CLEVELAND, OH — With a record 1,914 Ohioans dying from drug overdose in 2012, U.S. Sen. Sherrod Brown (D-OH) outlined a plan to help fight the scourge of opiate abuse wreaking havoc throughout Ohio. Brown announced his support for The Recovery Enhancement for Addiction Treatment Act (TREAT Act). Brown plans to re-introduce the TREAT Act to enable more health care providers to treat larger numbers of patients struggling with addiction.
“Americans all across the country have been affected by the growing public health crisis caused by opioid use,” Brown said. “This is a complex scourge that requires a multi-pronged solution. We’ve got a problem when it’s easier for Americans to get heroin than it is for them to get help to break their addiction. That is why we must give patients greater access to medically-assisted drug addiction treatment in the outpatient setting. The TREAT Act would accomplish this by enabling more health care providers to treat larger numbers of patients struggling with addiction to opioids such as oxycodone and heroin. This will help save lives while simultaneously saving our hospital system money and reducing drug-related crimes.”
During a press conference at the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County, Brown was joined by Jordan Puccinelli, a Cuyahoga County resident who struggled with an addiction to opioids and has been sober for three years. Dr. Christina Delos Reyes, Program Director for Addiction Psychiatry at University Hospitals Case Medical Center, and William Denihan, CEO of ADAMHS, discussed efforts to address addiction in northeast Ohio.
“Treatment works. People recover. We do not lack the technology or expertise to treat this illness. We lack the infrastructure, the systems, and the policies that would put treatment into the hands of the individuals who need it,” Dr. Delos Reyes said. “The TREAT Act offers an opportunity to directly impact access to treatment for opioid addiction, by removing limits on highly trained physicians and by allowing other providers such as nurse practitioners and physicians' assistants to prescribe medication that can reduce suffering and save lives.”
Opioid addiction is a chronic disease that, when left untreated, places a large burden on the healthcare system. Deaths from opioid overdoses in the United States have increased by more than five times since 1980. In Ohio alone, a record 1,914 citizens, or five people per day, died from unintentional drug overdose in 2012. Two-thirds of these overdoses involved opioids. Each year, about 475,000 emergency room visits are attributable to the misuse and abuse of opioid pain killers across the U.S.
Federal law currently limits the capacity for providers to care for patients with opioid abuse problems using medically-assisted treatment. Under current law, physicians must meet specific conditions and apply for a special waiver in order to be authorized to prescribe certain opioid addiction medicines, like buprenorphine. Further, physicians are legally disallowed from treating more than 30 patients during their first year and are restricted to treating only 100 patients per year afterwards. This has led to long waitlists for medically-assisted treatment and has made it more difficult for patients to receive the combination of behavioral health and medical treatment they need.
As a result, of the approximately 2.5 million Americans who abused or were dependent on opioids in 2012, fewer than 40 percent received medication-assisted therapy for their condition. To help solve this problem, the TREAT Act would increase the number of patients that providers are allowed to treat in an outpatient setting and, for the first time, allow qualified nurse practitioners and physician assistants to treat addicted patients. Behavioral health and supportive care, combined with medication, can provide a powerful combination to give people a fighting chance against addiction.
Specifically, this legislation would:
- Increase the number of patients providers are initially allowed to treat from 30 patients to 100 patients per year during their first year of certification for treatment.
- Allow physicians, after one year, to request removal of the limit on the number of patients they can treat. To be eligible:
- Physicians must be substance abuse treatment specialists, as recognized by specific board or society certifications, or
- Non-specialist physicians must complete approved training and practice in a “qualified practice setting.”
- “Qualified practice settings” are named in the legislation and include clinical settings that have defined third-party oversight, performance metrics, or quality review, or that are part of systems serving populations with high need.
- Allow certain nurse practitioners and physician assistants to treat up to 100 patients per year, provided they:
- Are licensed in a state that already allows them to prescribe controlled substances (like Ohio),
- Complete approved training on opioid addiction treatment, and
- Are supervised by a physician who is approved to prescribe opioid addiction medicine, such as buprenorphine.
- Require the Government Accountability Office (GAO) to examine changes in treatment availability and utilization; quality of treatment programs; integration with routine healthcare services; diversion; impact on state level policies and legislation; and use of nurse practitioner and physician assistant prescribers.
Brown has led the fight to help prevent and crack down on prescription drug abuse. His work includes efforts to shutter pill mills, monitor physicians whose prescribing patterns are outside the norm, and end the practices of “doctor shopping” and “pharmacy hopping.” Brown is currently working on a bipartisan bill that will increase monitoring of and corrective action on prescription patterns on the part of doctors, pharmacies, and patients. It would include a Medicare lock-in program for patients whose prescription-filling patterns suggest drug overuse. Lock-ins limit high-risk patients from visiting multiple doctors and pharmacies to obtain and fill prescriptions. Last Congress, Brown joined a group of bipartisan senators to introduce legislation to reauthorize the National All Schedules Prescription Electronic Drug Reporting (NASPER) Act, a prescription drug monitoring program critical to combating the abuse of prescription drugs.
Brown has also joined his colleagues in introducing legislation that would prevent teenagers from gaining access to discarded prescription drugs by permitting individuals and long-term care facilities to deliver unused drugs for safe disposal and by expanding drug “take-back” programs.