An epidemic is sweeping across the United States, claiming thousands of lives each year. Drug overdoses are now the leading cause of accidental death in the U.S., according to the American Society of Addictive Medicine (ASAM). In just 2014 alone, heroin overdoses claimed the lives of 10,574 people in the U.S. Now the U.S. government is stepping up its efforts to provide treatment for drug addiction in hopes of reducing addiction and mortality rates in this country.
The Department of Health and Human Services (HHS) recently announced that it is sending $94 million to health centers to help treat the prescription opioid abuse and heroin epidemic in the United States. The HHS funding bolsters other financial support from the U.S. government earmarked to increase access to treatment.
Opioids are a type of painkiller chemically related to compounds in the opium poppy plant. Many people use the words “opioids” and “opiates” interchangeably but there is a significant difference between the two. Opiates are natural compounds found in the poppy plant. Early drug makers extracted the opiates morphine and codeine from the plant to make relatively strong opiate painkillers.
Modern pharmaceutical companies now synthesize and semi-synthesize the compounds to create incredibly potent opioid analgesics. Drug companies make semi-synthetic hydromorphone, hydrocodone and oxycodone from morphine; illicit drug manufacturers make heroin from morphine. Fentanyl, methadone and tramadol are types of extremely potent synthetic opioids. Many illegal drug makers are creating super-strong heroin by adding fentanyl and other synthetic opioids, drastically increasing the risk for addiction and overdose.
Opioid abuse and addiction have reached epidemic proportions in the United States. Much of this abuse and addiction stem from non-medical use, which means using a drug for recreation or for a condition for which it was not prescribed. Approximately 4.5 million people used opioids for non-medical purposes in 2013, according to NIDA, and an estimated 289,000 were current heroin users.
Opioid abuse and addiction increases the risk for accidental death from overdoses. The rising incidence of opioid abuse and addiction is driving up the number of deadly overdoses. Deaths from unintentional overdoses of prescription pain medications nearly quadrupled between 1999 and 2013. The number of deaths associated with heroin skyrocketed nearly 39 percent between 2012 and 2013.
NIDA estimates that 23 percent of people who try heroin become addicted to it. Addiction is a disease that changes the structure of the brain in a way that fosters compulsive drug use. Because it is a brain disease, quitting is difficult even for those who want to stop. As with other chronic diseases like diabetes or asthma, relapses can occur. Fortunately, medication-assisted treatment helps patients manage their disease.
The Use of Medication-Assisted Treatment for Heroin Addiction
Medication-assisted treatment combines drugs approved by the U.S. Food and Drug Administration (FDA) with behavioral therapies and patient monitoring to treat opioid disorders. The FDA-approved medications, such as methadone, buprenorphine, buprenorphine-naloxone combination products, and naltrexone, relieve the symptoms of opioid withdrawal. This approach to treatment allows patients to participate in counseling and behavioral therapy to learn how to live without drugs before going through the difficult withdrawal process.
MAT is highly effective but, unfortunately, only a small percent of people who might benefit from the treatment actually receive it. Federally administered health programs can increase access to these services and allow more people to get the help they need.
The Obama Administration and the Department of Health and Human Services have made the opioid crisis a top priority. HHS focuses their efforts on improving practices for prescribing opioids, increasing the use of naloxone to reduce fatalities associated with drug overdoses, and increasing access to medication-assisted treatment. Obama issued a Presidential Memorandum to ensure medical professionals receive the training they need to prescribe pain relievers appropriately and to improve access to MAT. In October 2015, the President included a $1.1 billion initiative in the budget to help ensure that those with opioid use disorders who are willing to undergo treatment are able to access the care and medication they need.
The good news is that more people are receiving help than ever before. More than 1.3 million people received behavioral health services at health centers in 2014, up 75 percent just since 2008. Support from the Recovery Act and the Affordable Care Act made the increase in care possible. The funding from HHS will build upon this support by helping health centers improve and expand delivery of medication-assisted treatment services to target opioid addiction in underserved areas.
HHS Ponies Up $94 Million in Funding
On March 11, 2016, HHS Secretary Sylvia M. Burwell announced $94 million in Affordable Care Act funding to 271 health centers in 45 states, the District of Columbia, and Puerto Rico. This funding should help improve and expand the delivery of substance abuse services in health centers, specifically focusing on opioid abuse and addiction treatment in underserved populations.
“The opioid epidemic is one of the most pressing public health issues in the United States today,” said Secretary Burwell. “Expanding access to medication-assisted treatment and integrating these services in health centers bolsters nationwide efforts to curb opioid misuse and abuse, supports approximately 124,000 new patients accessing substance use treatment for recovery and helps save lives.”
More than 1,300 health centers operate about 9,000 treatment delivery sites in every state, Washington D.C., Puerto Rico, the Virgin Islands and the Pacific Basin. More than 170,000 people work at these health centers currently, providing care for nearly 23 million patients. HHS expects the $94 million investment will help selected health centers at the forefront of the opioid epidemic hire approximately 800 providers to treat nearly 124,000 new patients in underserved communities.
The HHS Health Resources and Services Administration (HRSA) will administer the awards to health centers across the country. The funds will help improve care by increasing the number of patients these health centers screen for substance use disorders, connecting more patients to treatment, and helping more people access medication-assisted treatment. Funding will also provide educational and training resources to help healthcare professionals make informed decisions when it comes to prescribing pain relievers.
“HRSA's innovative investment in the delivery of medication-assisted treatment for substance use disorders affirms the importance of behavioral health to overall health,” said Kana Enomoto, Acting Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA).
The most recent steps by HHS show healthcare professionals, administrators and policymakers are taking every possible step to expand access to medication-assisted treatment and to stop the opioid epidemic in its tracks.