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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. 

  • Let’s be real for a minute . Most of these drug addicts are thieves liars and not very good people. Maybe once upon a time they were good people but not anymore. They will mentally torture everyone they know to steal cheat and lie to their patents friends everyone. Very many chose to be junkies and they accutually like it . And they will never become straight . Most non drug adicts will Agree with me . No answer to the drug epidemic just hope they stay away from the good people who chose not to become a junkie

  • I am a single mom of 7 i struggle daily from addiction and it is a danerous disease and ii am thankful for ur article people need educated on addiction treatment it will help alot ive been in treatment since 9-30-09 2 days after my grand daughter was born it was best thing i ever did and i know that i will always until my death be an addict but the treatment center im with really works for me but before going i thought it was completely different i think if the ones getting help could speak out and tell public how it helped and what it was like more people will go i am willing to do that in my area but dont really no what to do because i want to let all know how it helps me i know i will probably have to be on treatment all my life cause of the personality i have im at the methadone center in my hometown i wish id gone sooner but i didnt understand it to be the way it is to this day my mother still calls me name even meth head because of the name she thinks thats what i do so many that soesnt know anything about these centers it saved my life and gave me a voice thats what my mom hates is she cant control anymore i do but i enjoyed reading ur article and if u ever need me to voice my actions in life id be glad to id love to save lives with u

    • Tanya,
      Your granddaughter (and by default your child – her parent) save your life. You realized she needed you to be a good role model and you wanted to see her growing up. Spread your kwoledge & experience.
      You could start up with Gary from NJ seeking a plan, in a comment below.
      You might like to provide a few pointers – where to find help and what to expect. Other professionals might complement it. Congratulations and keep your progress!

  • Current Medicaid practices encourage addiction with all the forced delays in obtaining imaging and thus definitive treatment of injuries. This is compounded by a lack of pain specialists, comprehensive physical rehab clinics, and addiction specialists for primary care physicians to utilize when needed.
    While training could be helpful, in many cases physicians simply lack the the resources needed to combat the problem.

  • Yes opioid abuse is a very serious issue. People who need the medication for chronic pain or other ailments do become physically dependent which is different in many ways from addiction. Addicted people will do anything to get opioids. Steal, scam, attack people, rob stores… I agree there are serious problems, I’m not trying to sound callous when I say it was each individuals choice to abuse them and then turning to heroin? I’ve been responsibly taking my opioids, I am a 100% disabled veteran and yes after this amount of times I’m physically dependent but I’m no addict. I’ve never searched for them, purchased illegally… those are choices people make on their own and they need to take responsibility for themselves, their choices and consequences. Legally obtaining opioids shouldn’t be villainized, there are people who can control themselves and those who make that life changing choice to abuse them and that leads to addiction. Some go through rehab, get clean and make the choice again to go right back to it. We can’t control opioid addiction anymore than we can control alcoholism and how many people die each year from that? That’s legal, so it makes it not an epidemic? Get real. We can spend trillions of dollars to help addiction but it would much better serve us spending it on education and medical benefits for everyone.

    • Are you reaching out for an individual plan or a clinicians stepped plan?
      In searching detox clinic sites, I noticed a stepped plan is used, and involving only patient and clinician with a first evaluation performed by an expert MD.
      Family involvement is not permitted until the very final step and successful completion.
      It seems to me if a person can not afford these $30k to $40k type isolated treatment, a family could play a tremendous positive or negative impact depending on their background and culture.
      Given above, either you would enroll the entire family or a subject in isolation for best results.
      If you are a practitioner I would be glad to talk to you in regard to better understanding your concern and possible ways to resolve to sustain including tools that might help if you do not have that in place already.
      From an individual perspective research and finding best clinic, talk to them and they might make suggestions that would benefit, including understanding their stepped plan.

  • Hydrocodone is now classified as a schedule 2 narcotic and most states have a data base to prosecute and imprison doctor shoppers. The prevailing presumption is that anyone professing pain and a need for a narcotic pain killer is a potential-if not already- junkie, and that its better to reject any request for pain pills and it better to be safe than sorry since pain is subjective and how can a practioner really know if the requester is actually pulling a con. Doctors are cynical and afraid to prescribe pain pills and many pharmacies refuse to fill a legitimate prescription. The so called “opioid crisis” masks the reality that the many people now unable to get their prescription are turning to street drugs to fill their needs. The logical result is the needless death of record numbers of unsophisticated opiate users. Charlatans like you skew the numbers and reasons for the record number of deaths and have a vested interest in misleading the public, and I despise you and others for the dishonest way you line your pockets.
    I’m a criminal attorney and have gotten the word out that I will defend, for free, any needful person that has had the necessity to go to the street after being turned down for a legitimate pain medication need. Has Caron treatment centers offered any freebies to treatment at their ” luxurious and discreet treatment centers”
    Sent from my iPad

