By Beth Connolly and Craig Meidl
COVID-19 is not the only public health crisis ravaging Washington and the rest of the country. As the 1.6 million Americans with opioid use disorder (OUD) and their loved ones know well, overdose deaths have risen dramatically since the start of the pandemic.
According to the Centers for Disease Control and Prevention, overdose deaths nationwide climbed to more than 93,000 in 2020, about three-quarters of which were associated with opioids, including fentanyl and heroin. This rise could be explained in part by the increased social isolation and financial stress that have resulted from COVID-19.
And the problem grew faster in Washington than in most states: In 2019 and 2020, 1,187 Washingtonians died from an opioid overdose – a 46% increase compared to 37% for the nation as a whole. This September, as we observe National Recovery Month, we urge federal elected officials to make addiction treatment more readily available and help stop these preventable deaths.
That goal is well within reach. The Food and Drug Administration has approved three medications to treat OUD – buprenorphine, methadone and naltrexone. These medicines, which do not cause a “high,” help people with OUD secure long-term recovery and cut the risk of overdose death by half. They also save $25,000 to $105,000 in health care and criminal justice costs over the lifetime of a person with OUD.
Yet only 18% of Americans with OUD receive these effective treatments, in part because the medications are hard to obtain – particularly buprenorphine, which greatly reduces overdose risk and helps patients recover from opioid addiction.
Federal law requires doctors and other health care providers to obtain a special waiver to prescribe buprenorphine for OUD – a hurdle not required for any other prescription drug. The waiver requirement, which limits how many people each prescriber can treat with the medication, is based on concerns – now dispelled and rooted in stigma – that buprenorphine can lead to misuse.
Consequently, only 6% of U.S. physicians are authorized to prescribe the medication, and in 2018 – the most recent year for which data is available – 40% of U.S. counties lacked a buprenorphine prescriber. This percentage is even higher in rural areas, leaving almost 30% of residents without adequate access to buprenorphine. Washington also has gaps in access. According to the U.S. Department of Health and Human Services Office of Inspector General, 19 Washington counties, including Spokane, had a high need for buprenorphine treatment services in 2018. Of those, Garfield, Lewis, Lincoln, Mason and Pacific had few or no providers to treat patients.
There’s a legislative solution to this challenge. The Mainstreaming Addiction Treatment (MAT) Act, introduced in both the U.S. Senate and the House of Representatives earlier this year, would immediately increase the number of health care providers able to prescribe buprenorphine. The bill would remove the cumbersome waiver requirement in this time of dire need and allow all clinicians with a controlled substance license from the U.S. Drug Enforcement Administration to treat patients with this lifesaving medication.
Eight members of Washington state’s congressional delegation, representing both political parties, have expressed support and added their names as co-sponsors to this critical legislation. They’re not alone:
Law enforcement and legal organizations – including the National Sheriffs Association, the National Association of Attorneys General, National District Attorneys Association, American Jail Association, Law Enforcement Action Partnership and the Police, Treatment, and Community Collaborative – all support removing outdated federal restrictions on prescribing buprenorphine. Dozens of Washington state-based organizations agree, including the Washington Association of Sheriffs and Police Chiefs, University of Washington School of Medicine, Washington State Association of Drug Court Professionals, Washington State Hospital Association and Washington State Medical Association.
Washington has two members of Congress – Rep. Cathy McMorris Rodgers, a Republican, and Senator Patty Murray, a Democrat – in committee leadership positions with the power to move this legislation. We urge them to do so as soon as possible and demonstrate their commitment to tackling overdose deaths.
With the delta variant of the coronavirus prolonging the consequences of the pandemic and the resulting social isolation, there’s no time to waste. This month – and every month – we must focus on concrete actions we can take to help our fellow Americans and Washingtonians recover from the scourge of opioid addiction. The good news is that we have medicine and treatment programs that we know work. Now, it’s time for Congress to pass the MAT Act and help more people access lifesaving care.
Beth Connolly leads The Pew Charitable Trusts’ substance use prevention and treatment initiative. Craig Meidl is chief of the Spokane Police Department.