Amy is proposing a plan to combat substance use disorder and prioritize mental health, including launching new prevention and early intervention initiatives, expanding access to treatment and giving Americans a path to sustainable recovery.
Amy’s dad struggled with alcoholism and she saw the toll that substance use disorders can take on families and communities. Her dad climbed the highest mountains but also sank to the lowest valleys because of his battle with alcoholism. He had three DWIs and after the third he got real treatment and was, in his own words, “pursued by grace.” Faith, treatment, friends, family and the community of people who stood by him made all the difference.
Substance use and mental health disorders do not discriminate. Everyone knows someone who struggles. Opioid overdoses — including overdoses of prescription opioids, heroin, and synthetic opioids like fentanyl — kill more Americans than car crashes each year. Nearly half of Americans have a family member or close friend who’s been addicted to drugs. And 1 in 5 Americans experiences a mental health condition. As President, Amy will take action with a $100 billion plan so that everyone has the right — and the opportunity — to be pursued by grace and receive effective, professional treatment and help.
Prevention and Early Intervention
● Promote early intervention for mental health disorders and drug use: Amy will launch a nation-wide campaign to support prevention and early intervention strategies for people with substance use disorders, alcoholism and mental health illnesses. She will expand funding for states and localities to detect and respond to mental health conditions, including mental health programming and resources for schools and school counselors, as well as training for pediatricians and primary care physicians. She will also lead new initiatives focused on the risks of alcohol and alcohol addiction and support school and community drug early-intervention programs. While opioid use has skyrocketed, other drugs continue to wreak havoc on communities across the country. The rate of cocaine-related overdose deaths among black Americans is as high as that for opioids among white Americans. Funding for prevention and early identification of substance use disorders — including the use of cocaine and methamphetamine — will be driven by needs in the hardest hit communities.
● Launch a nationwide suicide prevention and mental health awareness campaign: Amy will increase investments in state and local suicide prevention initiatives, including a focus on veterans, farmers, LGBTQ and tribal communities. To expand the tools and data available in this fight, Amy will invest in suicide prevention programs, expanded resources and health services that address suicide among students and share information with parents, mental health research and data reporting.
● Prevent opioid addiction: Opioid addiction can begin with the use of appropriately prescribed pain medications. That’s why Amy will prevent doctor shopping by supporting the mandated use by doctors and pharmacists of prescription drug monitoring programs, which is a bill she leads in the Senate. She will also make a major investment into research and development of pain alternatives to opioids. And to build upon successful federal and local drug take-back programs, Amy will launch a national effort to create additional safe and responsible ways to dispose of unused prescription medications and controlled substances in every urban and rural community. In 2010, Amy led and passed the bipartisan bill with the first major expansion of federal drug take-back programs.
● Tackle alcoholism and prevent drunk driving: Amy will support incentives for state governments to enact ignition interlock laws for those convicted of drunk driving to help reduce repeat offenders. Since problems with alcoholism often start early, Amy will support educational initiatives that focus on the risks of alcohol as well as early identification and treatment of alcoholism.
● Expand access and increase beds for mental health, alcohol and drug treatment services: In 2017, an estimated 21 million people needed substance use treatment, but fewer than 20 percent were able to access it. Under her plan, Amy will expand access to treatment and recovery services by increasing the number of beds in mental health and substance use treatment centers, supporting public and nonprofit entities, expanding Certified Community Behavioral Health Clinics and treatment facilities,[i] investing in treatment services in the hardest hit communities and launching an aggressive national awareness campaign to combat stigma associated with seeking treatment for substance use and mental health conditions. Amy will also target increased investments in early intervention and treatment programs for drugs including cocaine and methamphetamine.
● Expand health care coverage for mental health and substance use, build a more integrated health care system, and enforce mental health parity: Mental health is as important as physical health and Amy’s plan will build a health care system that integrates mental and physical health care. She will protect mental health and substance use coverage as essential health care benefits and enforce federal laws like the Affordable Care Act and the Wellstone-Domenici Mental Health Parity Act that she helped pass to ensure health insurance companies cover all mental illnesses and substance use disorders in the same way they do physical illnesses.[ii] In the Senate, Amy introduced and passed the bipartisan Anna Westin Act, which increases awareness and early detection of eating disorders and requires insurers to cover residential treatment. As part of her plan, she will make major investments in increasing access to community-based services, telehealth and a fully integrated health system, while also making inpatient services available to more people by permanently repealing Medicaid’s “IMD Exclusion,” which prohibits Medicaid reimbursements for those receiving mental health or substance use care in facilities with more than 16 beds.
