Analysis

For People With Substance Use Disorders, Treatment Can’t Come Soon Enough

Prince’s death is a stark reminder of a national public health crisis

Authorities have released Prince’s autopsy results, confirming that the renowned singer died from a prescription opioid overdose. Tragically, his cause of death is not rare: On April 21, Prince was just one of an estimated 52 Americans who lost their lives to an overdose of prescription pain relievers.

Prince’s death underscores the reality that substance use disorders can affect anyone. More importantly, it suggests that treatment for these devastating illnesses is often not readily available to those who need it.

Substance use disorders are complex brain diseases that must be treated like any other chronic condition; unfortunately, many people still view them as moral failings. As a result, individuals struggling with dependence on opioids, alcohol, or other addictive substances may be unwilling or unable to ask for help. Even those who speak up often encounter barriers to effective treatment.

Eliminating the stigma around substance use disorders and expanding access to treatment requires a change in the national conversation. Thankfully, leaders from across the public health spectrum—including Secretary of Health and Human Services Sylvia Mathews Burwell, National Drug Control Policy Director Michael Botticelli, and U.S. Surgeon General Vivek Murthy—are steering this dialogue. These experts are calling for a comprehensive approach to preventing and treating substance use disorders that includes increased access to medication-assisted treatment (MAT), which pairs medications approved by the Food and Drug Administration with behavioral therapies. Multiple studies have shown MAT to be more effective than other interventions in treating substance use disorders.

However, current access to MAT is woefully inadequate. For example, barely 2 percent of licensed U.S. physicians are approved to prescribe buprenorphine, a medication used to relieve withdrawal symptoms and cravings for opioids. These physicians practice primarily in urban areas, leaving more than 30 million people in rural areas with no access to this proven treatment. Furthermore, federal regulations prohibit physician assistants and nurse practitioners—often the only available health care providers in rural areas—from treating any patients with the drug.

Congress has the power to expand access to MAT. The president’s fiscal year 2017 budget proposal calls for $1.1 billion to support prevention and treatment of substance use disorders, including more than $50 million in grant funding for states that would expand access to MAT and recovery support services, as well as more than $10 million to evaluate expanding buprenorphine prescribing privileges to other health care providers. Pew urges Congress to fund these public health efforts. Furthermore, several legislative proposals currently pending in Congress would expand prescribing rights to nurse practitioners and physician assistants. Congress should pass legislation granting this authority.     

Prince’s death is a harsh reminder that the prescription opioid epidemic ravaging our country is far from over. With 19,000 people dying each year from prescription opioid overdoses, it’s time that we acknowledge substance use disorders as treatable diseases and work to ensure that people in need have access to effective drug therapies, no matter where they live.

Cynthia Reilly directs The Pew Charitable Trusts’ prescription drug abuse project.  

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