A safe drug treats opioid addiction. But most doctors can’t prescribe it. | Opinion
A new bill would allow medical providers to treat addiction like the medical condition it is, rather than some moral failure.
As an addiction counselor for the last 25 years, I’ve seen many patients struggle with opioid use disorder. Cumbersome, unnecessary red tape makes it even harder for them to get better.
Take one of my recent clients, David. To combat his cravings, he sought out a prescription for buprenorphine, which works by binding to the same receptors in the brain that opioids do. This is a lifesaving medication that cuts the risk of overdose death in half.
But David struggled to find a primary care doctor who was approved to prescribe buprenorphine. So to reduce his risk of relapse and overdose, he was forced to seek methadone, a treatment that has its own unnecessary red tape, and which required him to spend three hours a day commuting, every day, to a clinic.
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COVID-19 has led to two years of incalculable loss. But we cannot become desensitized to the other devastating sources of loss in our lives. Namely, the overdose epidemic that has tragically and silently taken so many: 100,000 lives lost in a single year. In Philadelphia alone, 1,214 died from a preventable drug overdose in 2020. Nationally, that translates to 273 deaths per day; 11 people, all loved, are taken every hour.
Every one of these overdose deaths, most of them involving synthetic opioids such as fentanyl, was preventable. Yet, today, less than 1 in 5 Americans with opioid use disorder have ever received buprenorphine or other similar drugs to curb cravings. Despite more than 100 years of scientific evidence that medications like buprenorphine effectively treat opioid use disorder, federal law prohibits most medical providers from prescribing these medications.
A new bill aims to change that by making it easier for providers to offer buprenorphine and other similar medications to patients with opioid use disorder. We urge Congress and President Biden to support the Mainstreaming Addiction Treatment Act (MAT Act) to help us begin to turn the tide on the overdose crisis.
Under the current system, medical providers can prescribe buprenorphine for pain, but to offer it to patients with opioid use disorder, they need additional federal approvals, which can take two to three months to obtain. Given this bureaucratic burden, less than 7% of medical providers have received permission to prescribe buprenorphine for opioid use disorder. And once they get permission, providers can only treat up to 30 patients without additional approval and training.
These are too many barriers. Every day that a person addicted to opioids is left untreated puts them at risk of overdosing and losing their lives to this epidemic.
Under the MAT Act, any medical provider could prescribe buprenorphine and other medications to prevent painful withdrawal symptoms associated with opioid use disorder, without additional training or approvals. The medications would be treated like any other prescription for any other condition.
Opioid use disorder is the only medical condition subject to these strict barriers to treatment, which result from policies that criminalize substance use disorder, and are not supported by evidence.
To put it simply, opioid use disorder is a medical condition, not some sort of moral failure, and the time has come to treat it as such.
“Opioid use disorder is a medical condition, not some sort of moral failure, and the time has come to treat it as such.”
The most vulnerable Americans are bearing the brunt of this staggering epidemic. Rates of opioid overdose deaths are growing fastest among Black and Latino Americans, while Indigenous populations have suffered the highest rates in past years. Veterans are 1.5 times more likely to fatally overdose than the general population. It is also a leading cause of death among new mothers.
We must abandon the punitive drug-war mentality that has devastated our communities and unfairly targeted Black and brown individuals, and refocus instead on a comprehensive public health approach to create safer, healthier communities.
Too many people — sons, daughters, parents — are dying. Congress must pass the MAT Act, and President Biden must sign it swiftly into law to prevent tragic overdose deaths and save thousands of lives.
More than 400 organizations have endorsed the MAT Act, and I am proud to stand with them. The only path to recovery is to treat opioid use disorder as a medical condition and fully integrate its treatment into the health-care system, where it belongs.
Sandy Gibson, PhD, LCSW, LCADC, is a professor of counselor education at the College of New Jersey, where she teaches addiction counseling.