Pubdate: Thu, 28 Apr 2016
Source: Orlando Sentinel (FL)
Copyright: 2016 Orlando Sentinel
Contact:  http://www.orlandosentinel.com/
Details: http://www.mapinc.org/media/325
Note: Rarely prints out-of-state LTEs.
Note: Hartford Courant

OBAMA MUST DO MORE TO FIGHT HEROIN

President Obama's administration has missed opportunities to stem the 
opioid overdose crisis, and therefore it's no great surprise that 
heroin overdose deaths have tripled since 2010.

The administration dragged its feet on requiring mental health and 
addiction treatment to have the same insurance coverage as physical 
ailments; inexplicably, it took five years to write the federal 
regulations needed to implement the 2008MentalHealth Parity and 
Addiction Equity Act. Many insurance plans still ignore the need for 
parity, studies show. The administration is only this month 
finalizing rules to implement parity for mental health and addiction 
treatment in Medicaid...

Still... Obama has talked publicly about the opioid addiction 
epidemic and recently announced more money and a few federal actions 
to help quell the overdose crisis. It's a welcome change, but it is 
also a sign that bodies are piling up like cordwood and becoming hard 
to ignore: 47,000 died of overdoses in 2014 alone, with 61 percent of 
the fatalities from prescription pain relievers and heroin....

Here are a few of Obama's proposals, with suggestions that he go further:

More treatment medication. The likelihood that people will recover 
from hero in or painkiller addiction is vastly improved if they take 
medications such as Suboxone, which both blocks the euphoria of 
opioids and reduces craving.... Yet under federal law, doctors are 
limited to prescribing Suboxone to100 patients at any one time. Obama 
advocates increasing that limit to 200 patients- a good move, but not 
good enough.

The president's budget this year proposed money for a pilot project 
to authorize nurse practitioners, and not just doctors, to prescribe 
Suboxone. Why stop there? There's no reason why nurse practitioners, 
who can already prescribe medications in every state, should not have 
such prescribing authority...

Better medical education. Obama also announced that more than 60 
medical schools have agreed to include some form of training in 
prescribing opiates as a prerequisite to graduate. Excellent. But 
doctors should have broad training in addiction, which most medical 
schools skim if they cover it at all, not just prescription training.

Money. Obama said he is releasing money to help curb opioid 
overdoses. He included $1.1billion in his budget, but even if his 
budget passed, the money wouldn't be released until October. Other 
proposals include $11million to purchase naloxone, or Narcan, the 
drug that helps reverse overdoses; $94 million to be spread across 
271community health centers, or a little less than $300,000 each; 
another $11million to help states expand treatment. None of this 
gives the sense that we are dealing with a public health emergency.

Of course, money is a stumbling block in Washington. A case in point: 
In March, the Senate passed by a near-universal vote the 
Comprehensive Addiction and Recovery Act... The Republicans who 
control the Senate successfully beat back a Democratic attempt to 
attach $600 million in emergency funding to the legislation, airily 
telling proponents that they could use $400 million meant for other 
programs that was passed last year in the omnibus spending bill....

The most honest assessment came from New Hampshire Democratic Sen. 
Jeanne Shaheen. She said, "There is simply no excuse for Congress 
providing emergency funding for the Ebola and swine flu epidemics 
while ignoring an opioid crisis that's killing a person a day in the 
Granite State."

And, she could have added, killing 130 a day nationwide.
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MAP posted-by: Jay Bergstrom