July 16, 2018
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Trump administration has a plan to ease the opioid crisis. It needs to follow it.

Butch Comegys | The Times-Tribune via AP
Butch Comegys | The Times-Tribune via AP
U.S. Attorney General Jeff Sessions speaks on immigration policy and law enforcement actions at Lackawanna College in downtown Scranton, Pennsylvania, June 15, 2018.

U.S. Attorney General Jeff Sessions will be in Maine on Friday to talk about the opioid crisis. Like his boss, President Donald Trump, who wants to execute drug dealers, Sessions is expected to focus on a law enforcement approach during his Portland visit to the U.S. attorney’s office.

If the administration is serious about lessening the epidemic’s deadly consequences, he’d have a much broader discussion, one that involved treatment providers and Mainers who are living with substance abuse disorder. They could shed light on what tactics are working and need more support from state and federal officials.

Further, the administration already has a plan for easing the opioid crisis that is killing thousands of Americans each year. It just needs to follow it.

Last year, a commission on opioid addiction, appointed by Trump, offered concrete steps that should be taken now, such as the universal distribution of the anti-overdose drug Narcan to all police officers and expanded access to medication-assisted treatment, which has been found to be the most effective therapy.

The biggest impediment to many of these recommendations is that they run counter to the Trump administration’s rhetoric about substance abuse and medical care. The commission, headed by former New Jersey Gov. Chris Christie, did not call for the hiring of more police officers or the construction of a border wall to reduce the flow of illegal drugs through Mexico. Instead, it rightly focused on proven steps that should be taken to reduce the death toll from what is a medical and health crisis, in terms of treatment for those who already are addicted to opioids and preventing new addictions by tightening the supply of these drugs, most of which are obtained with prescriptions.

Trump has echoed some of these recommendations, but more often, he has called for more and tougher law enforcement, including the death sentence for drug dealers. He’s also called for “ great commercials” to scare kids away from drugs.

We don’t need more meetings to know what to do to ease the opioid crisis. What we do need is a leader who makes stopping the opioid crisis a priority with a commitment to federal support of what works: Medication-assisted treatment, federal and state reimbursement rates that aren’t so low that they dissuade medical providers from offering this treatment, the elimination of time limits that often cut short needed treatment and an expansion, not contraction, of Medicaid to enable more Americans to access treatment.

For those in the grips of substance-use disorder, medication-assisted treatment is the most promising pathway forward. “The research is unassailable,” the Pew Charitable Trusts said in a report last year. “Staying in recovery and avoiding relapse for at least a year is more than twice as likely with medications as without them. Medications also lower the risk of a fatal overdose.”

But only about 10 percent of those needing treatment get it, according to the 2014 National Survey on Drug Use and Harm. That leaves more than 20 million Americans unable to get treatment.

Barriers include a shortage of medical providers licensed and trained to provide the medications, a lack of insurance among those who need them and limited coverage for addiction treatment or none at all from some insurance plans. The result is long waitlists of people with substance-use disorders who want to stop using drugs.

The president has pledged more federal funds to address the opioid crisis. To make effective use of that money, much of it should be directed to a proven treatment methods.

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