Julián Castro Presidency Would Make Sure Patients Who Actually Need Opioids Could Get Them

Julián Castro, the former Secretary of Housing and Urban Development and current presidential candidate, said his presidency would be careful not to be "overzealous" in regulating opioid prescriptions "in a way that hurts people who actually need medication."

The interview between Castro and the Iowa Harm Reduction Coalition (IHRC) came amid reports that patients are being removed from their opioid medication at rates that surpass federal guidelines, leaving many with chronic pain and crippling withdrawal symptoms.

In their talk a week ago, Sarah Ziegenhorn, the founder and executive director of IHRC, said that many people suggest going after pharmaceutical companies and providers who push their addictive medication on patients in order to prevent issues with substance misuse.

At the same time, "deaths of despair," or those due related to alcohol, drug-use and suicide are increasing in general, whether prescription pills are involved or not, according to Ziegenhorn.

"[The] overdose crisis is located in this broader, social, cultural and economic moment in which the root causes are more complicated than just a pharmaceutical company pushing its drugs or a doctor prescribing too many pain medications.

"So I'm curious in your plan and in your presidency, how would you use the power of the federal government to address those root causes and those socioeconomic drivers of substance use and mental health more broadly," Zigenhorn asked.

Castro Cognizant of "Overzealous" Drug Policies
Democratic presidential candidate, former U.S. Housing and Urban Development Secretary Julian Castro speaks during the Nevada Democrats' "First in the West" event at Bellagio Resort & Casino on November 17, 2019 in Las Vegas, Nevada. David Becker/Getty Images

Castro's "First Chance Plan" would expand the juvenile system to age 21, ensure free lunch for in-need students and provide rent tax credits for the middle class, in an "ambitious" effort to address criminal justice reform before people become incarcerated, according to Castro's campaign materials.

It also focuses on preventing dependence on drugs through a "public health approach," but doesn't suggest specific initiatives.

Castro argued that connecting all of these dots—better health care, housing and educational opportunities—is necessary to give people a real shot at success and prevent drug misuse. At the same time, those who need treatment from a place like IHRC, which provides social services to those who use or inject drugs, should also receive it, he said.

"That part I think starts with changing our federal laws and also getting serious about a health care system that can meet those needs. And then also—when it comes to the issue of prescriptions, I hear that. I also hear from people that—we want to make sure that if somebody actually needs medication or a certain drug that they're able to get that, too. And so I am mindful of not being overzealous in way that hurts people who actually need certain medication," he concluded.


Kate Nicholson, a civil rights attorney and advocate for chronic pain patients, said the issue of legitimate patients being denied opioid medication is largely invisible on a national scale—in part because treating pain has been blamed for spawning the opioid crisis.

"The problem in my view was not that we treated pain, which remains under-treated when daily pain affects one in six Americans...but in how we went about doing so. We opted for simple solutions and too many people were given opioids when it may not have been the best option for them," Nicholson said in a statement to Newsweek.