“With my medication … I will be fine,” croons the English singer and songwriter, Lloyd Cole, in the tongue-in-cheek song, “Antidepressant,” on his 2006 album by that name. Now, more and more of those seeking treatment for heroin or opioid addictions may be joining Cole’s chorus, thanks to groundbreaking federal policy changes that will award addiction treatment centers for providing medical aid to heroin addicts in the form of medications like Suboxone (buprenorphine).
Push for Medication-Assisted Treatment (MAT) in Rehab
The medical establishment has for more than a decade hailed Suboxone and other medications like methadone as the “standard of care” for treating heroin and other opioid addicts, The Huffington Post recently reported. And the latest funding guidelines released by the Substance Abuse and Mental Health Services Administration (SAMHSA), the main federal body overseeing public funding of drug addiction treatment, seem to agree: they direct states to require rehab facilities to provide patients with the option of medication-assisted treatment. The new language that appears in SAMHSA’s block grant application for the fiscal years 2016–2017 reads as follows:
There is a voluminous literature on the efficacy of [Food and Drug Administration]-approved medications for the treatment of substance use disorders. However, many treatment programs in the U.S. offer only abstinence-based treatment for these conditions. SAMHSA strongly encourages the states to require that treatment facilities providing clinical care to those with substance use disorders be required to either have the capacity and staff expertise to use MAT or have collaborative relationships with other providers such that these MATs can be accessed as clinically indicated for patient need. Individuals with substance use disorders who have a disorder for which there is an FDA-approved medication treatment should have access to those treatments based upon each individual patient’s needs.
This fiscal year of 2015, SAMHSA had $1.8 billion to give away through its block grant program. These latest changes to SAMHSA’s funding guidelines may therefore cause addiction treatment programs that currently do not provide meds to heroin addicts to rethink their “abstinence-only” approach. In July, SAMHSA awarded $11 million in grants for the treatment of opioid use disorders. These 11 states —those with the highest rates of treatment admissions for heroin and opiates per capita — were the recipients: Indiana, Iowa, Kentucky, Maryland, Massachusetts, Missouri, New Jersey, Vermont, Washington, Wisconsin and Wyoming.
Will Greater Access to Suboxone, Other Meds Improve Heroin Addiction Treatment?
A story earlier this year in The Huffington Post gives a resounding “yes,” and a chorus of news articles have followed suit. Yet Chief Medical Officer at The Right Step Dr. Jason Powers, M.D., who since 2006 has been directing The Right Step’s medication-assisted program, has his reservations. “There is always a time and place for medications, and I utilize medications often in helping my patients lead happy lives,” Dr. Powers said. “But, I try to get to know individuals first, rather than having their treatment already predetermined, and then together we formulate the best plan. In my opinion, SAMHSA’s big push basically says, ‘We don’t care if your patients need opiates or not, if they have addiction and use opiates, then you must give them opiates.’ Some people do extremely well without opioids and some people don’t. One size does not fit all. I think we need to pause and question SAMHSA’s big push for medication-assisted treatment before swallowing it whole, pun intended.” The latest funding guidelines from SAMHSA are, moreover, according to Dr. Powers, an indication of “how big pharma has hijacked the medical field.” “Thought leaders agree that big pharma has been profoundly influencing physician prescribing practicing and legislation for decades, and now its grasp is extended into the addiction arena,” Dr. Powers said. “I don’t mean to suggest the big push for medication-assisted treatment is the most evil piece of legislation ever created, but it will create collateral damage … there is a reason why methadone and other opioids are tightly regulated: they can be diverted, misused and cause death from overdose.”
Heroin Epidemic in America
Meanwhile, heroin use is now an epidemic in this country, Time Magazine reported in July. In just over 10 years’ time, heroin use saw a 63% increase, according to the Centers for Disease Control and Prevention (CDC), which also reported that those who abuse prescription opioid painkillers are 40 times more likely to abuse or become dependent on heroin. Closer to home here in Texas, heroin is enjoying a very successful illicit trade, as a number of record heroin busts in recent months have confirmed. Sources:
- “New research reveals the trends and risk factors behind America’s growing heroin epidemic,” CDC
- “Feds Now Pushing States Toward Medical Treatment for Heroin Addicts,” The Huffington Post
- “Dying To Be Free,” The Huffington Post