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 17:33:33 -0700
List-Id: <speechdrafts.hillaryclinton.com>

Hi all -

I am hearing separately that even with this change that the screenings
could be misconstrued and likely more trouble than they are worth. Let's
kill it and I'll revisit it as a good policy idea on the other side of this
election but not one for campaign fodder.

Here is my suggestion for four full points:

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 our mental health parity laws are fully enforced so
that insurance practices are not a barrier to substance abuse treatment;
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.

Does this work for everyone?

Thanks,
Ann

On Sun, Aug 16, 2015 at 4:58 PM, Ann O'Leary <[email-masked]>
wrote:

> 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
>

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