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PostPosted: Tue Feb 16, 2016 12:22 am 
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Better late-- very, very late-- than never:

Here is the latest news concerning the Comprehensive Addiction Recovery Act of 2015 (aka Heroin Crisis Act): http://www.modernhealthcare.com/article/20160211/NEWS/160219972. It has easily passed Committee and is headed to the Senate floor next week. If approved, the bill is scheduled to go into effect this year.

Here are some new highlights:

• The proposed funding was originally $80 million. It may go to $1.2 billion with a proposal of $600 million in emergency funding (note that this article says ‘billion’, but that is a typo. Other sources confirm $600 million.
• Mid-level providers are looking to be added to those who can treat opioid-dependent patients
• Language addressing regulations around the current marketing, manufacturing and prescribing of prescription opioids (pain meds)

This funding (including any emergency monies) would directly impact every state. Additional federal funding would not only mean additional education and treatment services but could also mean more affordable access to medicated assisted treatment.


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PostPosted: Tue Feb 16, 2016 1:29 am 
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Doc J,

Sure sounds like good news for saving lives and hopefully med assisted Rx (MAT). I also hope mainstream (AA/NA) recovery type work improves, with new ideas and means to include MAT, and can somehow be included in this $$spend, because without real recovery work - well for me, I'd likely have failed with just sub. There are tons of remarkable profound important brutal naked truth/stories on addiction horrors and help in your 2 sites here and I hope somehow this is harnessed in this new federal $$spend.

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PostPosted: Tue Feb 16, 2016 2:07 pm 
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It is hard to make professionals in addiction change their minds once they are convinced that abstinence-only is the best way to go. Many of my fellow students give lip service to evidence based practice, but they are referring to therapy practices like motivational interviewing and cognitive behavioral therapy. Even though buprenorphine based recovery shows much higher rates of success for keeping opiate addicts safe and away from their drugs of choice, very few treatment centers are going to start including MAT or even referring people for MAT (medication assisted therapy). It's frustrating to me that other students in my program are holding on to antiquated models of treatment. I hope this Act helps bring addiction professionals into this millennium!

Amy

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PostPosted: Tue Feb 16, 2016 3:45 pm 
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Yep Amy, sadly, I agree, yet will keep hoping that change will happen. I would have loved to be abstinence only. Its frustrating to me that during my professional intervention, MAT was not mentioned, nor from my pain mgt doc, nor was it at rapid detox in FL, (I wanted what I thought was the easy way out) where my arm almost broke flopping about from WD while under anesthesia, nor after I later ODd or when I went to 30 day rehab and got really sick from WDs. I left rehab to get on sub, where I worked hard on my recovery (including NA/AA but bc I was on sub, I never felt truly welcome) and I rebuilt my life.

It appears those who visit this site are aware of sub/MAT and decide to choose it or not, stay on it or not, but unfortunately I had no awareness and I suspect others might not either. If I'd discovered MAT much earlier, I might have have kept my spouse, job, home.


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PostPosted: Tue Feb 16, 2016 10:34 pm 
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I have not followed this bill closely at all. My question is, does this bill include language to raise the 100 patient cap? I'm guessing not? Mathews/Burwell states she is working on administrative action to raise the cap by the end of this year - 2016. She made the exact same claim LAST YEAR - 2015. It's that statement that leads me to believe once again we are throwing money at the problem while something without cost that can help right now is not included.

Please tell me raising the cap is part of this bill. I fear it is not.


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PostPosted: Thu Feb 18, 2016 9:27 pm 
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Donh, I admit to being in the same position as you. I hope to look it over this weekend and write a post about it... I did read that a third of the billion will go to 'studies that examine the efficacy of medication -assisted treatment'. My feeling was that the reason for a third of it to be used in that way was to placate the 'anti' crowd. That's only a guess, and I may be entirely wrong about that.

My thought when I read that, though, was that there are NEVER studies looking at efficacy (or lack of efficacy) of residential programs. And why the heck not?! Think about all the money spent on traditional treatment, whether IOP, outpatient, or residential... money from patients, money from the Feds, money from state, county, and local governments, money from private donors and grants....

Many of the programs out there have large endowments. Endowments!! WTF.... these huge piles of money, left in wills by rich people who think they are 'solving the problem'... when in reality, many of the people who seek help are kicked out for 'not getting it'... and most of the people treated there are using within a year after discharge.

Hazelden has it's own publishing company, for pete's sake. They've managed to create this huge sense of respect for what they do, even with such crappy results. One think I miss, now that Reckitt Benckiser is out of the tank for Suboxone, is that nobody does marketing anymore. Their 'here to help' program put good-looking actor-addicts in ads, all smiling because of Suboxone. Now, we have DA's and law enforcement telling reporters that 'addicts are getting high on Suboxone', or 'buprenorphine is the same as heroin.' Meanwhile I have people addicted to opioids ask, at their appointments, 'how can a person get high from buprenorphine?!' They'll say 'I tried to get high from it a bunch of ways, but it never worked for me.'

Crazy...

The other thing that is supposedly in the bill is the allowance for APNP's to get certified and prescribe buprenorphine. I'm not sure if that will make much of a difference or not.... but i don't see it increasing the docs in my part of the country.


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Dr. Jeffrey Junig, M.D., Ph.D.

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