As the nation grapples with what the Centers for Disease Control and Prevention has identified as a nationwide prescription drug abuse epidemic, the commentary by Judge David Tapp advances a flawed view that has resulted in barriers to medication-assisted treatment (MAT) for Americans with substance-use disorders.
Prescriptions for addiction treatment medications have sharply increased in Kentucky and across the nation, paralleling the rise of the opioid abuse and heroin epidemic. Still, the federal government in 2013 found that just 11 percent of the nearly 23 million who needed treatment actually got it, and more than 300,000 who tried to get it were unable to do so.
Federal laws, health insurance restrictions, lack of training among health-care providers and stigma pose obstacles to treatment, resulting in 24,492 opioid- and heroin-related overdose deaths each year, with more than 1,700 Kentuckians among them.
Prior to this column, a Herald-Leader editorial stressed the urgent need to expand access to medications approved by the Food and Drug Administration to treat opioid addiction, including buprenorphine, methadone and naltrexone.
The FDA and addiction-treatment specialists agree these treatments are safe and effective when part of a comprehensive approach which includes counseling, behavioral therapies and other recovery support services.
During an April congressional hearing, Dr. Patrice Harris, an American Medical Association trustee, told lawmakers, "MAT has been shown to be highly effective in the treatment of opioid addiction." Dr. Laurence Westreich, president of the American Academy of Addiction Psychiatry, testified that "opioid-addicted people need access to a broad range of treatments (which) ... must include access to medication-assisted therapy..."
The reported proliferation of buprenorphine "pill mills" has resulted in crackdowns by policy makers and law enforcement, but the actions of a few bad actors should not restrict access to medication-assisted treatment.
Tapp favors one medication over others, yet each of the three approved medications has its qualities and purposes, and patients benefit when providers have this variety of tools. When we provide effective treatment to those who need it, we can expect a reduction in the demand for treatment medications on the streets, and a shrinkage of the customer base for pill mills.
The economic costs of the prescription-drug abuse and heroin epidemic total more than $55 billion each year in lost wages and workplace productivity, health care and criminal-justice costs. As the judge recognized, providing interventions and treatment is also costly to taxpayers.
Nevertheless, the National Association of Drug Court Professionals reports that taxpayers save $27 for every dollar invested in therapeutic drug courts. Additionally, if all inmates who needed treatment received such services and only 10 percent remained successful in their recovery after release, the nation would break even in a year.
We cannot lose sight of the benefits to families, communities and society of taxpayer funding for accurate testing for substance use and medication-assisted treatment. To echo the Herald-Leader editorial: "Lives are at stake."