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Wednesday, February 24, 2016

U.S. Agriculture Secretary Tasked With Tackling Rural Drug Problem

U.S. Secretary of Agriculture Tom Vilsack (Left) and Secretary of Health and Human Services Sylvia Burwell (R) testify during a hearing before the House Agriculture Committee October 7, 2015 on Capitol Hill in Washington, DC. The committee held the hearing to review the development of the 2015 Dietary Guidelines for Americans. (Alex Wong/Getty Images)

U.S. Secretary of Agriculture Tom Vilsack (Left) and Secretary of Health and Human Services Sylvia Burwell (R) testify during a hearing before the House Agriculture Committee October 7, 2015 on Capitol Hill in Washington, DC. The committee held the hearing to review the development of the 2015 Dietary Guidelines for Americans. (Alex Wong/Getty Images)

U.S. Agriculture Secretary Tom Vilsack has been been tasked by President Obama with tackling heroin and opioid abuse in rural America. It turns out he has some personal experience with that problem in his family. Secretary Vilsack talks with Here & Now’s Robin Young about the U.S. Department of Agriculture (USDA) agenda for 2016.

Note: This is the first part of a two-part conversation. Part two will air tomorrow in the 1 p.m./3 p.m. Eastern hour of the show.

Interview Highlights: Sec. Tom Vilsack

What would you say the USDA agenda is?

“We like to say we’re an ‘everyday, everyway’ USDA. The reality is we touch American lives every single day, whether you live in rural communities or inner city, we have an impact on your life. From food safety to access to food to helping our farmers and ranchers produce the food to making sure our children in schools have healthy lunches and breakfasts, and to make sure we have jobs that are helping families live, work and raise their families in rural areas.”

On recent food stamp legislation requiring locations that accept food stamps to have a wider range of healthier options

“The key here is to make sure that healthy choices are easy choices for folks, and the reality is that we have many areas that are serviced by convenience stores, not full-scale grocery stores. These convenience stores are places where people do in fact redeem their SNAP benefits and the reality is they ought to be willing to engage a wider variety of food products so that people who have SNAP and are basically depending on SNAP have access to stable food groups.”

What do you want more of on the shelves?

“Well we need more dairy, more breads and cereals, more fruits and vegetables, more protein options, poultry and fish, and there’s no reason why folks can’t in a convenience store operation be able to provide those basic food groups to folks so that if they indeed need, and only have access to a convenience store, that they in fact are able to have a wide variety of good, wholesome, healthy foods.”

Convenience stores are pushing back, saying it’s harder to stock perishable foods and easier to stock processed foods.

“We’re trying to address access issues. We’ve basically made our SNAP families be able to access farmers markets through providing EBT machines to 6,200 farmers markets across the United States. We’ve got a food and security nutrition initiative that’s helping to deal with the issue of ‘food deserts,’ and the reality is that a lot of these foods can, in fact, be provided. This is not a situation where it is a major change we’re proposing. We’ve done this in WIC, many of the convenience stores that are WIC-eligible have made the transition. We fully expect that when folks really think about this, and understand the purpose and intent of it, that they’ll find a way to provide more dairy products, more breads and cereals, and there’s no reason why poultry and fish cannot be provided in some way, or fruits and vegetables. It’s not an unreasonably high standard that we are asking, but I think it’s important from a standpoint of the overall health of the country.

On the push for drug screening SNAP recipients

“Eighty percent of SNAP beneficiaries are people with severe disabilities, senior citizens, moms and dads that are in the workforce, playing by the rules, and their children. The 20 percent that are not in these categories are basically required to seek employment or seek training or schooling, and if they are not involved in an employment opportunity or schooling opportunity, they can basically be limited to their benefits of three months of every 36 months. So I’m not quite sure what the problem is we’re trying to solve here, but I think it would create a stigmatization of SNAP beneficiaries and it would raise questions of whether or not there are other federal programs that people are receiving where we would require a request, and if there are not, would there be legal issues in terms of singling out SNAP beneficiaries.”

On the argument ‘why punish the mother because the father may have drug issues’

“That’s the other issue, is that these benefits are for families. If there is a person who is making a mistake in life and having a tough time and having to deal with an addiction issue, perhaps it would be better for Representative [Robert] Aderholt to figure out ways in which we could expand access to mental health services and behavioral services. Seventy-six percent of the shortages in those categories, in mental health and substance abuse, happen to be in rural America. So rather than focusing on drug testing, perhaps we should focus on expanding access to services so that people who do have problems and challenges can overcome them.”

As the child of an alcoholic, what do you bring to this discussion on substance abuse?

“A commitment to try and move the dial. Opioid abuse is rampant, tragically and unfortunately. We’ve had a 300 percent increase in the prescriptions of painkillers issued to Americans even though the level of pain suffered by Americans has not substantially increased in the last 15 years. Over 47,000 people died as the result of opioid abuse or heroin, and unfortunately it disproportionately impacts and affects rural America. The reality is, in many cases, people feel isolated in rural America. They feel, in terms of self-reliance that they can’t admit or acknowledge that they’ve got a problem, and there aren’t services to basically provide them with assistance and help, and so the president is deeply concerned with the fact that we have a rising mortality rate among white males in rural America and has asked me to do something about it, and we’re gonna bring a focus to this, we’re going to track results, We’re gonna look at ways we can increase access to drugs that will help to reverse an abuse situation. We’re going to have better trained and more trained physicians that can provide medication-assisted treatments. We’re going to try and look at ways in which we can creatively use our resources to expand behavioral services, either by having brick and mortar facilities constructed or by having telemedicine, through broadband provide access to experts and professionals.

“My mother is a great example. She certainly suffered, but she survived and ultimately succeeded. But, she didn’t succeed alone, she had a lot of help. The key here is to make sure when the person makes the decision and is in a position to turn their life around, that there is plenty of help and assistance to make sure that that works.”

You seem to have come out of your experience with as sympathetic view, that this is a disease and these people need help.

“Well, I feel very badly even today – my mom has been gone for quite some time – that I didn’t have the understanding at the time that this was not a character flaw on her part, that this was a disease. So I was quite judgmental as a young person. I probably put my mom through additional levels of pain by the fact that I distrusted her and was very upset with her. It took me a while to realize that what she did was truly remarkable, that it is physiological, that it is a disease and it needs to be treated as such. It’s no different from cancer or heart condition; we have sympathy and we have great fondness and admiration for people who survive cancer, but for some reason the issues of mental illness or substance abuse are treated differently out in the countryside and we need to change that mindset and I think once we change that mindset then the services and the support are gonna be there and we’re going to see fewer people essentially not survive. We’re going to see fewer deaths and we’re going to perhaps see a much more engaged community, and I think that’s what the president is interested in making happen in the next nine to 10 months and that’s something I’m going to be focused on as well.”

It’s funny how that works, you get to put your personal background to use.

“Well, I have a very close friend, probably my best friend who I’ve known for 60 years, whose son passed away from a heroin overdose, so I have been reeducated about the pain of loss watching him deal with the loss of his son. It’s real, and it’s real for so many Americans and that’s the other thing, I think there’s hardly any American I meet that doesn’t have some connection, to a relative, a friend or even themselves who has struggled with this.”

Guest


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Robin and Jeremy

Robin Young and Jeremy Hobson host Here & Now, a live two-hour production of NPR and WBUR Boston.

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