Politics and the Fallacy of Treatment Policy

In the State of Florida, residents are thrilled that the Governor finally declared the opioid epidemic a Public Health Emergency. This great first step is a clear acknowledgment of the problem we have been seeing getting worse every day, and it can give the state access to $54 million for prevention, treatment, and recovery resources. The problem remains that this money might not go to the places where it can do the most good. It is unclear if this money will help individuals without insurance access treatment. At this time, there are very few public beds available for those suffering. Even in private facilities, of which South Florida especially has no shortage of, those who have insurance are given limited time in treatment to truly get the help that they need. What we do know is that there seems to be a lot of support for medication-assisted treatment (MAT). In this respect, the proposal allocates:

• $17.7 million per year to pay for methadone and buprenorphine maintenance treatment (and associated counseling) for indigent, uninsured, and underinsured individuals with opioid use disorders.
• $3.7 million per year to pay for VIVITROL, a medication that blocks the effects of opioids and helps prevent relapse to opioid dependence.
• $140,400 per year for additional training on medication-assisted treatment and continuous quality improvement initiatives for peer support services.
• $365, 182 per year to expand the Medication-Assisted Treatment Prescriber Peer Mentoring Project.

Medication Assisted Treatment (MAT) is one good treatment option for those diagnosed with Opioid Use Disorder, but it is not the only treatment option. It is important for money to go towards comprehensive treatment which includes MAT but is not limited to it or only supportive of it. The proposal (which includes more than what was stated above) lacks support for intensive psychotherapy, increased public treatment beds, a continuum of care, treatment for co-morbid problems or diagnoses (both other substance use disorders and non-substance related mental illness), life skills and other re-integration support. We have an alcohol and substance use disorder problem in the United States! Until we put our time, energy, and money towards prevention, education, and adequate treatment, it will continue to get worse no matter what politicians say or where this money is allocated!

Dr. Rachel Needle has specialized training in the area of substance use disorders. She is a professional consultant to substance abuse facilities and assists them in expanding and enhancing clinical programming. Dr. Needle also does expert training on the topic of substance abuse, mental illness, and sexual health for staff members at residential and outpatient facilities that specialize in alcohol and substance use disorders.

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