● Invest in research to develop effective substance use and mental health treatments: Research is critical to our success not only in understanding the dynamics of addiction and mental illness, but also in how to treat it. Despite significant strides in research, there are still gaps in our understanding of the interrelation between the brain and substance use disorders. Amy will make a dramatic federal investment in the National Institutes of Health for research on the impact of substance use on the brain and body and the development of safe treatments. She will also invest in public health surveillance and biomedical research to help develop the most effective substance use treatments.
● Improve training for health care professionals and address workforce shortages: Combating mental health conditions and substance use disorders requires a workforce with the training to provide the highest level of care. Amy’s plan will support improved training for mental health and substance use health professionals, including training for health care professionals to administer medication-assisted treatment (MAT). And mental health and addiction services are often lacking in rural and urban communities where accessibility, availability, affordability and acceptability may be limited. For example, 65 percent of non-metropolitan counties do not have a psychiatrist and almost half of non-metropolitan counties do not have a psychologist. Amy will expand access to mental health and substance use care, including support for clinics and community-based services, as well as technical support and telehealth services. She will also focus on recruitment, retention, training and workplace protections for the mental health and substance use health care workforce in rural areas and our hardest hit communities.
Justice, Economic Opportunity and On-going Recovery
● Prioritize mental health and substance use treatment over jail for non-violent offenders: As the former Hennepin County Attorney, Amy was committed to helping people struggling with addiction stay out of the criminal justice system. As the County Attorney, she worked to provide specialized supports and services for those with mental illnesses and severe chemical dependency by building stronger collaboration among drug court staff, probation officers, case managers and various treatment and social service providers. As President, Amy will increase federal support for drug courts, mental health courts and treatment alternatives to incarceration and expand wraparound services and regular follow-ups. In the Senate, she has advocated for expanding drug courts and reducing racial disparities in sentencing. Read more about Amy’s criminal justice reform and clemency proposal here.
● Train and equip law enforcement officers to address challenges including crisis intervention: About 1 in 10 police calls involve someone who has a mental illness, and yet many police officers do not have the training they need to handle these calls or respond in a crisis situation. Amy will work with local and state authorities to ensure that crisis intervention is a core part of law enforcement officer training, and expand crisis intervention training to public health departments, first responders and school personnel. Amy will also provide funding for state and local agencies to equip first responders with life-saving naloxone, an effort she led as one of the four original sponsors of the Comprehensive Addiction and Recovery Act. She will also direct the federal government to negotiate a discounted price for naloxone and promote law enforcement efforts to follow up with people and direct them to harm reduction services. In addition, Amy will increase access to medication-assisted treatment (MAT) in federal prisons and expand treatment in state and local prisons. She will also work with law enforcement to help stop dangerous synthetic opioids from being shipped from foreign countries to the United States.
● Provide economic and housing opportunities and support on-going recovery in communities: For those recovering from addiction, including formerly incarcerated people, a job can support recovery, provide income and a sense of purpose. Yet the unemployment rate among those who are recovering is more than twice the national rate. Amy will invest in training, employment and social services that connect people recovering from substance use disorders to housing and economic opportunity. In addition, Amy will significantly expand access to transitional or supportive housing and homeless shelters that can help people with mental health issues and prevent homelessness. She will also invest in existing and new recovery community organizations that meet the on-going needs of people as they return to work, school and their families.
To pay for her plan, Amy will hold opioid manufacturers responsible for their role in the opioid crisis. She will place a 2 cent fee on each milligram of active opioid ingredient in a prescription pain pill to be paid by the manufacturer or importer,[iii] establishing a permanent revenue stream that will be used to provide and expand access to substance use and mental health treatment. And she will make opioid manufacturers pay their fair share to fix the crisis they helped create by crafting a Master Settlement Agreement that provides money directly to the states for the cost of addiction treatment and social services. The plan will also be paid for by requiring hedge fund managers to pay their fair share of taxes on investment earnings and by ending pharmaceutical company tactics that prevent generic competitors from entering the market.