The Four-Letter Word for the Opiate Crisis Affecting Cities Everywhere: H-O-P-E

On Thursday, December 1, 2016, 12 people died from a drug overdose between 6 and 10 pm in Philadelphia. Then came four more overdose deaths on Friday, seven on Saturday, nine on Sunday and three on Monday, for a total of 35 deaths in one city over five days. The victims ranged in age from their 20s to their 40s.

Police say these deaths may be attributed to a deadly batch of heroin. Whatever it was, it’s safe to say that we can no longer try to sweep the opiate epidemic under the rug, hide it within our families, or ignore its presence as simply a matter of choice. No, recent events surely illuminate the fact that we are dealing with a force to be reckoned with, one that is vociferously demanding our full attention and taking the lives of our loved ones at an insatiable pace.

Opiates are undeniably a national issue. Drug overdose is now the leading cause of accidental death in the United States, with over 47,000 in one recent year alone. Our country represents just 4.6% of the world’s population but consumes 80% of its opioids, including 99% of the world’s hydrocodone, the opiate that is in Vicodin. In one year, 259 million prescriptions were written for opioids.

With numbers like those, it’s no wonder we have an issue.

But there is hope. President Obama just signed into law the 21st Century Cures Act which includes $1 billion in new funding to prevent and treat opioid addiction. While some details of how this will be carried out are still unclear, and while some believe the law conceded to big pharma, it is a step in the right direction of acknowledgment and awareness of this drug crisis that we on the front lines of treatment have been shouting about for years.

So how should this enormous amount of money be spent? If it were up to me…

Expand Access to Treatment

The law astutely expands on parity enforcement, something we desperately need. Despite parity being the law of the land for years now, insurance companies have still found ways to limit people’s equal access to addiction treatment. The new law provides for further guidance and compliance efforts in parity and more oversight. Access to treatment is critical for us to create change and help decrease these surging numbers of overdose deaths. Long wait lists for state-funded, insurance-accepting programs are literally killing people, as are insurance denials of coverage. I sincerely hope that revitalized parity enforcement will make a difference to the nearly 90% of people who struggle with addiction but are not (yet) seeking treatment.

Require Evidence-Based Practices in Treatment

It’s encouraging that the law created a new National Mental Health and Substance Use Policy Laboratory with a mandate to identify programs the agency administers that are not evidence-based and to promote innovation. I have been a longtime advocate for evidence-based treatment that includes multiple treatment approaches for optimum, individualized success. These include medication assisted treatments, motivational interviewing, relapse prevention, 12 Step process, Dialectical Behavior Theory, Cognitive Behavioral Therapies, and more. Extensive independent research has been conducted on each of these modalities and it is in our best interest to provide options as not every person or addiction is the same.

Encourage Long-term Recovery Programs

In addition, this new National Mental Health and Substance Use Policy Laboratory is focused on helping people enter long-term recovery programs, as evidence has illustrated that the longer a person is in treatment, the higher the likelihood of success. This can be accomplished by providing a full continuum of care for clients: detox, residential treatment, PHP and IOP programs, and sober living options. Ongoing engagement with clients beyond treatment can also look like alumni groups, phone or email communication, and even apps.

The bottom line is that millions of people are knowingly or unknowingly depending on more access to better, longer term treatment. As the President wisely stated:

“From Ohio and New Hampshire to New Mexico and West Virginia, the disease of addiction is affecting communities big and small, urban and rural; it doesn't discriminate. Instead, it strains families as well as the capacity of law enforcement and our health care systems in ways that hurt all of us. Those on the front lines of this fight have made it clear they need more resources … Those devastated by the heroin and prescription opioid epidemic cannot wait any longer. They need help now, and we need to help turn the tide of this epidemic.”

I’m rooting for the Cures Act to turn the tide.

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

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