Combating the opioid epidemic: Why science should guide policymaking

Combating the opioid epidemic: Why science should guide policymaking
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Amsterdam, New York is a small former carpet and mill town perched on the banks of the Mohawk River. Nearly its entire population could fit inside the Times Union Center, a 17,500-seat arena in nearby Albany. Once a thriving manufacturing center on a major industrial waterway, Amsterdam’s greatest assets today might be the hardworking character of her people and the sense of community that makes it feel like home.

As it happens, Amsterdam is my home. And in the span of just two weeks last December, my hometown lost four people to fentanyl overdose deaths.

The devastating struggle, pain and loss of the opioid epidemic has touched many places like Amsterdam. Family members, friends and neighbors, desperate to access treatment, find themselves put on yearlong waiting lists buried in bureaucratic red tape. I’ve heard from local community coalitions making real progress preventing drug use by educating our youth. However, flat funding leaves them with less and less as decades pass.

Today, just one in five individuals struggling with opioid use are receiving treatment for this disease. Although we’ve made gains in treatment capacity in recent years, this gap reflects a severe shortage of treatment providers still facing communities all across the country.

Congress took its first major steps on this issue when we passed the Comprehensive Addiction and Recovery Act last year. That bill included a provision I authored to expand access to medication-assisted treatment by allowing nurse practitioners and physician assistants to prescribe buprenorphine.

My colleague Rep. Ben Ray Luján (D-N.M.) and I took another step recently, introducing H.R. 3692, the Addiction Treatment Access Improvement Act to make permanent a program that allows nurse practitioners and physician assistants to prescribe addiction treatments and expand prescribing privileges to advanced nursing specialists.

Earlier this year, President Donald TrumpDonald John TrumpTrump threatens ex-intel official's clearance, citing comments on CNN Protesters topple Confederate monument on UNC campus Man wanted for threatening to shoot Trump spotted in Maryland MORE went in front of cameras and called the opioid crisis a national emergency. Saying that aloud was an important step for a sitting president, but it carried no weight in policy. The president needs to sign a public health emergency declaration for the opioid crisis, as requested by the president’s own bipartisan opioid commission. That still has not happened.

Unfortunately, old stereotypes and a lack of imagination continue to hinder our work to expand this type of care, which science and experience tells us gives most individuals their best shot at recovery. Health and Human Services Secretary Tom PriceThomas (Tom) Edmunds PriceJuan Williams: Trump weaves web of corruption Pelosi seizes on anti-corruption message against GOP White House staff offered discounts at Trump's NJ golf club: report MORE recently attacked medication-assisted treatment, claiming “If we’re just substituting one opioid for another, we’re not moving the dial much.”

Respectfully, I think Secretary Price is missing the point. Medical science continues to show that the truest path back to a normal productive life for those suffering from addiction starts with medication-assisted treatment, backed by appropriate counseling and support.

Secretary Price’s views on this matter are not unique. Unfortunately, I believe such views prevent us from using the best tools available to save lives. In our nation’s jails and prisons, incarcerated individuals are routinely denied treatment for the disease of addiction because of the stigma attached to this type of medication.

This represents a missed opportunity. Individuals reentering the community after incarceration are eight times more likely to suffer an overdose in their first seven days out of prison, a condition made worse by a lack of effective treatment options while incarcerated.

We are not without success stories on this issue. The Rikers Island Correctional Facility has maintained a well-regarded medication-assisted treatment program since 1987. They have put thousands of individuals on the path to recovery and driven down health-care costs at the same time.

More institutions should follow their example. I am preparing to introduce legislation that would provide evidence-based treatment through an advance restoration of Medicaid benefits for eligible incarcerated patients in the final 30 days before their release.

2016 was the deadliest year yet for America’s opioid epidemic. According to the Centers for Disease Control, more than 64,000 family members, friends and neighbors died from drug overdoses last year, an astonishing 21 percent increase from 2015. These sobering numbers, equivalent in death rate to a commercial airliner crashing every day for a year, should be a wakeup call for policymakers at every level of government.

There are many good ideas floating out there for how to help those struggling with this deadly disease, but there is one, common, absolute and indisputable truth: we must act quickly if we’re going to get control of the opioid epidemic.

My hometown of Amsterdam, and thousands of cities, towns and villages just like it all across the country are now on the front lines of this fight. As we go forward, let us be guided by the facts of science and medicine, follow the path of solutions that truly work, and take the steps most likely to achieve meaningful results before it’s too late.

Tonko represents New York’s 20th District and is a member of the Energy and Commerce Committee.