We’re at a pivotal point in the battle against the opioid epidemic, a public health catastrophe that claimed more than 64,000 lives in 2016 alone and has tracked to be even deadlier since then. Public policy, specifically leadership from our elected officials in our nation’s capital, has the power to reverse the course of the opioid epidemic. And in my view, Washington needs to focus its energy first and foremost on two critical measures:
1. Improving patient access to lifesaving treatment
2. Building a sustainable addiction treatment workforce
On March 21st, I was honored to testify before Congress as part of the Energy and Commerce Committee’s public hearing, "Combatting the Opioid Crisis: Prevention and Public Health Solutions." Through my testimony and the testimony of other leaders and advocates in addiction medicine, I hope that Congress will find ways to focus on expanding evidence-based treatment.
I shared with the committee the work that we’re doing at CleanSlate. Our medication treatment program is grounded in evidence-based treatment as defined by the American Society of Addiction Medicine (ASAM) and recently issued guidelines from the Substance Abuse and Mental Health Services Administration (SAMHSA). We encourage patients suffering from the chronic disease of addiction to be accountable for their treatment goals, and we work closely with partners throughout the community to provide a continuum of care that helps patients regain their health and rebuild their lives.
In 2016, Congress took an important step and passed the Comprehensive Addiction and Recovery Act, which allows nurse practitioners and physician assistants to prescribe buprenorphine (which includes brands such as Suboxone). The passage of that act has helped providers increase their operating capacity and expand treatment to more patients.
Unfortunately, providers such as CleanSlate are still not able to meet the high demand for treatment. There are not enough physicians and advanced practice clinicians willing to work in addiction medicine. Even those who meet the requirements for prescribing buprenorphine often do not serve the maximum number of patients they are permitted to treat
Retaining high-quality, compassionate staff is also challenging. Misconceptions about patients with substance use disorders often deter people from entering the addiction treatment field. Additionally, current federal and state limitations on what functions clinicians can undertake and how many patients a treatment center can handle stymie the ability of treatment programs to grow.
In short, we need more addiction medicine professionals, and we need to untie their hands so that they can treat more patients.
There are two bills before Congress that can help expand access to high-quality treatment and encourage a stable workforce to meet the growing demand for evidence-based treatment for opioid use disorder (OUD).
The Addiction Treatment Access Improvement Act, H.R. 3692, has been introduced by Representative Paul Tonko. This bill would allow more advanced practice clinicians to prescribe buprenorphine. In addition, this bill would allow highly qualified medical personnel to immediately apply for waivers to prescribe buprenorphine for up to 100 patients. Currently, those medical professionals can only prescribe buprenorphine to 30 patients.
Here’s an example of why this bill is so necessary. At our center in Anderson, Indiana, we have four medical professionals who are able to prescribe buprenorphine. In total, they’re able to treat 190 patients. Though we have recently hired another part-time physician, the Anderson center still has a waiting list of 60 patients. To get treatment, some of those patients travel over an hour away to Indianapolis, which creates challenges for them to work and take care of their families.
The bottom line is that CleanSlate - just like other medication treatment providers - doesn’t have enough medical personnel who are able to prescribe life-saving medication. If this bill became law today, we could deliver treatment to everyone on our waiting list, and we would see a meaningful increase in the number of patients that could receive treatment across the country.
The Substance Use Disorder Workforce Loan Repayment Act, H.R. 5102, was introduced by Representative Katherine Clark. By authorizing $25 million over ten years to reimburse eligible student loans up to $250,000, this bill will incentivize newly-minted medical professionals to move into addiction medicine and stay in addiction medicine.
These bills will close key parts of the treatment gap that exists in our country. Both bills directly address barriers that keep providers from treating more patients who desperately need medical care and will make it easier for healthcare providers to enter the field of addiction medicine.
I’m grateful for the progress that has been made, but there is a long way to go. Our elected leaders in Washington can move us forward in the fight against opioid addiction. There are too many patients needing treatment, and we need to ensure that they have access to the services they need.
Lives depend on it.
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