> >>>>
>> >>>> Folks --
>> >>>>
>> >>>> At Dan's request, passing along  a draft HRC op-ed to accompany the
>> substance abuse prevention initiative fact sheet rolling out midweek.
>> Maya, Ann, Sara, Zach, and Ian have all reviewed, edited, and commented.
>> It's now with Tony/research for a fact-check before going up in the book.
>> >>>>
>> >>>> Thanks,
>> >>>>
>> >>>> Kristina
>> >>>> <08.14 Substance Abuse Op-Ed ALL EDITS CLEAN.docx>
>>
>
>

-- 
Ann O'Leary
Senior Policy Advisor
Hillary for America
Cell: 510-717-5518