Someone dies from a drug overdose every 12 minutes in the U.S. That’s the startling reality for public health and safety workers striving to curb our nation’s drug use epidemic.

But how do we best reduce illicit drug use and its consequences?

“It really begins with prevention,” said Michael Botticelli, director of the White House Office of National Drug Control Policy, during a meeting this week at APHA in Washington, D.C.

Botticelli — sworn in as the nation’s top drug control policy official in February — outlined the framework of the National Drug Control Policy, which, when initially launched in 2010, set a new course supporting a shift from law enforcement to a public health approach. The policy calls for prevention through education, expanded access to treatment, reform of our criminal justice system and support for Americans in recovery.

Michael Botticelli

New Director of National Drug Control Policy Michael Botticelli speaks with members of the APHA Alcohol, Tobacco and Other Drugs Section during its midyear meeting in Washington, D.C. Photo by Natalie McGill

“Substance use disorders are diseases of early onset,” said Botticelli during his meeting with members of APHA’s Alcohol, Tobacco and Other Drugs Section during its midyear meeting. He pointed to an escalation of drug use during the teen years that marks a critical period for education around the risks associated with drug use.

A growing concern is the rise of drug poisoning as the major cause of death from injury in the U.S. According to the Centers for Disease Control and Prevention, drug overdose fatality rates have more than doubled from 1999-2013 and now eclipse the number of deaths from motor vehicle crashes.

“We’re facing one of the largest and most significant epidemics since HIV/AIDS,” said Botticelli.

While deaths from heroin use are up sharply over the last several years, fatalities from prescription drug abuse remain a much larger concern.

Botticelli said most misusers of pain medications get their drugs from family members or friends who had been prescribed the medications. Many others get their drugs prescribed by their own health care providers who may be unaware of the risk for abuse.

Regardless of the source, the supply of opioid pain relievers is clearly overwhelming the clinical need, he argued.

“We want to make sure pain is adequately treated” but there’s just not that much pain in the U.S., Botticelli said.

There is a direct correlation, he noted, between morbidity and mortality and prescribing behaviors.

The good news is that data show that state prescription drug monitoring programs and pain clinic regulations are working.

Florida, for instance, began regulating pain clinics in 2010 and stopped health care providers from dispensing prescription painkillers from their offices. Two years later, the state saw a more than 50 percent decline in overdose deaths from oxycodone.

Botticelli underscored the importance of collaboration between the public health and safety communities and said there’s a “key role” for APHA to play in helping address our drug use epidemic.

“We’re eager to help support these efforts however we can,” said Andre Stanley, chair of APHA’s ATOD Section. “We’re grateful to Director Botticelli for meeting with us this week and we look forward to continuing our work together to reduce the toll of drug abuse in our communities.”