Magazine article Clinical Psychiatry News

Opioid Addiction: More Tools, Better Education Needed

Magazine article Clinical Psychiatry News

Opioid Addiction: More Tools, Better Education Needed

Article excerpt


WASHINGTON -- Doctors need a variety of options to treat opioid addiction and more training on safe opioid prescribing, according to experts called to testify before the House Energy & Commerce Committee's Subcommittee on Oversight and Investigations.

One of the primary options--medication-assisted treatment (MAT) using buprenorphine--was criticized by Subcommittee Chairman Tim Murphy (R-Pa.).

Increased availability of MAT is among the recommendations made in late March by the Health & Human Services department.

"We are not going to end this opioid epidemic by increasing the use of opioids," Rep. Murphy, a psychologist, said at the April 23 hearing. "We need an exit strategy that enables Americans to become opioid free altogether. We can do better than addiction maintenance."

Physicians testifying before the subcommittee unanimously suggested that MAT needs to be a vital part of the treatment toolbox, noting that for some patients, it is an essential component of recovery.

Witnesses called for recognition that opioid addiction is a long-term issue; patients can need lifelong treatment to help prevent relapse.

"Opiate dependence is not like the common cold. It does not go away," testified Dr. Robert L. DuPont, president of the Institute for Behavior and Health in Rockville, Md. "It is a lifetime problem. A person who has opiate dependence is going to deal with that problem one way or another for his or her lifetime. People are not fixed in treatment."

Treatment options, including MAT, almost always prove to be short-term, and that needs to change, Dr. DuPont said, adding that it is critically important to get health insurers to recognize longer-term treatment.

Dr. Anna Lembke of the department of psychiatry and behavioral science at Stanford (Calif.) University, testified regarding the difficulty in getting Medicaid and private insurers to cover addiction treatment.

"When you try to get coverage for addiction treatment, they give you the huge runaround," she said, noting that ironically, that it's fairly easy to prescribe opioids and have those covered by most insurers.

"What that means is that if you want to get addiction treatment for patients who are struggling with the disease addiction, you can't get insurance to pay for it, which means that patients don't access the treatment," Dr. …

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