The uncertainty of the Federal approach to addictions in general and opioids in particular is even deeper now that the HHS Secretary is gone. While the President’s Commission on Combating Drug Addiction and the Opioid Crisis nears the release of its final report on November 1st, the President has not yet followed through on formalizing his verbal declaration of a national emergency in regard to opioid addiction.
I was pleased to receive a last-minute invitation to speak before the Commission last week. Because of Secretary Price’s negative comments about buprenorphine, my hope was to describe how the use of that medication has improved my success in treating people with opioid addiction in outpatient drug rehabilitation. Within 24 hours, however, my invitation was withdrawn and Secretary Price had left. Fortunately, the Commission has been hearing this positive experience from others, along with the observation that effective interventions such as this are underutilized.
This past Sunday, the New York Times devoted its entire editorial section to a comprehensive summary of how to approach the opioid addiction problem in the country. I welcomed its emphasis on treatment and particularly its highlighting the effectiveness of supportive medications. I was a little taken back by the description of addiction medicine as “a relatively low-status specialty,” but I do not have the necessary objectivity to argue about this.
Although deaths from opioid overdoses have not approached the level of mortality caused by alcohol and tobacco, public focus has led to more attention from the Federal government on addictions than has traditionally been the case. None of the prospective HHS Secretaries currently being discussed have a reputation of being knowledgeable about addictions. My best hope is that the person finally chosen will have an open mind about what works and will consider the evidence before making ongoing policy decisions.
Watch this space for further developments.