Jerry Waters, Contributor
Now that it’s finally reached headline-grabbing epidemic proportions, Blue Cross Blue Shield just released an eyebrow raising report that opioid addiction has increased 494% from 2010 to 2016, yet medication-assisted treatment for opioid addicts has only increased by 65%. Worse, the Republican healthcare bill doesn’t seem to be addressing this as any type of a health crisis. And if that wasn’t horrifying enough, many judges across the nation refuse to accept medication-assisted treatment such as methadone or suboxone as legitimate substance abuse treatment. They demand abstinence-only treatment and continue to impose harsher sentences on addicts who relapse.
Ironically, the very hallmark of addiction is relapse. Let that sink in just a moment.
Admittedly, the judges do have a point that many methadone clinics are profit driven and there isn’t enough emphasis on titrating addicts off medication, but that’s something that can be fixed with sensible regulations. The bigger problem is that many judges just don’t understand medication-assisted treatment and think that either the addicts are getting a legal high, or that they just lack the will power to stop on their own. Also, there’s a difference between someone who is an opioid addict and someone who uses medication-assisted treatment for legitimate, chronic pain management. When it comes to these stark distinctions, it’s time for the judiciary to catch up.
If we go back to the time before Obamacare and we allow insurers to be able to pick and choose what they think are essential benefits in a healthcare plan, substance abuse treatment will be surely one of the first things to get cut. This will hurt the people who need treatment the most.
Sadly, doctors are still being incentivized by Big Pharma to write opioid prescriptions like they’re going out of style. Further, they’re not actively checking patients to ensure that they are not becoming addicted to the medication they’ve prescribed.
We live in an un-nuanced chiaroscuro culture where we love to criminalize and penalize the addict, but refuse to hold the people who write the prescriptions responsible unless their actions are so greedy or grotesque that someone finally takes notice.
Insurers shouldn’t be determining the parameters, modality, or qualifications for substance abuse treatment. They have a conflict of interest that’s worse than a monkey trying to sell bananas. Besides, weren’t these the geniuses who came up with the 28-day Minnesota treatment model because it fit neatly into their billing cycle? It’s taken decades and mountains of research to debunk their arbitrary treatment model, but it’s still going strong in many parts of the country.
Culturally, we seem obsessed with one-size-fits-all solutions. Maybe we can get our legislators to explain the difference between an opioid addict, a methamphetamine addict, a cocaine addict, and an alcoholic. We’d love to hear their take on co-occurring disorders and even though they haven’t the first clue, they’re happy to write legislation about these things. They’re more than happy to let people with strong profit motives, like insurers and drug companies, tell them what addicts need to get sober.
The opioid epidemic is real and it wasn’t caused by a bunch of middle-aged folks who went to doctors drug-seeking. This was caused by the profit motivations of doctors, hospitals, and pharmaceutical giants. This was caused by a still broken healthcare system that focuses on illness instead of wellness and pathology over prevention.
It’s time for people across the country to take a deep breath and reflect on the failed War on Drugs. It’s time to put people first again and not be so quick to put them in jail because they have an addiction problem.
Maybe, we can switch from saying “Just say no!” to “We can help you recover”.