It’s an irresistible pairing: Big-name Washington politicians Newt Gingrich and Patrick Kennedy have joined forces to help a new advocacy group push for wider use of medications to treat opioid addiction and expanded government funding.
As paid advisers to Advocates for Opioid Recovery, Gingrich, the former Republican House speaker and a Trump confidant, and Kennedy, a former congressman and a scion of the family that defined liberal Democratic politics for decades, have generated a flurry of media attention. They have conducted joint interviews with outlets ranging from Fox News to the New Yorker.
But the nonprofit group refuses to answer a simple question: Who is funding the campaign?
Gingrich told STAT he had no idea who was supporting Advocates for Opioid Recovery, which was founded last year. Kennedy declined to be interviewed, as did Van Jones, the CNN commentator and former Obama aide who is another paid adviser. Jones has coauthored opinion pieces with the other two men and promoted the advocacy group on social media.
While there is widespread support in the treatment community for use of the medicines being promoted by the three men, there is growing concern about misuse of the drugs. Suboxone is itself an opioid that is sold on black markets to drug abusers. There are also alternative treatments that do not rely on medication, including abstinence-based and behavioral therapy programs.
Kennedy has close ties to treatment centers that could benefit from wider use of the medications in opioid treatment and broader payment for the treatment by insurers. Several treatment centers that make use of medication-assisted treatment are sponsors of the Kennedy Forum, a nonprofit he founded to increase access to treatment for people suffering from mental illness and addiction and promoting research in the area.
One of those organizations is CleanSlate Addiction Treatment Centers, where Kennedy has also been a board member since 2015. The organization paid $750,000 last year to settle government allegations that it was improperly prescribing Suboxone, one of the class of medications advocated by Kennedy and the other paid advisers to Advocates for Opioid Recovery.
A spokesman for the treatment centers said the company was not providing funding for Advocates for Opioid Recovery, also known as AOR. It declined to discuss if Kennedy is paid for his board position, or how much. The company also said it cooperated with the government probe of its operations and had already put in place improvements before the settlement.
In an interview with STAT, Gingrich declined to disclose how much he is being paid. “That is all confidential,” he said.
“If you are doing something positive and good, there is a certain amount of privacy involved,” he said. “If I am doing something I clearly believe in and if people with resources want to let us have the time and resources to do that, that is a good thing.”
A spokesman for Advocates for Opioid Recovery declined to say how much the men are paid. He said the organization would not disclose information on who is funding it other than it is “a variety of organizations and people” that want to be anonymous. The spokesman, Peter Collins, declined to answer whether or not any of the funding is coming from manufacturers or suppliers of the medications, or facilities that base their treatment model on use of the drugs.
Disclosures of funding sources are important because they allow the public to make decisions about the credibility of organizations promoting health care policies, said Matthew McCoy, a postdoctoral fellow in the Department of Medical Ethics and Health Policy at the University of Pennsylvania and the author of a recent study on conflicts of interest in patient advocacy organizations.
“Even when a group strives to maintain independence, financial conflicts of interest can influence decision-making in more or less subtle ways that benefit an organization’s funders rather than the population it aims to serve,” he said.
Medication-assisted treatments include methadone and buprenorphine. The drugs have been shown in studies to reduce the risk of relapse while helping to control cravings for more potent opioids such as heroin.
Because the treatment medications are opioids, their use has been regulated. There is a cap on the number of patients doctors can treat using buprenorphine, and some insurers have been reluctant to pay for the treatment. Treatment with the medications is most effective when accompanied by counseling and behavioral therapy, research has shown.
The three men, in opinion pieces and interviews, have called for increasing the number of patients a doctor can treat with the medicines as well as boosting government funding and insurance coverage for medication-assisted treatment.
Kennedy and Jones declined interview requests. “Patrick is not interested in spending time on this story,” Anne Woodbury, a former Gingrich aide who serves as executive director of AOR, wrote in an email. A representative for Jones said he would check whether Jones had time for an interview but didn’t respond to multiple follow-up emails.
Gingrich said Kennedy was the driving force in creating Advocates for Opioid Recovery. Kennedy, the son of former Massachusetts Senator Edward Kennedy, is himself in recovery for addiction.
While Gingrich and Kennedy may appear to be an odd political coupling, they have a long history of working together on health-related measures, including legislation related to health care technology and insurance reimbursement for mental health treatment. They also share an interest in brain research.
The nonprofit was incorporated in Delaware last June. The three directors of Advocates for Opioid Recovery all have ties to Kennedy. One of them, Washington health care lobbyist Sean Richardson, was Kennedy’s chief of staff when he was in Congress. Richardson said he did not know who is funding the nonprofit or how much the group is paying the three men. He referred questions about the nonprofit’s finances to Kennedy.
The group is operated from the public relations firm cofounded by Woodbury. The other founder, Jeff Valliere, identifies himself as an adviser to Kennedy. A spokesman said a variety of employees at Woodbury’s firm, called CURA Strategies, work on AOR matters. CURA was launched last February.
A recent report from the US surgeon general concluded there was “well-supported scientific evidence” that medications can be effective in treating serious substance use disorders. The same report found similar support for behavioral therapies. The report said both treatment modalities were underused, and that the combination of the two approaches is “highly effective.”
One concern with expanded access to buprenorphine-containing drugs such as Suboxone is that there is a street market for the medicines. When crushed, the pill form of the drugs can be snorted to get high. They produce a potent, and potentially fatal, high when combined with the class of anti-anxiety drugs that includes Klonopin. There is evidence that some drug users illegally obtaining Suboxone are doing so to self-treat themselves, or avoid becoming “dope sick” from withdrawal from more dangerous opioids including heroin and fentanyl.
A doctor in Philadelphia recently pleaded guilty to charges of inappropriately prescribing Suboxone as part of an operation that netted him over $5 million.
Several prison systems have recently reported large influxes of contraband Suboxone. Prison officials in Indiana are asking Medicaid officials in that state to stop paying for Suboxone that is prescribed as a thin film strip because so much of it is being smuggled into jails.
US sales of buprenorphine drugs were $772 million last year, according to QuintilesIMS, a research firm.