Trump’s health secretary isn’t a fan of the ‘gold standard’ substance-use treatment — bad news for the opioid crisis

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US Health and Human Services Secretary Tom Price was visiting West Virginia on Tuesday for a “listening tour” to brainstorm solutions to the current opioid crisis when a reporter asked Price his thoughts on various drug treatment options, according to a report from the Charleston Gazette-Mail.

While Price echoed the Obama administration by calling substance-use disorder a “disease” and the crisis a “public health issue” and not a “criminal justice issue,” Price went against the prevailing wisdom on treatment options.

Price touted the success of faith-based treatment programs, and was decidedly non-supportive of medication-assisted treatment (MAT).

“If we’re just substituting one opioid for another, we’re not moving the dial much,” Price said of MAT, according to the Charleston Gazette-Mail. “Folks need to be cured so they can be productive members of society and realize their dreams.”

Considered by many experts to be the “gold standard” for overcoming opioid addiction, MAT uses prescription medications like buprenorphine or methadone to reduce cravings, allowing patients to work on the underlying issues leading to their substance use, without the constant pressure of withdrawal.

Studies in 2008 and 2011 conducted by the National Institute on Drug Abuse found that treatment using Suboxone, the most commonly prescribed version of buprenorphine, showed a “marked reduction” in drug use for participants. Approximately 50% of participants in the 2011 study reduced their substance use during extended Suboxone treatment. The success rate dropped to 8.6% once it was discontinued.

Because of its promising results, MAT has gained bipartisan support in statehouses, on Capitol Hill, and in scientific, medical, and treatment circles. But it’s expensive and remains difficult to access.

Bradley Stein, a senior natural scientist at the RAND Corporation who studies substance-use disorders, told Business Insider that MAT has “changed the landscape of treatment” for opioid-use disorder.

Stein said that states hit hard by the crisis like West Virginia and Pennsylvania have worked hard to expand access to MAT through public programs, Medicaid, and by expanding the number of physicians trained and certified to provide MAT.

West Virginia University is currently working to train primary care physicians throughout the state on how to administer medication-assisted treatment to expand desperately needed treatment across the state, Dr. Richard Vaglienti, the director of the Pain Management Center at West Virginia University told Business Insider earlier this year.

West Virginia had the highest drug-overdose death rate in the US with 41.5 deaths per 100,000 people in 2015.

Why Price’s opinion is important

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Secretary Price’s comments are extremely important because his opinions will shape the Trump administration’s approach to the opioid crisis.

With the American Health Care Act set to gut funding to Medicaid if passed, programs and policies implemented or championed by Price will take on increased relevance

During his last year in office, President Barack Obama signed two landmark laws — the Comprehensive Addiction and Recovery Act and the 21st Century Cares Act — that call for considerable funds for the opioid crisis. But how much and where those funds will go are hardly certain. Congress will continue to debate that in its budget negotiations.

It is not inconceivable to imagine Price recommending shifting funds allocated for MAT to faith-based treatments, if he thinks it is the best treatment option available.

Opioids, unlike many other substances, fundamentally change a person’s thought and behavior patterns.Almost all faith-based treatments are centered around achieving abstinence, but many addicts’ physical dependence on opioids makes abstinence incredibly difficult, if not impossible. Countless users relapse or skip out on treatment, no matter what stage of recovery they’re at.

MAT can be the difference between life or death for deeply entrenched opioid users, Turner Bitton, the president of the Drug Policy Project of Utah (DPP), told Business Insider. Those who fail out of abstinence-based treatment can go into a deep spiral of continuing use. Bitton is working to improve MAT access in Utah.

Trump established a commission headed by New Jersey Gov. Chris Christie in March to come up with solutions to the opioid crisis. The commission is set to submit a report by the end of the year.

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Source: http://www.thisisinsider.com/hhs-secretary-tom-price-medication-assisted-treatment-suboxone-news-opioid-crisis-2017-5

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