WA healthcare and social service professionals in support of the Mainstreaming Addiction Treatment Act
We are healthcare and social service professionals in Washington state, from nurses to social workers, physicians, nurse practitioners, mental health specialists, peer counselors and more. We work with our community members who have an opioid use disorder (opioid addiction). We see the pivotal role that accessible, non-stigmatized and evidence-based addiction treatment can make in stemming the disturbing trend of suffering and deaths due to opioid use disorders. We strongly support US House Resolution 2482, the Mainstreaming Addiction Treatment (MAT) Act (as well as the companion Senate Bill 2074) which would remove non-evidence-based regulatory barriers around the use of buprenorphine, one of the gold-standard treatments for opioid use disorder. We ask all Washington Congresspersons to co-sponsor the Mainstreaming Addiction Treatment Act and to support its passage, so that we in Washington can more easily and effectively offer this lifesaving treatment to our communities.
We thank the following for already co-sponsoring the bill (to be updated as others sign on):
WA Congressperson & date of co-sponsoring the MAT Act:
Pramila Jayapal [D-WA-7], 5/7/2019
Denny Heck [D-WA-10], 6/4/2019
Dan Newhouse [R-WA-4], 6/19/2019
If you work in healthcare or social services in Washington state, sign-on to show your support for the Mainstreaming Addiction Treatment Act.
A list of signatories is found here.
Contact your Congresspersons here: https://democracy.io
Background
In our state — as in the country as a whole — the epidemic of opioid use disorders (OUD) and opioid-involved overdose deaths continues. No single intervention will solve this public health crisis. Important interventions on the state, community & health clinic levels have been implemented and are welcomed.
Access to medication-based treatment remains a foundational component of our response to this crisis, and treatment capacity in WA is increasing. Yet in recent studies, only an estimated 32–40% of persons with an OUD received evidence-based treatment. Unfortunately there are many barriers to treatment, and one major challenge is with government regulations that stymy access and have no basis in clinical evidence.
Treatment with buprenorphine — a partial opioid medication — reduces overdose mortality rates and reduces the use of illicit opioids. Compared to other “full” opioids — such as oxycodone, hydrocodone or heroin — buprenorphine (often co-formulated with naloxone) is far safer. As healthcare professionals, we have seen how buprenorphine treatment can give control of their lives back to our patients, improve their overall health, reduce deaths, and allow people to engage meaningfully in their lives and communities..
Sadly, additional federal regulations around buprenorphine inhibit accessibility and serve to stigmatize this treatment amongst health teams. These regulations apply only when buprenorphine is used to treat opioid addiction: (1) they require health care prescribers to complete an 8 or 24 hour training (depending on the type of prescriber), and (2) impose a cap on the number of patients a prescriber can treat for addiction at a time. While this very safe medication is highly regulated, there are no such regulations around far riskier medications that are often prescribed, such as full opioid agonists like oxycodone or hydrocodone.
Additionally, while we now understand that OUD is a chronic condition similar to other diseases such as diabetes or congestive heart failure, the regulations around buprenorphine prescribing discourage primary care providers from treating it as they would any other chronic disease. It is costly to health clinics to put all providers through such a training, and, most importantly, the presence of regulations stigmatizes opioid addiction treatment. The additional regulations create a false narrative that buprenorphine is somehow more complicated, or more risky, than other medications often prescribed. Consequently, these regulations dissuade many in healthcare from embracing OUD treatment as part of their practice. Until this changes, treatment access will never be as widespread as it could be, and particularly inhibits its incorporation into primary care settings.
Over a recent 10+ year period, nearly 500,000 deaths occurred from ‘full’ opioids, like oxycodone, heroin or fentanyl. While the prevalence of opioid use disorders has climbed, our regulatory system maintains the tightest rope around buprenorphine — the safest amongst opioids, and an effective treatment for OUD that reduces mortality rates. As those working in healthcare, we in Washington wish to see this curious logic change.
How would this change what is happening on the ground?
The person treated for a non-fatal opioid overdose at an emergency room (ER) expresses desire to start OUD treatment with buprenorphine. With the MAT Act, any ER provider could follow their ER’s protocol for providing a prescription of a buprenorphine treatment, with locations for outpatient follow-up, rather than only those who have completed the current regulatory hoops.
A person hospitalized for infections related to injection of opioids is ready to leave the hospital. With the MAT Act, any hospital provider could follow their hospital’s protocol for providing a prescription of a buprenorphine treatment, to allow time for the patient to follow up with a primary care clinic, rather than only those who have completed the current regulatory hoops.
A person arrives at a primary care clinic seeking OUD treatment with buprenorphine, having heard of its safety and efficacy. With the MAT Act, any primary care provider can treat this patient. With removal of the regulatory hoops, the stigma around OUD treatment will lessen, and more primary care teams will start to treat opioid use disorders as they do for many other chronic conditions.
It’s not just us. Leaders in addiction medicine catalyzed this push for regulatory change. Heads of departments of health from 18 states, DC & Puerto Rico agree. Medical societies — from those for primary care, hospital medicine, mental health care, and more — are in support of this overdue change. And the Mainstreaming Addiction Treatment Act has already garnered 77 co-sponsors, Democrats & Republicans alike, and counting.
To our WA Congresspersons: please help us in health care make opioid use disorder treatment easier, more accessible, and less stigmatized. Sign-on as a co-sponsor.
