Every 19 minutes, someone in America dies from an opioid overdose. President Barack Obama’s administration used that stark statistic Tuesday to announce a set of new policies and practices aimed at easing the drug addiction crisis in the United States.
The most important piece of the new initiatives is a new rule from the U.S. Department of Health and Human Services to double the number of patients a medical provider can treat with buprenorphine, a medication used to treat addiction. Currently, providers are limited to 100 patients — a ceiling that limits patients’ access to the medication. The proposed new rule would raise the cap to 200. More than $100 million will be made available to states and community health centers to increase access to medication-assisted treatment, according to Tuesday’s announcement.
Sens. Susan Collins and Angus King, along with Rep. Chellie Pingree in the House, have co-sponsored federal legislation to end the buprenorphine cap. After the Obama administration’s announcement Tuesday, Collins said raising the patient limit to 200 was a step in the right direction.
Medication-assisted treatment, coupled with therapy, is the one method proven to work for those seeking to end opioid addiction.
“The research is unassailable,” the Pew Charitable Trusts said in a recent report. “Staying in recovery and avoiding relapse for at least a year is more than twice as likely with medications as without them. Medications also lower the risk of a fatal overdose.”
Yet medication-assisted treatment is available to too few. Only one in five Americans dealing with opioid addiction is receiving methadone or buprenorphine, the two most common anti-addiction medications, according to a November study by researchers at Johns Hopkins’ Bloomberg School of Public Health.
Raising the number of patients buprenorphine providers can treat is an important step toward making treatment more readily available.
On the supply side, Maine lawmakers are close to taking steps to restrict the prescription of opioid painkillers. Four of five new heroin users began their addiction with opioid pain medication, according to the American Society of Addiction Medicine.
We and the Maine Medical Association have concerns about state law dictating how doctors treat their patients. But given the determination of lawmakers to move ahead with opioid limits, the amended version of LD 1646 is in line with what other states, including Massachusetts, have done and what is now recommended by the U.S. Centers for Disease Control and Prevention.
The updated bill would limit opioid painkiller prescriptions to seven days for acute pain and 30 days for chronic pain. The amended bill also would limit patients to 100 morphine milligram equivalents per day, in line with CDC guidelines. It also includes needed exemptions for cancer patients and palliative and hospice care.
At the same time, however, members of the Legislature are poised to take a step backward with legislation that would increase the penalties for those convicted of drug possession. Sentencing users to jail for possession offenses is entirely counterproductive. It delays needed treatment while leaving users with a criminal conviction on their record.
In fact, while drug arrests in Maine more than doubled between 1986 and 2010, addiction and overdose rates continued to rise. Instead of jail time, those addicted to opioids need treatment, preferably medication-assisted treatment coupled with counseling.
“Each time Ryan went to jail it became harder for him to continue his education, keep a job and maintain the support of people who loved him,” Andrew Bossie wrote in a persuasive column this week about his brother, Ryan, who died of an overdose last year at age 26. “From my perspective now, jail time actually pushed Ryan farther away from from the things that helped him stay sober.”
That’s why LD 1554 would move Maine in the wrong direction. The measure passed the Senate on Tuesday in an 18-16 vote. The House wisely rejected it Thursday. The bill now goes back to the Senate, which should reverse its support.
State and federal policymakers have taken important steps to recognize addiction as a disease that requires treatment. Continuing this focus, instead of emphasizing punishment for a medical problem, is the right way to address the deadly consequences of the opioid epidemic.