State Sen. Chris Eaton is planning to introduce legislation to encourage opiate treatment providers and doctors to break with an abstinence-based model and embrace evidence-based practices for treating addiction, the Minnesota Democrat told The Huffington Post.
Eaton, a member of Senate leadership, said a recent article in The Huffington Post on treatment for heroin addiction convinced her that one of the first things needed is to remove “the restrictions and intimidation of doctors who are prescribing Suboxone,” a maintenance medication. Those restrictions include federal regulations that cap the number of opiate patients a doctor can treat, which creates long waiting lists.
Eaton said she is also looking at ways to encourage the use of Suboxone by withholding public funds from treatment centers that refuse to follow evidence-based practices in favor of the ideologically driven abstinence model.
The lawmaker said she wants to send a signal to doctors that the state welcomes their involvement. “You’ve worked a long time for that license. I have a nurse’s license, I understand,” she said.
HuffPost’s article highlighted the case of one Maryland doctor, Dr. Preston Gazaway, who was treating slightly more than 100 Suboxone patients, having taken over his partner’s patients after his partner became ill.
That number of patients breaks the federal limit, and he got an unfriendly visit from the DEA. “The first thing you have to do is take your own pulse, take a deep breath,” Gazaway said, recalling that he kept reminding himself he hadn't done anything wrong. “I’m working to get it down,” he said. “I just can’t kick somebody out because I’m over census and they’re doing well.”
Because the patient limits are part of federal law, Eaton said, she plans to talk to “Amy and Al” -- Minnesota Sens. Amy Klobuchar (D) and Al Franken (D) -- about getting them loosened.
Another obstacle to the treatment is that only doctors who’ve been certified by the DEA can prescribe Suboxone. Eaton said she would work to address this by having the state provide reimbursements for the costs of the certification, or otherwise reward doctors who participate.
Eaton said she has encountered resistance from some in the recovery community to medically assisted treatment. “You’ve got ... the 12-step programs that just smear it and say you’re still on a drug. So that’s very prevalent here,” she said. “I’m a reformed 12-stepper. I mean, I still think it’s a good avenue for people with alcohol issues, [but] I don’t think alcohol makes the extreme changes in the brain.”
The consequences of an alcoholic relapse are not always as irreversible as those of an opiate relapse, she added. “People say, 'Well, alcoholism’s more prevalent,' but they don't always die, unless they’re driving.”
Eaton speaks from experience. She and her husband, Tim Willson, the mayor of Brooklyn Center, Minnesota, are both recovering alcoholics who have been sober for 30 years. But the opiate crisis is a different beast, and when it hit their family, they didn’t recognize it until it was too late. The couple’s 23-year-old daughter, Ariel Eaton-Willson, died of a heroin overdose in 2007.
In September, Willson appeared at an event at the White House marking the 25th anniversary of National Recovery Month. Christina Huffington, daughter of Huffington Post Editor-in-Chief Arianna Huffington, joined the panel to share her experience as a young addict in recovery. Also in attendance was White House Drug Czar Michael Botticelli, an advocate of medically assisted treatment who on Thursday spoke out against the abstinence-only approach in response to The Huffington Post’s article. “Medication for opioid use disorders=standard of care. Too many ppl are dying to withhold this valuable treatment," he tweeted.
Eaton is working with the Steve Rummler Hope Foundation as she moves forward with legislation in the next few weeks. Rummler received treatment at Hazelden, Minnesota’s iconic treatment center that merged with the Betty Ford Center. Until recently, and during the time it treated Rummler, Hazelden was an abstinence-only institution that rejected medications such as Suboxone.
“He wanted Suboxone. All of us sat down and said, ‘No.’ All of us. But maybe it is the right answer,” said Lexi Reed Holtum, Rummler’s fiancee, who is now an advocate with the foundation.
Dr. Marvin Seppala, chief medical officer at Hazelden, led the clinic's move away from an abstinence-only approach. “The fact that people were dying from relapse was not being fully addressed,” he said.
Hazelden's dropout rate for opiate addicts plummeted after medically assisted treatment was introduced in 2013. Between January 1, 2013, and July 1, 2014, 7.5 percent of those getting medically assisted treatment dropped out, while 22 percent of those not in the program bailed. Not a single addict in the new model curriculum died from an overdose the first year.
“He just paid attention to science. That’s totally unique,” Eaton quipped of Seppala. “I don’t know what got into him.”
Having Hazelden on board helps, she added, but the rest of the industry might still need a legislative push to have the same awakening. “It makes them stand up and take notice,” said Eaton of Hazelden’s effect on abstinence advocates. “They have a reputation that makes them give it more credence. It’s very helpful that they’re doing that; I don’t know if it’s enough to make anybody change.”
Jason Cherkis contributed reporting.