Over the past couple decades, as opiate addiction treatment has evolved, many addiction treatment providers have remained reluctant to give up on abstinence-based programs for recovery. A persistent stigma against Medication-assisted treatment prevented the integration of buprenorphine, naloxone, and methadone into mainstream addiction therapies. It’s time to reduce that stigma by getting these physicians onboard with medication-assisted opiate addiction treatment.
Steven Ross Johnson of Modern Healthcare describes a long-standing climate of opiate addiction treatment shaped by the past experiences of substance abuse treatment providers. They came from a time when abstinence-based treatment was the only road to take, and so they have continued promoting therapies based on those experiences.
Primary care physicians have likewise been slow to recognize the therapeutic benefits of medication-assisted addiction treatment. In past years, the accepted road to recovery involved traditional 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous. While participation in those widespread support groups remains an integral part of addiction treatment, they have both failed in “stepping up to the plate in the context of our new opioid addiction epidemic,” according to Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing (PHOP).
But things are changing. Statistics have clearly shown that more people die from drug overdoses than from vehicular accidents. Prescription pain pills and heroin claim the lives of 60 percent of more than 47,000 overdose deaths. The most effective addiction treatment options identified by professional medical organizations, such as the American Society of Addiction Medicine, include medication-based treatment programs; as well as, access to naloxone and mandatory use of prescription-drug monitoring programs.
Still, the stigma against medication-assisted treatment continues. That stigma prevents getting people into the proven therapeutic regimens involving buprenorphine and methadone, and it continues to send them to early graves. Johnson cites statistics published by the Johns Hopkins Bloomberg School of Public Health indicating that over 5 million Americans suffer from opiate dependence, but only 1 million of them enter medication-assisted opiate addiction treatment programs.
That same study tells us that since 1997, the number of Americans addicted to opiates has grown by 900 percent. This horrific number brings not only the associated opiate-related deaths but it also heralds a parallel increase in the numbers of Americans affected by HIV/AIDS, hepatitis C, and sexually transmitted diseases. It means fewer Americans capable of joining the workforce and fewer of them capable of parenting their children, as well as increases in drug-related violence.
President Obama’s 2017 Budget Proposals
President Obama’s 2017 budget includes $1.1 billion to fight the battle against opiate addiction specifically. Of that money, $920 million will go toward cooperative agreements with individual states to expand opportunities for medication-assisted opiate addiction treatment.
Another $50 million will fund access to substance abuse treatment providers in parts of the country where access to opiate addiction treatment is severely limited. Effectiveness of opiate addiction treatment will be evaluated with programs funded by $30 million. The remaining funds will be spent on expanding the availability of naltrexone and also in evaluating the inclusion of physician assistants and nurse practitioners as legitimate medication-assisted addiction treatment providers who can prescribe drugs like buprenorphine and naloxone.
Integration of Opiate Addiction Treatment Into Primary Medical Care
Johnson believes that opiate addiction treatment professionals must teach our primary care providers to embrace medication-assisted treatment protocols. Today’s opiate addiction treatment options offer opportunities for primary care physicians to get involved in aggressive treatment from the outset, Johnson tells us. We cannot miss the opportunity to integrate addiction treatment into standard medical care.
This works two ways: First, the physicians must be educated in and believe in the value of medication-assisted therapy for their patients who need opiate addiction treatment. Second, the physicians must ensure that their patients who are addicted do not fail to overlook their basic medical needs. Far too many people with addiction issues fail to address health issues such as diabetes, thyroid disorders, COPD, hypertension, or many other common medical ailments.
In today’s climate we must treat the whole person: We must manage the addiction effectively with buprenorphine, naloxone, and methadone, and we must ensure that the person with health issues has immediate access to good primary medical care. For many addiction treatment programs, this means a real battle with the insurance companies to gain their cooperation in paying for both behavioral and medical health care concerns.
Your Responsibility to Fight For Treatment
Your responsibility is to get yourself into opiate addiction treatment, specifically into a program that offers medication-assisted treatment protocols. You can do so by calling local medication-assisted treatment providers and finding out whether you can just walk in or if you can schedule an appointment for an assessment. And don’t be afraid to talk with your primary care physician about the benefits of medication-assisted treatment. Show him or her written information like the resources on this page that back up your preference for medication-assisted treatment. We can change the world, one physician at a time; but the first change begins with you.