Hillary Clinton plans to tackle America’s opiate epidemic, The Huffington Post reported earlier this week.

A Clinton aide told the Huffington Post that Clinton decided to devote more time to substance abuse and mental health issues in her presidential campaign because of conversations with constituents in Iowa and New Hampshire.

According to The Hill, Clinton told two Iowa residents, “When I started running, when I started thinking about this campaign, I did not believe I would be standing in your living room talking about the drug abuse problem, the mental health problem, and the suicide problem. But I’m now convinced I have to talk about it. I have to do everything I can in this campaign to raise it, to end the stigma against talking about it."

America’s complicated relationship to opiates (drugs derived from opium, which include prescription painkillers, heroin, and other drugs. "Opioid" is often used to describe the entire family of these drugs, natural and synthetic) is explained in detail in journalist’s Sam Quinones recently released book “Dreamland: The True Tale of America’s Opiate Epidemic.” “Dreamland” covers the spread of black tar heroin through America’s heartland at the hands of the Mexican network known as the Xalisco Boys, and the rampant over-prescription of painkillers like OxyContin that helped fuel demand for heroin.

In my interview with Quinones earlier this month, Quinones addressed the often devastating nature of opiate addiction and overdose. According to Quinones, in 1999, opiate overdoses contributed to ten deaths per day—by 2012, opiate overdoses contributed to one death every half hour.

“This is tearing families apart but it is below the surface, we aren’t talking about it because it is something that is hard to deal with," Clinton said on Monday, according to The Hill. In “Dreamland,” Quinones described families he encountered that were ashamed to admit that overdose was the cause of their daughter or son’s death. Yet as opiate addiction and overdoses have become more prevalent, attitudes towards individuals with substance abuse problems are shifting. 

“Before, a lot of legislators didn’t know any addicts,” Quinones told ATTN:, discussing this gradual emergence into public consciousness. “Now they do. Now they go to church with their parents, or their son played on the same football team with the kid who just died…There’s a proximity of addiction to people who never saw it before and therefore could comfortably have attitudes of 'lock ‘em up and throw away the key.' Now those attitudes are being revised because all around them people are becoming addicted. This is changing a lot of minds."

Even while public awareness is rising, the Xalisco Boys continue to expand their market share and Drug Enforcement Agency authorities continue to bust clinics and pharmacies suspected to be illegally selling prescription drugs—an operation, according to The Associated Press, that's referred to as “Operation Pilluted.”

Hope for reform. 

Andrew Kolodny, M.D., Chief Medical Officer of Phoenix House, outlined his ideas for Clinton’s opiate epidemic strategy in The Huffington Post. Dr. Kolodny urged Clinton to use language emphasizing that most opiate-related deaths are due to addiction, rather than recreational opiate use. Dr. Kolodny also encouraged Clinton to enforce the Federal Food and Drug Cosmetic Act, which would curtail the practice of drug companies promoting high-risk drugs and to remove the existing cap on the number of buprenorphine prescriptions that physicians can issue. 

“When the opioid crisis is correctly framed as an epidemic of opioid addiction, the strategies for controlling the problem become clear -- and they are very similar to the strategies we would employ for other disease epidemics,” Dr. Kolodny wrote. “We must prevent new cases of the disease (mainly by getting the medical community, including dentists, to prescribe more cautiously) and we must see that individuals suffering from the disease are able to access effective treatment.” 

Years of rampant over-prescription of painkillers have also created a misconception that such drugs are the only possible way to manage pain, crowding out other holistic pain management programs. 

"The problem was not so much that these pills aren’t really good for some kinds of pain, they are, particularly when very judiciously prescribed and controlled, but also widespread prescribing seemed to suck all of the oxygen out of the room, in a sense," Quinones told ATTN:. "There was no room for any other approach. Insurance companies stopped funding other approaches. There are a lot of ways you can attempt to control pain, this was only one of them, but it was so dominant that no other approach was really tried. If another approach was tried, it was de-funded eventually or not reimbursed.” 

America’s opiate crisis is years in the making and an extremely important and personal issue for the many Americans who have lost loved ones to addiction. Perhaps increased awareness and commitment to reform on the part of one presidential candidate will encourage others to address the seriousness of this epidemic, and to acknowledge the importance of multi-pronged, holistic treatment of chronic pain. 

You can find out more about Clinton’s stance on issues you care about through ATTN:’s video here.

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