Greater Access to Medication Essential for Treating Opioid Addiction

By John Lavitt 03/17/15

A new report released by the Legal Action Center advocates for more access to effective addiction medicines.

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In a clearly stated report released at the beginning of March, the nonprofit Legal Action Center advocates for wider use of medication-assisted treatment to combat opioid addiction. The report criticizes both the insurers and criminal justice officials for raising obstacles to effective care.

In the report entitled, Confronting an Epidemic: The Case for Eliminating Barriers to Medication-Assisted Treatment of Heroin and Opioid Addiction, the national organization expresses a strong belief that such policy change is essential to combating the prescription painkiller and heroin epidemic that continues to spread across the geography of the United States.

Medication-assisted treatment has demonstrated effectiveness in both detoxification and ongoing treatment. Nevertheless, the report explains how such treatments remain, “tragically, and senselessly, underutilized” by the insurance companies and the courts. The lack of effective utilization is a result of an institutionalized stigma.

The report's release coincides with legislation being reintroduced into the Senate that would invest in comprehensive treatment initiatives, including those incorporating medication treatments, in communities, and the justice system. Sens. Rob Portman (R-Ohio) and Sheldon Whitehouse (D-R.I.) are the main sponsors of the Comprehensive Addiction and Recovery Act (S. 524).

The Legal Action Center recommends that privately and publicly insured patients should have access to all three federally approved medications to treat opioid addiction (methadone, buprenorphine, and injectable naltrexone). In addition, since recent studies have shown that patients respond differently to the different treatments, opioid treatment programs should make use of all three options.

Further recommendations made in the report by the Legal Action Center include the following:

  • Final guidance needs to be issued on how the federal parity law specifically applies to medication-assisted treatment.
  • No judge or justice official should be allowed to deny medication-assisted treatment that a physician has recommended for an individual. Greater education and outreach for healthcare and judicial professionals.
  • Medication-assisted treatment should be fully integrated into jails and prisons, with post-release medication options available as well.
  • Promote treatment over incarceration when someone is arrested for opioid possession, addiction, or abuse. This is the key.

The Legal Action Center describes itself as, “the only non-profit law and policy organization in the United States whose sole mission is to fight discrimination against people with histories of addiction, HIV/AIDS, or criminal records, and to advocate for sound public policies in these areas.” Recommendations made in the report are well-constructed, citing published data points.

For example, it states that individuals whose treatment included medications were 75% less likely to experience an addiction-related death. Incredibly, the report explains how fiscal research on methadone maintenance programs show that every dollar spent on methadone treatment generates $38 in long-term financial benefits, including increased employment and decreased judicial costs.

A major problem is that only 28 states currently provide Medicaid coverage for all three medications for opioid dependence. When it comes to private insurance covering these medication-assisted treatment regimens, “many policies impose onerous prior authorization requirements, place arbitrary limits on medication dosage and length of treatment, or require people to 'fail first' at other treatments for one or even all medications.”

Barriers in the judicial system reveal the institutionalized stigma of addiction in America. Even when medication-assisted treatment is proving an effective solution outside of custody, people are often forced to stop upon entering jail or prison.

As the report expresses in arguably its most strongly-worded section, “Many courts, probation and parole agencies routinely prohibit individuals under their supervision from receiving [medication-assisted treatment]. Even when prescribed by a physician, those receiving medication-assisted treatment are sometimes sanctioned with jail time and disqualified from alternative sentencing programs.”

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Growing up in Manhattan as a stutterer, John Lavitt discovered that writing was the best way to express himself when the words would not come. After graduating with honors from Brown University, he lived on the Greek island of Patmos, studying with his mentor, the late American poet Robert Lax. As a writer, John’s published work includes three articles in Chicken Soup For The Soul volumes and poems in multiple poetry journals and compilations. Active in recovery, John has been the Treatment Professional News Editor for The Fix. Since 2015, he has published over 500 articles on the addiction and recovery news website. Today, he lives in Los Angeles, trying his best to be happy and creative. Find John on Facebook, Twitter, and LinkedIn.