Physicians, as well as many in the rest of the country, watched with dismay when Congress attempted to change healthcare policy without requesting input from the medical community. Believing that we have experience and ideas that would be useful to incorporate into the decision-making process, I and many of my addiction medicine colleagues have recently begun to put these beliefs into action.
The Trump administration has identified dealing with the opioid epidemic as one of their priorities. HHS Secretary Tom Price, however, has made negative public comments about the use of buprenorphine and methadone, saying, “If we’re just substituting one opioid for another, we’re not moving the dial much. Folks need to be cured so they can be productive members of society and realize their dreams.” The hopeful view is that this opinion is the result of his being uninformed and would be open to change by education. He could do no better than to listen to the words of Dr. Nora Volkow, the director of Price’s own National Institute on Drug Abuse: “This is not ‘exchanging one drug for another.’ That argument betrays a lack of understanding about how these drugs work.”
In line with the more optimistic view, leaders of all the addiction specialty medical organizations met on June 19 with Secretary Price to present specific recommendations about steps that could be taken to address this problem. The importance of incorporating opioid-based medications in the treatment of opioid use disorders was among their recommendations.
I had the opportunity myself to participate in this process on July 16 when I represented the American Society of Addiction Medicine at a meeting of a broad-based group called the Collaboration for Effective Prescription Opioid Policies. In keeping with their focus on the appropriate use of opioid medications, I spoke to them about some of the barriers that still need to be removed for their goal to be accomplished.
Many addiction experts testified at the first meeting of the President’s Commission on Combating Drug Addiction and the Opioid Crisis in June. For those interested, the second meeting is on Monday, July 31, 2017.
The impact of addiction on our country is too great for those of us with knowledge about what works to stand by while policymakers move so slowly, especially if they are heading down blind alleys.