The United States recently reached a grim milestone: 100,000 overdose deaths in one year. This spike is the result of numerous factors, from the social isolation and economic destruction of the Covid-19 pandemic to a surge in the availability of fentanyl, a potent synthetic opioid.
Although an effective treatment for opioid use disorder exists — methadone, a medication approved by the Food and Drug Administration in 1947 — restrictive federal regulations create powerful barriers to people seeking access to this lifesaving medicine.
Historically, people struggling with opioid use disorder seeking to break the chain of addiction have needed to line up every morning at a methadone clinic to receive a single dose of the drug. The process is often time-consuming and logistically difficult — especially for rural residents who need to travel long distances to the nearest opioid treatment program — and further enhances the stigma associated with opioid addiction. That is why I introduced into the U.S. Congress the Opioid Treatment Access Act, which would improve access to and modernize the delivery of opioid treatment for people with opioid use disorder.
I have attended too many funerals of people who died from opioid overdoses. As a union electrician working in the construction industry in New Jersey, I saw firsthand how the use of opioids prescribed for those injured on the job could become transformed into opioid use disorder. And when the Great Recession crashed the housing market starting in 2008, I witnessed deaths of despair due to the loss of livelihoods.
More than a decade later, we’re witnessing another increase in opioid overdose deaths. It is no coincidence that this comes on the heels of a pandemic that has caused the same economic upheaval, plus the added torment of isolation and lasting uncertainty. Anyone familiar with opioid use disorder knows this is a dangerous combination.
Fortunately, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) took action in 2020 to counter the reduction of access to health services brought on by the pandemic, allowing people to take home larger quantities of methadone at a time. Preliminary studies have shown this has increased engagement with treatment with few incidents of misuse.
Although SAMHSA’s exemptions were recently extended for a year, these changes are not permanent. And even with the exemptions, people must go through opioid treatment programs to receive methadone.
The Opioid Treatment Access Act improves access to and modernizes the process of receiving treatment for opioid use disorder by allowing pharmacies to dispense methadone — and not necessarily for just a day at a time — so people can receive treatment at more convenient locations. This reduces treatment-associated stigma by allowing people with opioid use disorder to pick up medicine at their local pharmacy just like everyone else instead of forcing them to wait in line at methadone clinics, which have become erroneously branded as magnets for crime and other antisocial behavior, despite studies saying otherwise.
We don’t force people with diabetes to trek to “the wrong side of town” to receive the insulin they have been prescribed. Treating people with opioid use disorder as outcasts strips vulnerable members of our community of their dignity and dissuades them from seeking treatment.
The Opioid Treatment Access Act would also make other important changes to the current system of opioid treatment. It builds on SAMHSA’s Covid-19 exemptions to allow people to receive larger quantities of methadone at once and codifies regulations that allow opioid treatment programs to operate mobile medication units without having to complete separate registrations for them. It also allows states to permit aspects of opioid treatment to be conducted via telehealth. Taken together, these advances lower the obstacle to care for people with opioid addiction, allowing them more flexibility and more time to carry on their lives beyond seeking and receiving treatment.
Addiction is a neurobiological process, not a moral deficiency, and it needs to be treated as such. If the country is serious about ending the opioid epidemic, an excellent place to start is by removing restrictions on opioid treatment that create opportunity costs for people needing help and stigmatize them. The country should take advantage of a robust national network of pharmacies and advancements in telehealth to give people the dignity and access they need to beat their addictions and get back on their feet.
Donald Norcross (D-N.J.) is a member of the U.S. House of Representatives Committee on Education and Labor and the Bipartisan Addiction and Mental Health Task Force.
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