Addiction treatment is not enough

 The President’s Commission on Combating Drug Addiction and the Opioid Crisis heard a consistent message from families, advocates and experts at its first meeting on June 16: now is a terrible time to throw millions of people off of health coverage. That’s because coverage under the Affordable Care Act, including the Medicaid expansion, is essential for access to life saving addiction treatment. Republican Senators from hard hit states including Ohio and West Virginia are now trying to reconcile their party’s ideology with the health of millions of their constituents.

The obvious approach would be to protect the Medicaid expansion. An alternative approach is now emerging: Roll back Medicaid, but set aside $45 billion or more over 10 years in special funding for opioid addiction treatment. 

I am a doctor who specializes in the care of patients with opioid addiction. Even though this alternative approach would assure funding for clinics like mine, I think it is a terrible idea.

First, it won't work to expand access to all who need care. According to the Surgeon General’s 2016 report, Facing Addiction in America, only about 1 in 10 people who need treatment get it. And the number of people who need treatment for opioid addiction keeps climbing, without an end in sight. Our country needs much more access to treatment, but who would invest to build and staff treatment programs for temporary funding?

Second, the proposal misunderstands the problems facing people with addiction. It's more than opioids. It is HIV, hepatitis C, skin and heart valve infections, cancer, high blood pressure, diabetes, chronic obstructive lung disease, schizophrenia, and depression. And those were just the challenges facing my patients last week.

Medicaid provides access to a range of essential services, from medications for psychiatric disorders to laboratory testing for infectious disease to surgery for hernias. When patients come to me, I take care of their addiction and work to assure these other needs are met. It’s part of what is necessary to get them back on their feet, and help them stay there.

The Congressional recess is starting soon. If a Republican Senator wants to appreciate the impact of this latest proposal, he or she is welcome to visit my clinic in Baltimore. What will be apparent on such a visit is that my patients suffer from opioid addiction, but they are not defined by it. They are real people, with families who love them and with futures they are reaching for. They want not only to be free of addiction but also to be healthy.

Throwing money at addiction treatment is no substitute for real access to care. I implore Senators concerned about opioid addiction to see the whole picture.

Powerful words from Massachusetts on the Stigma of Opioid Addiction

Thank you, Massachusetts, for a powerful, and empowering, public health message! 

May all of us step up to the challenge of changing our language -- and actions. 

The Stigma of Opioid Addiction

                                   from Massachusetts department of Health and Human Services

It’s a huge public health threat – addiction to powerful opioid painkillers.  But you can help by changing the way you think about, talk about and treat people with addiction. Words like “junkie,” “addict” and “druggie” can hurt and stand in the way of recovery. There are perceptions that addiction is a personal choice (when in fact it’s a disease), that addiction is a sign of human weakness, or a lack of morals or willpower.  While the initial decision to take drugs may be voluntary, neurological changes to the brain restrict a person’s self-control. The disease hinders the ability to resist impulses to take drugs despite harmful consequences.

A stigma is a mark of disgrace that sets a person or a group apart.  Stigmas aimed at people with substance use disorders come from many sources including personal shame and disgust at one’s own appearance, behavior and feelings of being unworthy of help, negative labels from friends or family, negative attitudes from healthcare providers, the media, law enforcement, places of work and government agencies.

We are all affected by the current epidemic of opioid addiction. Many of us know someone who struggles with addiction, or who is in treatment.  What can we do?

• We can take a stand against stigma. 

• We can support treatment opportunities. 

• We can encourage people in recovery.

          We can talk about addiction with our friends and family.

          Each of us can commit to not using hurtful or damaging words about those who struggle with addiction.  

Great article from Chris Vestal on MAT in Washington Post

Christine Vestal of Stateline, a Pew Charitable Trust initiative, just wrote a great article on opioid addiction and treatment with medications published yesterday in the Washington Post. Check it out!

https://goo.gl/OQCdFp

Hillary Clinton's substance use initiative

On this Labor Day, I thought it fitting to highlight Hillary Clinton's newly unveiled proposal for how she would address alcohol and drug addiction as President.

We know that one of the best ways to help people achieve and maintain recovery is through treatment, often including a medication. When people are able to manage their chronic illness (or illnesses as if often the case), they are more likely to return to work or school, reconnect with their families, and improve their quality of life. All those things we celebrate today.

So please check out the attached story and the link to the complete proposal:

http://www.huffingtonpost.com/entry/hillary-clinton-addiction_55e6fca6e4b0c818f619ceca

Complete proposal:

https://www.hillaryclinton.com/p/briefing/factsheets/2015/09/02/combat-addiction/