The U.S. Surgeon General, Dr. Vivek H. Murthy, has joined thousands of treatment professionals and researchers speaking out in support of opiate treatment programs. Dr. Murthy was appointed to his post in December 2014, and by the latter part of 2015 he was already spreading his message about fighting addiction and preventing the stigma associated with it.
He delivered heartfelt remarks at a rally organized by a fledgling nonprofit group called Facing Addiction. October 4, 2015, was a keynote event that became known as The Day the Silence Ended. It took place at the Unite to Face Addiction rally, and participants amassed at the National Wall in Washington, D.C., to hear musicians like Steven Tyler and listen to a wide variety of recovery veterans spreading a message of hope and progress.
Dr. Murthy’s remarks at the rally were preceded by those of Congressman Patrick Kennedy, who talked about his decades-long battle against addiction to cocaine in earlier years and to OxyContin about a decade ago. He has also spoken out about Mental Health Parity and Addiction Equity Act, which was passed in 2008 but has not yet functioned to provide treatment for those who need it. The insurance companies and their powerful lobbies have gotten away with simply ignoring the Act and have done as little as possible to provide benefits for people who need help at opiate treatment programs.
Dr. Murthy then gave his remarks about the hope that we need in order to achieve recovery. He said that recovery starts with humility and with the deep-rooted strength it takes to reach out for help. He also said that we have to maintain hope because it will buoy us through the hard times, and that being part of a recovery community is important so that none of us has to face stigma or stand alone.
Nobody wants people in pain to go without medication. But Dr. Murthy is asking physicians to begin pain management with something other than prescription pain pills, the medications that send so many people to opiate treatment programs. He also has focused his efforts on dentists. In a speech given to the Association of Healthcare Journalists in April 2016, he reported that 42 percent of dental patients filled a prescription for opiates within a week of a dental extraction. Worse yet, most of those prescriptions were filled by impressionable young adults in the age range of 14 to 24, those who are least likely to make good decisions.
In his role as Surgeon General, Murthy reached back into history and reminded participants of the 1950s and ’60s when cigarette smoking was rampant and people ignored the need for assistance to beat that addiction. The tobacco lobbies were strong. One tobacco executive, when asked whether tobacco should be marketed to school kids, responded, “If they got lips, we want ’em.”
Murthy remembered the 1980s when HIV/AIDS was a shameful diagnosis swept under society’s carpet. Politicians refused to believe or discuss that Americans could contract a disease spread through unprotected sex or the sharing of dirty needles. It took brave people like Elizabeth Glaser, the wife of Paul Michael Glaser, who founded the Pediatric AIDS Foundation after she was infected during a blood transfusion, to blaze into new territory. She wrote a book before her death describing her meeting with Nancy and Ronald Reagan and underwent some truly personal scrutiny.
Now we are going through similar difficult times overcoming stigma so that we can share open discussions about pain pill and heroin addictions and the opiate treatment programs that must be funded in order to treat those addictions.
If we can take hope from Murthy’s words, we are breaking out from the dark times when opiate treatment programs were regarded as a place to substitute one drug for another. We are accepting the truth that opiate treatment programs are the best way to overcome heroin or pain pill addictions. We are reaching a point when health insurance companies will be held accountable to pay for benefits so that someone with the medical diagnosis of addiction is treated just as equitably as a person with a diagnosis of diabetes or COPD.
Keeping the Pressure on Insurance Companies
It has been the practice of opiate treatment programs to accept Medicaid insurance or self-pay patients only, because insurance companies typically refuse to pay. Under pressure from the Affordable Care Act, some of them are gradually, reluctantly agreeing to pay for methadone or Suboxone administration.
There is then a two-step process. First, the opiate treatment programs need to explore new contracts with health insurance providers so that they are contracted to provide methadone and Suboxone. The second step requires the people who pay for services with health insurance providers—for example, the employers who offer health insurance to their employees—to specify that those services will be included among covered benefits. Only if the opiate treatment program is contracted to provide that service, and only if that service is included in the addicted person’s insurance benefits, will the insurance companies actually begin to pay.
Those who have no insurance and no job can apply for Medicaid through their local county offices. They should indicate on the form that they have a disability because otherwise they might not qualify for benefits. Addiction is recognized as a disability by the Americans With Disabilities Act. There are also a number of opiate treatment programs that receive state or federal grant funding to treat those without the financial means to pay for this life-saving treatment.
Stigma Cannot Stop Opiate Treatment Programs
The stigma of addiction lessens every time somebody successfully works an opiate treatment program that provides both the medication and the counseling necessary to stay clean. Each of those little victories adds up to a step toward compassion and support for those struggling with addiction.
Dr. Murthy is joined in his commitment to support addiction treatment and opiate treatment programs by Michael Botticelli, the White House drug czar appointed by President Obama. Botticelli is a recovering addict. In an interview about the stigma of addiction, he stated that it was easier to come out about being a man who was gay than it was to admit he was a recovering addict. That says a lot about the challenges yet to overcome in working together to face the epidemic of addiction head on, and without judgment.
A Promise to Persist
We can take heart from the words of Dr. Murthy, who promises a battle against addiction that he will fight obstinately. He states that when he was chosen for the position of Surgeon General, he promised his most fervent supporters, that if he accomplished one thing during his tenure as Surgeon General, it would be to make an impact on the drug epidemic.
With those words we can remember that the battle to treat opiate addiction and to find funding for opiate treatment programs will hopefully get easier in the not-too-distant future. But don’t wait for legislation or regulations that will force insurance companies to pay for treatment. Go to one of your local opiate treatment programs and get help now.