Last summer, the director of the American Psychiatric Association (APA) called on his colleagues to fight the epidemic, saying:
"This is a crisis that affects people from all walks of life, all races and all ethnicities. Opioid addiction knows no racial, economic or geographical bias. The sad truth of the opioid crisis is that it touches every segment of our communities, which is why it is so imperative that it come to a swift end."
The APA joined the American Medical Association (AMA) in highlighting factors critical to reversing the epidemic. Priorities include:
- Prescription drug monitoring programs
- Access to naloxone
- Addiction medicine as a sub-specialty
- Breaking down barriers to pain management
President Donald Trump and the GOP-led Congress are still working to repeal the Affordable Care Act (ACA), under which 20 million people gained health insurance coverage. That number comprises an estimated 2.8 million people with substance use disorders, including 220,000 with opioid disorders.
Healthcare practitioners who treat substance abuse fear repealing the ACA seriously threatens progress fighting the opioid epidemic. Under the ACA, more money went to treatment programs and accommodating increased demand for services. Even as the Trump administration continues to debate the future of the ACA, healthcare practitioners seem to face another obstacle in the opioid addiction fight. In the view of many, Attorney General Jeff Sessions represents a serious threat because he favors mandatory minimum jail sentences for drug infractions over drug treatment and recovery options.
Consider the comments he made at a March 7 Youth Summit on Opioid Awareness in New Hampshire:
- “There are three main ways to fight back against this problem: Prevention, criminal enforcement and treatment. Criminal enforcement is essential to stopping the transnational criminal organizations which ship drugs into our country … We are going to get rid of them.”
- “Treatment is also important, but treatment often comes too late. … Experts will tell you that recovery is not certain.”/li>
- “The most effective solution in the 1980s and early ’90s – when, for example, we saw a significant decline in teen drug use – was the Prevention Campaign.”
These are the broad issues that concern substance abuse experts about Sessions:
- He sees drug use as a moral issue rather than a health issue.
- He opposes marijuana use, even where it is legal or used for medical purposes.
- He opposes even modest prison reform and reduction of Reagan-era sentencing for drug crimes.
- He has suggested a return to “Just Say No” to decrease drug addiction.
Many substance abuse treatment experts see Sessions’ mindset as turning back the clock. “The first to pay the price for this will likely be people with substance use disorders and their families,” Lloyd Sederer, chief medical officer of the New York State Office of Mental Health, recently wrote in U.S. News and World Report. “We were moving away from a criminal justice approach for substance use disorders to a prevention-and-treatment approach, thanks to better and less discriminatory insurance coverage. Now, we may return to ‘bust ’em and jail ’em’ all over again, the most ineffective and costly approach known thus far.”
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