    • My son had a criminal attorney NJ helping him in something that my son did that was so unbelievable out of his character, my son is a business man and had a back surgery a few years ago and unfortunately became addicted to pain killers for 3 years our whole big family moved in to help found a great dr and so we or I thought yeah my son is not taking pain killers but this dr. has him on these meds and I thought he’s the doctor he knows what he is doing but since my sons actions etc have been out of character that I went checking on the meds he is taking and I will be taking them to my dr. to check if this is appropriate bc I think for a healthy 42 year old young man this is what the dr put him on Bupropion 150 3xdaily…Zolpidem Tartrate 10mg 1tbl night….Duloxetine 30mg 3 caps a day Temazepam 15mg 1 cap at night….Mirtazapine 15mg 1 tablet night …..Aripirazole 5mg tablets…Clonidine 0.1 mg tablet 2xday ….. Diazepam 10mg 1tablet 2-3 times a day ,,,zubsolv table.7 what the hell is he turning him into a zombie !!!! I think the drs. are to blame they want patients to keep coming back insurances pay $300.a visit if they were to cure each patient they would be out of business its all the pharmaceutical doctors making money.!!!!!!

  • I wonder what our elected bureaucrats should do to combat alcohol abuse, especially knowing that alcohol contributes to over 100,000 deaths in America per year. Not only that, it remains the number one substance of abuse in this country. Perhaps there’s an epidemic of tobacco addiction, considering the fact that tobacco products contribute to over 480,000 deaths each year in this country.

    Two substances (alcohol and tobacco) with no legitimate medicinal purpose contributes to almost 600,000 deaths each year in the US and all we hear are *crickets* Where’s that outrage among the media regarding these 580,000 deaths each year? Where’s the calls for more restrictions or bans from society? Where’s all the nanny-state legislation being passed to address the epidemic of alcohol and tobacco abuse?

    Oh, wait! I almost forgot – alcohol and tobacco products are taxed at much higher rates (aka “sin taxes”) and make excellent sources of revenue for local, state and federal government(s). For the record, I completely disagree with any further regulations or higher taxes being imposed on alcohol and tobacco. I’m merely pointing out the double standard and hypocrisy of both our media and our government.

    Some of you had better get your heads out of the sand and demand that your elected bureaucrats quit practicing medicine without a license. Your doctor is no longer in charge of controlling any future severe pain you may suffer from. The control and management of any future severe pain (acute, post-op, chronic) you might one day suffer from, is now not only at the mercy of your insurance company but also your state and federal government.

    Too many people with incurable diseases, conditions and inoperable disabling injuries that cause them constant agony are now been forced to needlessly suffer due to all of this more recent nanny-state legislation and regulations regarding the prescribing of opioids. The chronic pain community has witnessed a huge spike in suicides among those who suffer with constant physical pain. This also includes cancer patients.

    These are the same patients who’ve already tried alternative treatments and/or who used their medication in conjunction with other alternatives, were responsible with their medication, ensuring that they did not mix their medication(s) with potentially-harmful substances (including alcohol), and – through no fault of their own – became the “collateral damage” from all of these restrictive laws which further restrict access to the medication that gave them some quality of life.

    Some of these are the same ones who’ve ended their lives because they no longer had the quality of life they once had with medication – medication that they could no longer access. They could no longer stand the agonizing torture of 24/7/365 physical agony. If our pets were forced to suffer agonizing physical pain like this, society would be up in arms (rightly so). Unfortunately, many of those with compassion for animals can’t extend that same compassion to humans.

    Does our country need a better, more affordable mental health system that everyone can access when needed? Absolutely! Does our country need to get rid of ridiculous regulations regarding the prescribing of medications that may help curb cravings for some patients in recovery? Absolutely! Do addicts deserve compassionate treatment, individualized for them? Absolutely …

    But that same compassion and individualized treatment options should also be applied to those who are already vulnerable – the chronically-ill, the elderly, our veterans with life-altering injuries, the disabled – and suffering from severe physical pain. Further restricting access to medication that helps relieve pain and suffering does NOTHING to help an addict and instead harms those in legitimate pain. Our government can help patients with addiction without harming patients in physical pain.

    • No one wants or chooses to be an addict Lisa. I took pain meds for back issues & during that time went thru a very traumatic event. I began using my pills to bury all my pain but I promise you that I never chose to become addicted. Getting clean was the hardest thing I have ever had to do!

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