Nationwide, governors from Maine to Alaska are outlining their visions for 2017, setting out legislative agendas and presenting ambitious goals to serve their constituents.
These speeches will get less attention than President Trump’s expected address to a joint session of Congress later this month, but we should listen closely to what they are saying about a vitally important health topic: combatting the opioid epidemic and helping those in need of substance use disorder treatment recover from a chronic, deadly disease.
In Pennsylvania, where my organization, Caron Treatment Centers, is based, we lost nearly 3,400 citizens in 2015 to overdose deaths, most of them from prescription painkillers and heroin. Nationwide, 20,101 people were lost to prescription pain reliever overdoses and 12,290 to heroin overdoses. The economic toll is equally staggering. America spends $55 billion a year on prescription opioid abuse. This year, that number could increase.
The problem is so massive that it has no simple solution. It will require cooperation and coordination among policymakers, health care professionals, and communities. The 2016 passage of the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act gives governors a unique opportunity to work with the federal government to obtain funds intended to address this epidemic. As governors prepare their budgets, which policies should they and their legislatures implement to help those in addiction’s throes?
Improve physician training
Most patients with addiction have suffered for months or years before they seek treatment. We wish we could rewind to when they first showed risk factors for addiction, press pause, and speak to their doctors before they write a prescription for opioids. Opioids are often not an appropriate option for treating pain and alternatives should be considered first. Up to one in four patients who are prescribed opioids for long-term pain management will become addicted to them.
We depend on health professionals to identify and understand the disease of addiction, including signs, symptoms, and issues like depression that often go along with addiction. Yet our health care system is failing them by not providing the training they need to do this. Many health care providers receive under 10 hours of addiction-specific training in medical school.
Governors should work with their state medical societies to urge medical school deans to revise their curricula, call upon hospitals to offer continuing medical education on addiction, refer providers to training that will better help them identify the warning signs of addiction, and guide those who are unaware of how their prescribing practices can contribute to addiction.
Develop partnerships with schools
Our schools will be key elements to help prevent future generations from abusing opioids. We must equip administrators and guidance counselors to better identify signs and risk factors of addiction, address the disease, and provide support to students and caregivers. States like Ohio and New York have made this type of education mandatory, a decision I applaud and hope other state governments will fund. In the 2015-2016 school year, Caron partnered with more than 620 schools in 15 states. We’ll do it again this year.
Improve care transitions
Some of these efforts may take years to pay dividends. Others can have an immediate, lasting impact. I urge governors to follow Pennsylvania’s example in establishing 45 Centers of Excellence. These serve as central hubs to help those with opioid use disorders access behavioral, physical, and community-based care, along with medication-assisted treatment if needed.
One goal of these centers is to help transfer overdose survivors directly from hospital emergency departments to addiction treatment providers. This helps ensure that individuals with opioid-use disorders have a next level of care that helps them stay in treatment and recover. According to the National Institute on Drug Abuse, an appropriate length of stay is a minimum of 90 days in residential care, with year-long ongoing care and engagement. Without this type of intervention and treatment, patients are more likely to die from a drug overdose.
Expand access to addiction medications
Finally, governors need to expand access to lifesaving medication-assisted treatment, including methadone, buprenorphine, or long-acting naltrexone. But they cannot be the only tools we use to prevent overdoses. A multi-disciplinary approach is necessary, one that includes cognitive behavioral therapy, family therapy, psychological testing, and 12-step integration.
Ninety percent of individuals who suffer from opioid addiction will not get help. I urge governors — and all other elected officials — to put politics aside and go beyond party lines to tackle this epidemic. I hope that our governors will translate their words into action. Every person struggling with addiction, and those who care about them, are counting on it.
Doug Tieman is president and CEO of Caron Treatment Centers, a company that provides treatment for addiction and substance use.