Heroin epidemic gets attention in Washington and on the campaign trail

The number of women fighting heroin addiction is on the rise. The low cost of the drug is making it hard for officials to get a handle on the problem. Dr. Holly Phillips and Dr. Tara Narula join “CBS This Morning: Saturday” to discuss the latest health headlines.

There's no question the nation is facing a troubling rise in heroin use.

The number of heroin overdose deaths nearly doubled between 2011 and 2013, the Centers for Disease Control and Prevention reported earlier this month. In 2013 more than 8,200 people died from the narcotic.

The problem seems to have caught some political leaders by surprise. "I have to tell you, before I went to Iowa last week I wasn't aware of the depth of feeling people had about substance abuse issues," Democratic presidential candidate Hillary Clinton said in April, promising to make the "quiet epidemic" of substance abuse a major part of her campaign.

Since then, Clinton has talked repeatedly about substance abuse issues and heroin in particular, as have other presidential candidates, members of Congress from both parties, members of the Obama administration and state and local leaders. Several politicians see a role for criminal sentencing reform -- an issue that was already gaining steam in Washington -- in stemming the epidemic. Here's a look at how Washington and a selection of 2016 candidates are responding to the problem.

Obama administration: A comprehensive approach

The Centers for Disease Control has issued a strong warning about the "dramatic rise" of heroin use in the United States. Dr. Debra Houry of the CDC joins CBSN to discuss.

"The overall goal is that this has to be a comprehensive response," Michael Botticelli, director of the White House Office of National Drug Policy Center, told a subpanel of the House Judiciary Committee on Tuesday.

A large part of that comprehensive response includes stemming the problem at its source -- the over-use of prescription painkillers. The administration is taking steps to ensure that doctors do not over-prescribe opioid painkillers, which are closely linked to the increased use in heroin. It's also getting unused painkillers off the streets.

While it works with medical professionals and law enforcement on those efforts, the administration is also funding 680 community coalitions as part of its Drug-Free Communities Support Program. By working with local youth, parents, businesses, religious groups and other local leaders, the administration aims to improve general awareness about the dangers of opioid use.

Federal officials are also partnering with state leaders to increase access to naloxone, an emergency opioid overdose reversal medication, and to promote Good Samaritan laws and other measures that can help save lives.

"Everyone has a role here," Botticelli said.

Congress: Less focus on incarceration

Rep. Jim Sensenbrenner, R-Wisconsin, has introduced the Comprehensive Addiction and Recovery Act and the Safe Justice Act.

At a time when Democrats and Republicans disagree on just about everything, there's a growing consensus on Capitol Hill around the issue of criminal justice reform.

Rep. Jim Sensenbrenner of Wisconsin, one of the leaders on this issue, has co-sponsored the Safe Justice Act. The legislation would, among other things, increase the use of evidence-based sentencing alternatives like probation and reform mandatory minimum sentencing.

Additionally, his bill the Comprehensive Addiction and Recovery Act takes a number of steps to address the heroin problem, such as making grants available for local law enforcement training in the use of naloxone.

"This isn't a crisis we can simply incarcerate ourselves out of," Sensenbrenner said at a Tuesday hearing.

While there's bipartisan agreement that mandatory minimum sentencing for drug offenses should be scaled back, one lawmaker -- Rep. Trey Gowdy, R-South Carolina -- suggested that heroin should at least trigger the same level of incarceration as other drugs.

"Why can you go to prison for five years for 112 dosage units of crack cocaine but 3,000 [units] of heroin is what it takes to trigger" mandatory minimums, he asked at Tuesday's hearing. "That just seems absurd to me."

Rand Paul: A consistent advocate for reform

Republican presidential candidate U.S. Sen. Rand Paul speaks during a campaign stop at an Embassy Suites hotel on June 29, 2015 in Las Vegas, Nevada. Ethan Miller, Getty Images

Sen. Rand Paul, R-Kentucky, the libertarian-leaning 2016 candidate, has long called for reforms to the criminal justice system, starting with reforms to drug laws.

Along with a handful of other Republicans and Democrats, Paul signed onto the the Smarter Sentencing Act, which would give judges more discretion in sentencing those convicted of nonviolent drug offenses. He's also co-sponsored a bill crafted to complement other sentencing reform efforts, called the Redeem Act (the "Record Expungement Designed to Enhance Employment" Act) to reduce recidivism.

President Obama gave Paul a shout out for his work on criminal justice reform at the NAACP convention earlier this month. "To his credit, he's been consistent on this," Mr. Obama told the crowd.

Hillary Clinton: Addressing a "quiet epidemic"

Democratic presidential candidate Hillary Rodham Clinton speaks during a campaign event, Sunday, July 26, 2015, at Iowa State University in Ames, Iowa. Charlie Neibergall, AP

Since officially launching her campaign in April, Clinton has spoken with voters about substance abuse -- specifically heroin -- in just about every town she's visited.

"We also have to do more on substance abuse," she said at a house party in Beaverdale, Iowa last weekend. She chastised Iowa's Republican Gov. Terry Branstad for vetoing bipartisan legislation that would have kept open two mental health facilities in the state that serve Iowans with addiction problems.

If the nation is going to address substance abuse problems, it's "going to do it working with state and local communities," Clinton said.

The candidate engaged with voters on the issue in a Facebook chat, and members of her staff have consulted with substance abuse prevention advocates in Iowa and New Hampshire, the Associated Press reported.

Chris Christie: A prosecutor pushing for treatment programs

New Jersey Gov. Chris Christie, right, hugs drug addiction patient Julie Maldonado during a visit to Newark Renaissance House, Tuesday, Dec. 16, 2014, in Newark, N.J. Christie visited the drug addiction help center as part of his season of service program. AP

New Jersey Gov. Chris Christie, a GOP 2016 candidate, made a name for himself as a prosecutor. Yet as governor and as a presidential candidate, he's advocated treatment programs over prison sentences for drug offenders.

In late April, Christie signed legislation to establish a statewide Opioid Law Enforcement Task Force and to expand drop-off locations for unused prescription drugs. A week later, he visited the Farnum Center, a drug treatment facility in Manchester, New Hampshire.

"This is a treatable problem," Christie said of substance abuse. "And we need to be talking about it and treating it like an illness, and not like some moral failure."

Donald Trump: Focus on the border

Donald Trump has used some inflammatory and hyperbolic rhetoric to describe problems at the U.S.-Mexico border: "When Mexico sends its people, they're not sending their best," he said when he officially entered the 2016 race in June. "They're sending people that have lots of problems, and they're bringing those problems to us. They're bringing drugs. They're bringing crime. They're rapists."

While clearly not all undocumented immigrants are rapists or bringing drugs into the U.S., there has been an increase in heroin coming across the border. Trump tried to clarify that in a statement he later released, saying, "The largest suppliers of heroin, cocaine and other illicit drugs are Mexican cartels that arrange to have Mexican immigrants trying to cross the borders and smuggle in the drugs."

Approximately half of the heroin now in the U.S. comes from Mexican cartels, illustrating the "market genius of the cartel," Jack Riley, acting deputy administrator for the Drug Enforcement Association (DEA), told Congress on Tuesday.

"They've seen the spread of prescription drug use, and they know at some point that availability does cease," leading to an interest in heroin, he explained.

From 2008 through 2012, there was a 232 percent increase in heroin seizures along America's Southwest border.

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