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Obama discusses coal, drug industry role in epidemic in exclusive interview

President Barack Obama talks with Gazette-Mail reporter David Gutman backstage at the East End Family Resource Center after Obama’s town hall on opioid abuse.

After speaking at a community discussion in Charleston on the opioid epidemic afflicting West Virgina and the nation, President Barack Obama gave an exclusive interview to the Charleston Gazette-Mail.

Obama discussed the role that the declining coal industry plays in West Virginia’s drug problem, and the role that fading industries have played in small cities and towns across America that have been hit by the opioid epidemic. The president also discussed the role of the pharmaceutical industry in helping fuel America’s 15-plus-year boom of prescription painkillers.

Here is the unedited transcript of Obama’s discussion with the Gazette-Mail’s David Gutman. The conversation took place in a backstage hallway at the East End Family Resource Center before Obama left for McLaughlin Air National Guard Base to fly back to Washington.

Obama: All right, fire away.

Gazette-Mail: Well, Mr. President, this opioid crisis has kind of affected small cities and towns across rural America particularly hard. In West Virginia, that’s cities like Oceana and Williamson that are struggling with disappearing coal jobs, but there’s cities and towns all across the country dealing with this and at the same time hollowed-out downtowns and joblessness, so I’m wondering what do you see as the future for these small cities and towns that are maybe seeing major industries disappear, in terms of both beating this drug problem but also turning around local economies that kind of help fuel the drug problem?

Obama: Well, as you heard me say on stage, this substance abuse and addiction problem cuts across communities and demographics, but if a community is weakened, then it just has less resistance to this kind of epidemic.

And, you know, one of the things that we are really emphasizing is strategies to help local communities come up with a plan to diversify their economies, to invest in the kinds of strategies that are going to bring new businesses into their communities, to help retrain workers for the industries of the future rather than the industries of the past.

And, you know, we’ve seen successes around the country with concentrated effort, but it is particularly acute in a place like West Virginia, where you’ve got a lot of communities that were reliant on one particular industry, like coal, or one particular factory.

And part of our goal here is to help community leaders re-imagine new industries coming in that are more on the growth side. In my budget, we’ve got a program called POWER Plus and the whole purpose of it would be to give additional dollars to communities that have been adversely impacted by the decline of coal jobs, so that they can start looking at health care, high-tech, clean energy jobs.

There’s been a resurgence in manufacturing in America, how do we start looking at some of the more streamlined, high-tech manufacturing that’s taking place and get it into places like this?

But it’s going to be a long process. You know the decline in some of these local, rural economies didn’t happen overnight. Its resurgence will not happen overnight, but it can happen.

In the meantime we’ve got to make sure that our kids aren’t getting exposed to the kinds of debilitating drug problems that obviously are personal tragedies for them and their families but are also taking away a valuable resource for economic development.

Gazette-Mail: Yes sir. Time for one more?

Obama: Yeah, absolutely.

Gazette-Mail: You mentioned how there’s 259 million prescriptions [for opioids, per year in the U.S.], it’s enough for a bottle for every adult. And I think experts agree that part of this crisis was fueled by the marketing and merchandising of these drugs to doctors.

We’re one of very few countries where the government plays no role in setting drug prices, we’re one of only two countries where non-narcotic prescription drugs can be advertised on television.

So, why, A, is your DEA allowing drug companies to produce three times as many opioid pills as say 15 years ago, and more broadly, what can the government do to make sure that the pharmaceutical industry is focused on public health and not maximizing profits potentially at the expense of our citizens?

Obama: Well, you know, the role of the drug industry in the United States is unique. We have the most innovative, most successful and most beneficial drug industry in the world. Millions of lives are saved or enhanced every year because of the research and development and commercialization of new drugs here in the United States.

And other countries don’t have that same industry. So they kind of free ride off it, they can charge lower prices because they don’t do any of the front-end work, they just take what we produce.

So we should be proud of our drug industry.

What is also true is that too often our drug companies are making money not off innovation but off market control, advertising, passing on costs to consumers through the insurance system and that’s why we need better regulation than we currently have.

And we’ve been working with the FDA and other agencies to say, on the one hand, let’s streamline the process for getting innovative drugs to market, let’s make sure that companies are getting a fair return, let’s work with other countries to make sure they’re not stealing patents and intellectual property that our drug company’s produce.

We want our drug companies to be successful.

But, let’s also make sure that they can’t just charge 50, 100, 200 times what it costs them to make a drug, just for the sake of profit.

When it comes to opioids, there is a legitimate, narrow use for them in pain management.

People with severe pain, they’ve gone through, say back surgery, there may not be a better option for them to be able to manage that pain as they’re going through recovery. But it has to be monitored.

And it has to be carefully controlled and unfortunately not only do the pharmaceutical companies have very little restraint in terms of pushing their product out of the market, but what we’ve discovered is that the medical community — not out of malice, but I think out of carelessness — tends to over-prescribe or not manage their patients’ pain medications as carefully as they should.

One interesting statistic: For the thousands of hours that medical students and residents put in, in order to become a certified doctor, they spend about 11 hours, their entire academic career, studying pain medication.

Well, what that really means is that they may be a great surgeon, they may be a great internal medicine specialist, but if the patient comes in and says ‘I’m hurting,’ they’re just writing a prescription without really figuring out what’s best for that patient, and how do we avoid addiction.

So we’re going to have to work with the medical community, nurses, pharmacists, to restrict the easy availability of these opioids. And we’re also going to have to educate patients and consumers and families to make sure that they’re not holding on to stuff in medicine cabinets that could end up being a gateway for real problems for their kids.

All right? Thank you, man.

Reach David Gutman at david.gutman@wvgazettemail.com, 304-348-5119 or follow @davidlgutman on Twitter.