Everyone may not agree on how we’re going to quash the epidemic of heroin and prescription painkiller abuse that's killing thousands of Americans every month. But all can concur that there’s an urgent need to collaborate to stem the tide of addiction and death currently sweeping the country.
With that in mind, more than a dozen stakeholders recently banded together to work toward addressing the opioid crisis, calling themselves the Coalition to Stop Opioid Overdose. Including everyone from the National Association of Social Workers to the American Society of Addiction Medicine, one of the group’s first big pushes is to make sure that comprehensive legislation is passed on Capitol Hill to address the epidemic.
There are so many different concerns and facets of this wave of drug use that it’s important to find a unified voice, says Yngvild Olsen, M.D., an addiction medicine specialist based in Maryland and director at large of ASAM.
“An important piece to this is really being able to find where there is agreement and then move forward as a unified voice,” she says. “When we look at this epidemic, there are so many different parts to it and all of those parts really need to be tackled in order for us to make a dent.”
Coalition members convened Thursday in Washington, D.C., to announce their formation. They plan to target five top priorities to curb deaths from heroin and painkillers according to a press release:
- Improve access to medication-assisted treatments, such as buprenorphine and methadone, for those with opioid addiction.
- Expand the availability of the overdose-reversal drug naloxone in health care settings and beyond.
- Implement enhanced prescription drug monitoring programs that can help to track the dispensing and prescribing of controlled substances.
- Raise the level of opioid prescriber education.
- Enact the Comprehensive Addiction and Recovery Act (which was just approved by Congress and now needs to be reconciled with the Senate version of the law).
Olsen — who is also head of the Maryland Society of Addiction Medicine, and the state’s Association for the Treatment of Opioid Dependence, among other designations — notes that the first item on the list is also particularly pressing. Rural areas of the country, such as the Appalachian region, have been hit hard by the epidemic. And yet, there are some geographic areas where there are thousands of opioid addicts, with few or no doctors who are trained in treating such addiction. An estimated 1 million individuals are in need of opioid dependence treatment and can’t access it, she notes.
Insurers have also been hesitant to reimburse for the treatment of opioid dependence, but that’s starting to change. Earlier this month, the payer Cigna Corp. announced a partnership with Olsen’s American Society of Addiction Medicine to help improve treatment for those with substance use disorders. They’re supplying ASAM with two year’s of de-identified patient data to help the society analyze, test and determine best practices for treating drug dependence.
And just yesterday, Cigna announced that it’s setting a goal to reduce its health plan members’ use of opioids by 25 percent in the coming years. They’re also planning to encourage docs to rapidly adopt the Centers for Disease Control and Prevention’s new guidelines on properly prescribing painkillers, among others steps. “To respond to this crisis, all stakeholders — patients, physicians and other providers, pharmaceutical manufacturers and distributors, payers, pharmacists and governments — must join together to prevent substance use disorders, and assure access to all appropriate treatments,” David Cordani, president and CEO of Cigna, says in the announcement.
Just as hospitals and insurers seem to be getting some sort of a grip on the epidemic, a new wrinkle emerges. More recently, reports are emerging of a growing number of deaths from powerful fentanyl, Olsen notes — in states like Massachusetts, Rhode Island and Ohio. Just recently, in one northern Maryland county, three people died from fentanyl overdoses within a 19-hour span, she says.
“That’s really why this coalition is so important and why Congress needs to act boldly. This is not a time to be timid,” Olsen says. “We’re losing people every day across the country and it doesn’t really matter if it’s urban, suburban, rural, and all different types of economic strata. Addiction doesn’t discriminate.”
Here’s the full list of those involved with the Coalition to Combat Opioid Overdose, which is funded by Adapt Pharma, ASAM, CleanSlate Centers, Indivior, Merck and Proove:
- American Academy of Physician Assistants
- American Association of Nurse Practitioners
- American College of Emergency Physicians
- American Congress of Obstetricians and Gynecologists
- American Medical Student Association
- American Society of Addiction Medicine
- Association of Women’s Health, Obstetric and Neonatal Nurses
- Facing Addiction
- National Association of Clinical Nurse Specialists
- National Association of Social Workers
- The Association of Recovery Schools
- The National Center on Addiction and Substance Abuse
- Young People in Recovery