Bill would help those suffering from addiction through enhancing medication-assisted treatment
Additional efforts underway to encourage health care provider education
Congressman Brian Higgins, D-NY-26, has introduced a bill that aims to help those affected by opioid addiction get the most effective treatment available. The Recovery Enhancement for Addiction Treatment Act, or TREAT Act (HR 2536), improves treatment options for those addicted to opioids and heroin through the prescription of buprenorphine, a drug proven to help wean those affected off of harmful substances.
Higgins introduced the bill in the House of Representatives, along with Reps. Richard Hanna (NY-22), Paul Tonko (NY-20) and John Katko (NY-24). A similar bipartisan bill has been introduced (S.1455) by Sens. Edward Markey (D-Mass) and Rand Paul (R-KY), and cosponsored by Sens. Dianne Feinstein (D-Calif.), Sherrod Brown (D-Ohio), Mazie Hirono (D-Hawaii), Dick Durbin (D-Ill.) and Tammy Baldwin (D-Wisc.) in the Senate.
"Opioid abuse, while especially prevalent in Western New York, is a national epidemic that does not discriminate based on age or geography," Higgins said. "Giving prescribers the proper training and tools to combat addiction is an important piece of the puzzle to recovery and saving lives."
Currently, there is a disparity between those who can prescribe opioids, and those who can prescribe treatments for opioid addiction. More than 800,000 physicians can write controlled substance prescriptions, but only about 30,000 can prescribe the medication used to treat opioid addiction. Prescribers of buprenorphine are limited to treating 30 patients in the first year, and up to 100 in year two and beyond. Ability to prescribe buprenorphine is limited to physicians who meet specific qualifications.
The TREAT Act would enhance access to medication-assisted treatment by increasing the number of patients a buprenorphine prescriber can treat and expanding the ability to prescribe buprenorphine to nurse practitioners and physician assistants. The bill is supported by a number of professional organizations, including the American Medical Association, American Society for Addiction Medicine, Trust of America's Health, American Associate of Nurse Practitioners and the Association of American Medical Colleges.
The potential for legislative action to address this public health concern was called to Higgins's attention by Christene Amabile, a resident of Grand Island and nurse practitioner at Horizon Health Services. Horizon provides comprehensive services to those with mental health and substance abuse issues, including individual and group counseling, treatment services, case management, opiate overdose and prevention training, and support for families.
"There remains limited access to care for individuals with opiate use disorders, due in part to lack of health care providers who can prescribe buprenorphine," Amabile said. "It is important to examine the ethical aspects of this issue. We have a large pool of competent, well-prepared and educated NPs and PAs who could help restore the lives of individuals who are suffering from their addiction. It would appear that politics and lack of awareness are standing in the way of access to care and improved quality of life for not only the individuals who use substances, but for their families, friends and for the community at large."
Dr. Richard Blondell, director of the National Center for Addiction Training and professor and vice chair for addiction medicine at the University at Buffalo's department of family medicine, noted, "This legislation is needed. Medication-assisted treatment can help many who have become addicted to legal prescription medications or illicit street drugs; however, our small group of UB|MD addiction medicine physicians is not able to accept any more patients for this treatment option. We are deeply troubled when we have to turn away patients who we know we can help because we are at our 100 patient per physician limit."
In addition to the TREAT Act, Higgins sent letters to Health and Human Services Secretary Sylvia Burwell and Federation of State Medical Boards Chair Donald Polk, urging them to enact strict guidelines for the prescription of opioids and to enhance educational standards for prescribers. In March, the U.S. Department of Health and Human Services outlined steps to address opioid-related dependence and fatalities that include expanding the use of medication-assisted treatment, a goal reached through Higgins' TREAT Act; and providing training, prescriber guidelines and resources to help health professionals make informed decisions and reduce the over-prescribing of opioids.
Avi and his wife, Julie Israel, lost their 20-year-old son, Michael, in June 2011 as a result of opioid addiction. Michael was prescribed opioids as pain relief associated with Crohn's disease. To help combat the opiate epidemic, Avi started Save the Michaels of the World, an organization dedicated to raising awareness of prescription drug abuse and working on behalf of families touched by addiction. An advocate on the local, state and national level, Avi has worked closely with a number of elected officials, including Higgins, to enact legislative change.
Higgins announced this latest effort to address the addiction epidemic at Kids Escaping Drugs, an agency that works to support alcohol and substance addiction education and treatment services for families in Western New York.
Robin Clouden, executive director of Kids Escaping Drugs Inc., said, "As of April 2015, there were already 34 fatal opioid overdoses in Erie County alone. One hundred and sixteen people died of an overdose in Erie County in 2014. Nationwide, drug overdoses claim more lives than car accidents. More than 60 people die each day of an overdose in the United States and, according to the Centers for Disease Control, nearly 15,000 people die every year of overdoses involving prescription painkillers.
"Kids Escaping Drugs supports this initiative to educate more prescribing professionals about the epidemic of opioid addiction as well as the ability to provide this very effective treatment tool. It is imperative that more medical professionals be granted permission to help combat addiction through medication-assisted treatment to provide our patients greater opportunity of success in their recovery and not become one of the statistics referenced above."