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Eatontown, NJ / March 2, 2018 – In Thursday’s White House Opioids Summit, members of the Trump administration touted piecemeal programs, initiatives, and funding they support to address the opioid crisis, but neglected to mention the hundreds of billions of dollars they want to cut from Medicaid – the largest payer of addiction treatment services. By slashing Medicaid, the administration will essentially decimate critical treatment infrastructure during the worst public health crisis of our time.
The White House also chose to spotlight the actions of specific leaders within the administration, rather than any real progress they’ve made on the expert recommendations and evidence-based practices put forth by The President’s Commission on Combating Drug Addiction and the Opioid Crisis in November, 2017. Kellyanne Conway noted that the President has “accepted” the Commission’s 56 recommendations. What she didn’t note was that he has failed to seriously act on most of them. We don’t need any more summits, speeches, or taskforces. We need funding and action NOW.
The House and Senate are moving on this, although they will need to display a much greater sense of urgency to stop the death toll from continuing to rise. So far, Congress has appropriated $6 billion over the next two years to address the crisis. That’s a start, but not nearly enough. If we can spend $90 billion in the aftermath of hurricanes and wildfires that killed hundreds, we can spend more than $6 billion to address an epidemic that kills 175 people each day.
In addition to increased funding, there are several clear target areas that must be addressed up front. First, recent studies such as the alarming 2017 Milliman report show that we still have not achieved full implementation of the Mental Health Parity and Addiction Equity Act – which requires insurers to treat illnesses of the brain, such as depression and addiction, the same way they treat illnesses of the body, such as diabetes and cancer – nearly a decade after President Bush signed it into law. Enforcement has never been prioritized. Failing to fully address this fundamental flaw in our health care system is like building a home on a crumbling foundation. Consumers can learn to file an appeal with their health plan and send a complaint directly to state enforcement officials using The Kennedy Forum’s Parity Registry website – and track legislative, regulatory, and legal parity activities in their state using Parity Track.
Second, we need to expand access to medication-assisted treatment (MAT) immediately, per consensus among the medical community. Most insurance plans only cover one of three FDA-approved medications for treatment of opioid use disorder. Moving forward, all three options must be on the table for patients and covered by insurance. Doctors should be calling the shots, not insurers or the federal government.
Third, while we certainly need increased interdiction, we also need criminal justice reforms such as access to MAT for people who are incarcerated, increased use of drug courts, and other methods to align people with treatment and recovery rather than prison. Otherwise, the vicious cycle will never end.
Fourth, long-term recovery requires access to supported services, such as peer support, supportive housing, life skills training, and supported employment. We cannot expect people to detox and return to life as if they’ve been cured of some acute illness. That expectation is unrealistic, and quite frankly, ignorant. Addiction is a chronic brain disease that requires wrap-around care.
Fifth, we need to double down on research into non-opioid pain medications and new MAT medications alongside studies regarding cost-effectiveness and upstream factors such as social determinants of health.
Everyone agrees that our nation is in the midst of a serious public health crisis. Yet, our administration has chosen to largely ignore the evidence-based plans put before them to create their own agenda for political gain. Enough talk. Americans must stand up and demand action. Our voices must be heard.
About Patrick J. Kennedy
Patrick J. Kennedy, former U.S. Representative (D-RI), is the founder of The Kennedy Forum, a member of the President’s Commission on Combatting Drug Addiction and the Opioid Crisis, co-founder of One Mind, and author of the New York Times bestseller “A Common Struggle: A Personal Journey Through the Past and Future of Mental Illness and Addiction.”