There is one thing Hillary Clinton, the former first lady, senator and secretary of state, admits she has learned running for president: a heroin and painkiller epidemic is ravaging US communities, and it's getting worse. Her Republican rivals know it too. Several on the 2016 campaign trail have opened up about their personal connections to overdose tragedies. A retired doctor came to see Clinton in the spring in Keene, New Hampshire imploring her to do something about heroin, which has replaced opioid prescription analgesics as the narcotic of choice in some US cities and rural areas. Clinton promised to bring the problem "out of the shadows."
In September the Democratic frontrunner proposed a $10 billion plan to help the 23 million Americans who suffer from addiction or substance abuse, only 10 percent of whom currently get treatment. Over the past seven years, more Americans have died from overdoses than in traffic accidents, official statistics show. Overdose deaths topped 46,000 in 2013. Republican candidates have denounced the US health care system deficiencies that allow many who need treatment to slip through the cracks, and they have told their own stories of family tragedies to drive the point home.
New Jersey Governor Chris Christie cited a close friend from law school -- successful, handsome, rich -- who ended up addicted to painkillers after suffering a back injury. Eight years of hell ensued: the man lost his wife, job and home, and was eventually found dead in a motel room next to empty bottles of vodka and Percocet, a prescription painkiller which is a popular target for drug traffickers. A video of Christie's emotional plea has gone viral, drawing nearly seven million views online.
Fellow candidate Carly Fiorina, the former chief executive of Hewlett-Packard, also made a personal plea for expanded treatment for addicts, recalling her stepdaughter's 2009 death after years of struggles with alcohol and prescription pills. Candidate solutions include a recognition that addiction is a chronic mental illness requiring longterm treatment. Republican Jeb Bush has also spoken out. His daughter Noelle was arrested for prescription fraud in 2002 -- while he was Florida governor and brother George W. Bush was president. Senator Ted Cruz is among the most skilled orators in the race, but on Thursday he struggled when describing how his half-sister, whom he once dragged out of a crack house, succumbed to drug and alcohol addiction.
With prisons filling up with addicts, and little or no treatment options available to them, many argue for alternatives to incarceration. Texas offers such rehabilitation programs, while growing numbers of law enforcement officers nationwide are equipped with naloxone, an overdose reversal drug. Republican Ohio Governor John Kasich, also a presidential hopeful, signed emergency legislation in July making the anti-overdose tool available without a prescription, though critics say that fails to address the underlying problems.
The epidemic is particularly devastating in rural and poor areas.
"Prescription drugs become a gateway to heroin," President Barack Obama said during an October visit to West Virginia, the state with the highest rate of overdose deaths. He stressed that his health care law forces insurance companies to cover addiction treatment, but experts say the requirement is slow to take hold.
