By David Gutman

As President Barack Obama sat in a small community center gym on Charleston's East End on Wednesday, Cary Dixon told him what opioid addiction has meant to her family.

"We dread the next phone call," said Dixon, whose son is in jail, battling his addiction. "We neglect our marriages. We neglect other children in our homes, who are thriving, because all our attention is focused on addiction and substance abuse. We rest better at night when our loved ones are incarcerated."

Dixon, of Huntington, leads a support group for parents with children battling addiction.

Obama said her story made him think of his own daughters.

"They're wonderful girls, but they're teenagers. They do some," Obama paused, "things."

Obama referenced his book, in which he wrote about his drug use as a young man.

"I did some," again Obama paused for emphasis, "stuff."

"What I think about is, 'There but for the grace of God . . . ' " the president said.

Obama came to Charleston to talk about opioids, including heroin and prescription painkillers, and ways to deal with the epidemic of drug abuse across West Virginia and the rest of the nation.

The president led the discussion that was focused on the scale and the possible solutions to the nation's opioid epidemic, which took off in the mid-1990s and has grown rapidly since then.

He said that, in contrast to a previous tough-on-crime mindset, officials need to focus on strategies to reduce the demand side of the problem -- prevention and treatment.

"This is an illness, and we have to treat it as such," Obama said, to applause. "For a long time, I think, treatment was seen as a second-class citizen to interdiction and arrest."

The administration is not backing off on aggressive law enforcement, Obama said, just that, for far too long, prevention and treatment have been undervalued.

He talked about how addiction affects people all over the country, of all races and income levels.

"This is happening to families everywhere, with great parents who love their kids," the president said.

Obama also said, though, that race and income do play a role in making communities more vulnerable, and he touched on the connection between West Virginia's troubled economy and its spot leading the nation in overdose deaths.

"Part of the reason West Virginia probably has more cases partly has to do with the economics that have been taking place in some of these communities, which is why it's so important for us to push on that front, as well," the president said.

There were 259 million prescriptions written for opioid painkillers in 2012, Obama said, more than enough for every adult in America to have their own bottle of pills.

"As their use has increased," he said, "so has the misuse."

More Americans die from drug overdoses than car crashes, Obama said, and most of those overdoses come from legal prescription drugs.

The solution won't come from any one source, he said, talking about the importance of better training for drug prescribers, while also certifying more doctors to prescribe opioid treatment drugs like Suboxone and expanding the use of naloxone to save the lives of people who overdose.

"We've all got a role to play," the president said. "These are our kids. It's not somebody else's kids, it's our kids; it's not somebody else's neighborhood, it's our neighborhood."

In response to a question about the dearth of opioid treatment options in West Virginia, Obama pointed to his 2016 budget -- which has no chance of being passed by Congress. Obama's budget has more than $100 million in new money for overdose prevention programs and expanding medically assisted treatment programs.

He noted that the Affordable Care Act requires insurance plans to include coverage for substance abuse treatment, the same way they do for diabetes or heart disease.

The president pointed to America's success in battling smoking as an example of how the nation can battle the opioid epidemic -- on multiple points of attack.

The adult smoking rate has consistently declined, from about 40 percent of the population in 1965 to less than 20 percent today. The youth smoking rate has plummeted in the past 15 years, from about 35 percent to 18 percent.

"Nicotine is as addictive as any of the drugs we're talking about," Obama said. "There's no reason we can't do it here, as well."

Even though cigarettes have never been outlawed, he said that, through improved education, more difficult access, restrictions on tobacco advertising and cutting tobacco industry profits, the country has achieved big results.

Obama spoke at the East End Family Resource Center, in a small gymnasium, with hand-painted backboards, to an invited audience of health and law enforcement professionals, families affected by substance abuse and Democratic lawmakers and other officials.

Joining the president and Dixon on stage were U.S. Health and Human Services Secretary Sylvia Mathews Burwell, White House director of national drug control policy Michael Botticelli, Charleston Police Chief Brent Webster and Dr. Michael Brumage, director of the Kanawha-Charleston Health Department.

Obama said he was impressed with Charleston's Handle with Care program, described by Webster, in which police officers at violent crime scenes take the name of children present and then notify the child's school so they can receive special attention or counseling the next day.

The president said he'd like to see that program advertised more around the country.

"Most people probably look at the person in the uniform and think this is the guy who's going to tell me 'more jails,' and that's not me," Webster said.

"This is such an epidemic, and you cannot arrest your way out of this mess," the chief said to huge applause.

Obama noted that criminal justice reform and battling the opioid epidemic through treatment, rather than incarceration, is one of very few areas where there is bipartisan agreement in Washington.

Gov. Earl Ray Tomblin spoke briefly before the president's arrival, touting the steps that West Virginia has taken in the past several years to try to stem the flood of opioid abuse -- increasing community based treatment and treatment in state prisons, shutting down 11 "pill mills" and expanding access to naloxone, which reverses the effects of an overdose.

"Each of us has experienced this heartbreaking epidemic, in one way or another," said Tomblin, whose brother has struggled with opioid addiction. "It can affect the richest of the rich or the poorest of the poor."

During his trip to Charleston, Obama announced two new federal policies intended to help deal with the overabundance of prescription opioids and the dearth of available treatment for opioid abuse.

The president will require federal agencies to provide training, specifically on the prescription of opioids, to doctors and nurses who work for the federal government.

While heroin use has skyrocketed in recent years, it's still a problem that starts with legal drugs found in medicine cabinets.

Four out of five new heroin users started by abusing prescription medications, Obama said.

"Much of the morbidity and the mortality associated with prescription drug and heroin abuse correlates to over-prescribing of painkillers in the United States," Botticelli said.

Federal agencies also will have to examine the health insurance plans they offer, to make sure there are no barriers that prevent people suffering from opioid abuse from accessing medically assisted treatment like Suboxone.

Botticelli said the government is using federal grants to make sure local drug court programs are offering medically assisted treatment.

Both the changes affect only federal employees and agencies, so they will not have widespread effects, but like Obama's visit, they're intended to provide an example and shine a spotlight on the opioid epidemic.

"This is something that is not a top-down-solution type of problem alone," Obama said. "This is going to have to be everybody working together

(c)2015 The Charleston Gazette (Charleston, W.Va.)