With a new administration in place and Congress in session, our nation’s leaders must address many public health challenges, including the devastating effect of prescription and illicit opioid misuse on families and communities. Federal and state governments play a critical role in designing, funding, and implementing solutions to this crisis.
More than 33,000 Americans died from a drug overdose involving an opioid in 2015.
The scope of the problem is large—and growing. More than 33,000 Americans died from a drug overdose involving an opioid in 2015, surpassing the previous year’s record. During the same year, the rate of deaths from heroin alone jumped more than 20 percent. Although there are treatments for opioid use disorder, the most effective therapy—medication-assisted treatment (MAT)—is available to too few Americans.
MAT pairs behavioral therapy, such as counseling, with one of three medications approved by the Food and Drug Administration for treatment of substance use disorder (which includes opioids and alcohol). Studies show that MAT reduces illicit opioid use significantly more than nondrug approaches. But its use is limited, with only 23 percent of publicly funded treatment programs reporting offering any FDA-approved medications to treat substance use disorder and less than half of private sector treatment programs reporting that their physicians have prescribed FDA-approved medications.
Prescription opioid overdoses, misuse, and dependence cost the U.S. more than $78 billion in health care, criminal justice, and lost productivity in 2013.
Federal and state programs are crucial to making treatment available. In 2014, public dollars accounted for 69 percent of the $34 billion spent on substance use disorder treatment. This included $7 billion from Medicaid, $2 billion from Medicare, and $4 billion in other federal funds such as substance use disorder block grants from the Substance Abuse and Mental Health Services Administration (SAMHSA) worked together to address the toll that opioids have taken on local communities.
And high-quality treatment not only helps patients, it also makes good economic sense. Prescription opioid overdoses, misuse, and dependence cost the U.S. more than $78 billion in health care, criminal justice, and lost productivity in 2013.
Congress has made significant strides in recent years to increase access to treatment, with policies expanding health care coverage under Medicaid and private insurance. For example, more than a million people with substance use disorder became eligible for Medicaid when their states expanded the program. In addition, the Affordable Care Act requires all insurers to cover treatments for substance use disorder in the same way they pay for other chronic diseases such as diabetes, thus removing a substantial barrier to care.
Congress also took key steps in 2016 to expand access to treatment. The 21st Century Cures Act—which passed with overwhelming bipartisan support in December—authorized SAMHSA an additional $1 billion over two years for state prevention and treatment efforts. Half of this funding will be allocated in the coming months. The Comprehensive Addiction and Recovery Act, signed into law in July, also helped to expand treatment access by allowing nurse practitioners and physician assistants to treat patients with buprenorphine, one of the drugs that can be used as part of MAT. This change will help ensure access to treatment for the 30 million Americans who live in counties where nurse practitioners and physician assistants are often the only health care providers.
As Congress considers the future of health care coverage in the United States, lawmakers should build upon these programs and policies that have helped people with opioid use disorder get the treatment they desperately need. By doing so, legislators can help state and federal governments save lives, preserve families, and reduce the financial burden on our overstretched health care system.
This was originally published on The Hill on February 20, 2017.
Cynthia Reilly directs The Pew Charitable Trusts’ substance use prevention and treatment initiative, and Alaina McBournie is a senior associate on the team.
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The nation’s opioid epidemic has been making headlines, and much is required to curtail this public health crisis. In this episode, we hear more about the problems associated with opiate misuse and the path forward.