Drug overdose crisis worsens in shadow of COVID-19 pandemic

President BidenJoe Biden Winter Storm Strikes Southern US Biden Writes Valentine’s Day Post for Wife Biden Plans to Focus on Coronavirus at First G7 Meeting MORE and Congress is coming under pressure from advocates to address a public health crisis that has been overshadowed by the coronavirus pandemic – the surge in drug overdose deaths.

While most of the government’s attention and resources have been focused on COVID-19, the overdose crisis has worsened as people struggle with job losses, isolation, and the deaths of family and friends caused by the pandemic.

More than 83,000 people in the U.S. are believed to have died of drug overdoses in the 12-month period ending in June, according to the most recent data available from the Centers for Disease Control and Prevention, a record number. .

“We are going to solve COVID in the short term and hopefully we are on the way to do it. But this addiction crisis was serious and it was building up before that, and it has only gotten worse, “said Kevin Roy, policy director for Shatterproof, a nonprofit focused on the addiction crisis.

“Recognizing that we had an existing public health crisis before COVID is really very important because we have to address it.”

Advocacy groups are sounding the alarm about the persistent lack of access to substance use disorder treatment across the country.

Three years after the ex President TrumpDonald Trump Six people guarding Roger Stone entered the Capitol during attack: NYT Cassidy writes column explaining vote to convict Trump Governor of Puerto Rico: Congress is ‘morally obligated’ to act on statehood vote MORE declared the opioid epidemic a national emergency, and two years after Congress passed a multi-million dollar bill in response to the crisis, a substantial part of the country still lacks access to drug-assisted treatment, considered by experts. as the gold standard for addiction care.

Three drugs approved by the Food and Drug Administration (FDA) to treat opioid use disorder can suppress cravings, reduce or eliminate withdrawal symptoms, and have been found in clinical trials to curb illicit drug use and reduce drug use. risk of death from overdose.

But among the 1.6 million people in 2019 who had an opioid use disorder, only 18 percent received drug-assisted treatment, according to a survey by the Substance Abuse and Mental Health Services Administration (SAMHSA).

This is in part because such treatment can be difficult to find in many parts of the country, few providers are licensed to provide it, and a stigma around addiction treatment persists, both among healthcare professionals and the public.

“It’s not really up for debate, drug-assisted treatment should be part of every treatment plan for opioid use disorder, period,” said Shawn Ryan, chair of legislative advocacy for the American Society for Addiction Medicine. .

But 40 percent of US counties don’t have providers who can prescribe buprenorphine, one of the FDA-approved drugs.

Even in specialized substance use treatment facilities, drug-assisted treatment can be difficult to find.

Only 42 percent of substance use treatment facilities offered at least one of three FDA-approved treatments in 2018, according to a Government Accountability Office report released in December.

Of those who offered at least one treatment, 33 percent offered buprenorphine, 28 percent offered naltrexone, and 10 percent offered methadone.

One way to tackle the problem, experts say, is to remove the exemption requirement that requires eight hours of training to prescribe buprenorphine, one of the most effective drugs for reducing the risk of death from overdose.

Only about 7 percent of physicians have obtained the exemption that allows them to treat 275 patients with buprenorphine per year, according to SAMHSA.

“Federal law makes it easier to prescribe strong opioid pain relievers that carry a risk of fatal overdose, such as hydrocodone, oxycodone, and fentanyl, than to treat someone with [opioid use disorder]”Wrote various medical and health groups in a letter to House and Senate leaders earlier this month.

The groups, which included the American College of Emergency Physicians and the Drug Policy Alliance, also noted that buprenorphine is the only FDA-approved drug used to fight addiction that can be prescribed without an in-person visit to a healthcare provider, imposing lifting restrictions. most critical during the pandemic.

While the Trump administration moved to end the waiver requirement shortly before Biden took office, the new administration canceled the plan because it was issued “prematurely.” Biden officials added, however, that the Department of Health and Human Services and the Office of National Drug Control Policy are looking for ways to “increase access to buprenorphine, reduce overdose rates and save lives.”

Along the way of the campaign, Biden’s plan to end the opioid crisis included a commitment to make drug-assisted treatment universally available no later than 2025 by removing waiver requirements, providing $ 20. billion in grants to expand treatment capacity and train healthcare professionals, and take action on the “barriers” posed by insurance companies.

Ending the waiver requirement has the support of both parties in Congress. Two bills sponsored by Rep. Paul tonkoPaul David TonkoKey House Democrat urges an “economic” approach to climate change Reverse the Trump administration’s many harmful efforts to censor science Overnight Energy: Trump officials finalize plan to open Tongass protected areas to logging Feds say Offshore Oil Testing May Continue Despite Drilling Moratorium | Democrats Question EPA Postponement of Inequality Training MORE (DN.Y.) and Sen. Maggie HassanMargaret (Maggie) HassanThe Hill’s Morning Report – Presented by TikTok – The Senate trial will have drama, but it’s no wonder the end of the centrist Democrats poses a major problem for progressives ‘Purple America’ will set political direction in 2022 PLUS (DN.H.) would remove the requirement and direct SAMHSA to conduct a national campaign to educate healthcare professionals on integrating substance use disorder treatment into their practices.

Experts say that removing the requirement could involve more primary care physicians in prescribing needed drugs, an important step given the shortage of specialists.

But despite the fact that more than 20 million Americans have some form of substance use disorder, there are only 4,400 certified addiction physicians actively practicing in the U.S., according to the American Society for Addiction Medicine. .

“This burdensome requirement does not improve patient safety, but it creates treatment bottlenecks and a shortage of providers across the country, particularly in rural areas,” Hassan, Tonko and other lawmakers wrote in a letter to Biden last week.

“This outdated waiver requirement continues to limit access to treatment, even when medical professionals can prescribe the same pain management medication without going through bureaucratic hurdles.”


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