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 Post subject: HHS Leaders Call For Expanded Use of Treatment Medications
PostPosted: Tue Apr 29, 2014 5:37 pm 
National Institutes of Health Press Release: HHS Leaders Call For Expanded Use of Medications to Combat Opioid Overdose Epidemic

April 25, 2014 by ATForum

New England Journal of Medicine commentary describes that vital medications are currently underutilized in addiction treatment services and discusses ongoing efforts by major public health agencies to encourage their use

A national response to the epidemic of prescription opioid overdose deaths was outlined in the New England Journal of Medicine by leaders of agencies in the U.S. Department of Health and Human Services (HHS). The commentary calls upon health care providers to expand their use of medications to treat opioid addiction and reduce overdose deaths, and describes a number of misperceptions that have limited access to these potentially life-saving medications. The commentary also discusses how medications can be used in combination with behavior therapies to help drug users recover and remain drug-free, and use of data-driven tracking to monitor program progress.

The commentary was authored by leaders of the National Institute on Drug Abuse (NIDA) within the National Institutes of Health, the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Centers for Medicare and Medicaid Services (CMS).

“When prescribed and monitored properly, medications such as methadone, buprenorphine, or naltrexone are safe and cost-effective components of opioid addiction treatment,” said lead author and NIDA Director Nora D. Volkow, M.D. “These medications can improve lives and reduce the risk of overdose, yet medication-assisted therapies are markedly underutilized.”

Research has led to several medications that can be used to help treat opioid addiction, including methadone, usually administered in clinics; buprenorphine, which can be given by qualifying doctors; and naltrexone, now available in a once-a-month injectable, long-acting form. The authors stress the value of these medications and describe reasons why treatment services have been slow to utilize them. The reasons include inadequate provider education and misunderstandings about addiction medications by the public, health care providers, insurers, and patients. For example, one common, long-held misperception is that medication-assisted therapies merely replace one addiction for another – an attitude that is not backed by the science. The authors also discuss the importance of naloxone, a potentially life-saving medication that blocks the effects of opioids as a person first shows symptoms of an overdose.
The article describes how HHS agencies are collaborating with public and private stakeholders to expand access to and improve utilization of medication-assisted therapies, in tandem with other targeted approaches to reducing opioid overdoses. For example, NIDA is funding research to improve access to medication-assisted therapies, develop new medications for opioid addiction, and expand access to naloxone by exploring more user-friendly delivery systems (for example, nasal sprays). CDC is working with states to implement comprehensive strategies for overdose prevention that include medication-assisted therapies, as well as enhanced surveillance of prescriptions and clinical practices. CDC is also establishing statewide norms to provide better tools for the medical community in making prescription decisions.

Charged with providing access to treatment programs, SAMHSA is encouraging medication-assisted therapy through the Substance Abuse Prevention and Treatment Block Grant as well as regulatory oversight of medications used to treat opioid addiction. SAMHSA has also developed an Opioid Overdose Toolkit to educate first responders in the use of naloxone to prevent overdose deaths. The toolkit includes easy-to-understand information about recognizing and responding appropriately to overdose, specific drug-use behaviors to avoid, and the role of naloxone in preventing fatal overdose.

“SAMHSA’s Opioid Overdose Toolkit is the first federal resource to provide safety and prevention information for those at risk for overdose and for their loved ones,” said co-author and SAMHSA Administrator Pamela S. Hyde, J.D. “It also gives local governments the information they need to develop policies and practices to help prevent and respond appropriately to opioid-related overdose.”
CMS is working to enhance access to medication-assisted therapies through a more comprehensive benefit design, as well as a more robust application of the Mental Health Parity and Addiction Equity Act.

“Appropriate access to medication-assisted therapies under Medicaid is a key piece of the strategy to address the rising rate of death from overdoses of prescription opioids,” said co-author Stephen Cha, M.D., M.H.S., chief medical officer for the Center for Medicaid and CHIP [Children’s Health Insurance Program] Services at CMS. “CMS is collaborating closely with partners across the country, inside and outside government, to improve care to address this widespread problem.”

However, the authors point out that success of these strategies requires engagement and participation of the medical community.
The growing availability of prescription opioids has increased risks for people undergoing treatment for pain and created an environment and marketplace of diversion, where people who are not seeking these medications for medical reasons abuse and sell the drugs because they can produce a high.

The press release can be accessed at: http://www.nih.gov/news/health/apr2014/nida-24.htm

The New England Journal of Medicine article can be accessed at: http://www.nejm.org/doi/full/10.1056/NE ... tured_home

Source: National Institutes of Health – April 24, 2014


Article originally posted on AT Forum: http://atforum.com/news/2014/04/hhs-leaders-combat-opioid-overdose-epidemic/

 Post subject: Re: HHS Leaders Call For Expanded Use of Treatment Medicatio
PostPosted: Mon Oct 26, 2015 4:32 pm 

Joined: Thu Sep 24, 2015 11:51 pm
Posts: 20
Location: KY
It would be awesome for dr's to encourage MAT. BUT.... If these insurance companies dont wanna help us pay for treatment then ppl wont have the money to keep attending! I attend MAT in another state... which as of yet it dont matter where i attend treatment at because NONE of my 3 insurances want to even attempt to pay for my treatment or even pay part of the cost! It's very discouraging! They won't pay for my treatment but yet if i were to be out dr shopping getting unnecessary test and prescription after prescription my insurances would gladly pay for that... and end up being out more money than if they were paying for my treatment! It's just so very frustrating!!! i only get a little over $700 a month and now my treatment is up to $470 a month!!! That leaves barely any money to live on!!!! not to mention the gas it cost me to pay someone to take me to treatment. i have to go at least 2-4 times a month. and $20 for gas to get to the center and back is a lot of money when you gotta give it to someone 2-4 times a month. I am a compliant patient and have been since i started my treatment. I pass all my drug screens and attend my councilor meetings and my group meetings. but my insurance not wanting to pay is getting really old. one insurance says call the other ins then the other ins says call that ins then that ins says call the other ins and its just a ridiculous cycle that they are bouncing me around and im just STUCK in the middle and BROKE all the time! I would love LOVE LOVE to start a petition..... saying insurances need to start paying for MAT no matter what the diagnosis code is or treatment code is!!!!!! ...... i guess thats all..... rant over......

 Post subject: Re: HHS Leaders Call For Expanded Use of Treatment Medicatio
PostPosted: Fri Oct 30, 2015 11:58 am 
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Joined: Sun May 04, 2014 9:54 pm
Posts: 199
Location: North Georgia
You've got some good points! If we don't fight for an achieve TRUE "parity" (that is "equality" in insurance coverage with other illnesses) then expanding access won't do much good for anyone other than the rich or upper middle class than can afford to pay for it. Things are starting to get better, and there's a post in the main forum up top that has the codes for methadone re-imbursement that more and more folks are starting to see work since the Parity Act went into full effect this year. Also new diagnosis and procedure codes for insurance billing went into effect 10/1 (this month!), so that should help as well. I think things are getting better (slowly), but you're right.... until we have full parity expanding access is futile!

Zac Talbott, CMA
Email | zac@tnmethadone.org

Chief Operating Officer | Counseling Solutions Treatment Centers
Comprehensive Opioid Treatment Programs
Program Director | Counseling Solutions Treatment Centers - Chatsworth

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