Presidential Commission’s Findings Suggest Increasing Medicaid Spending for Opioid Addiction

Earlier this week, Recovery Unplugged discussed the release of a presidential commission’s report on national opioid addiction; on Monday, the world got its glimpse of the report. After multiple legislative attempts to cut Medicaid in the interest of reforming American healthcare, it would appear the White House’s own commission on opioid dependency is finding out what many experts already knew: Medicaid increases treatment access.

In response to a report requested by President Trump in March, the commission released their own set of  recommendations on Monday to help jumpstart the battle against opioid addiction and overdose. The commission was headed by long-time Trump friend and political ally, New Jersey Governor Chris Christie and painted a comprehensive, albeit grim, picture of the opioid abuse epidemic in this country. Some of the more alarming findings included:

  • In 2015, 27 million people reported current use of illegal drugs or abuse of prescription drugs.
  • Approximately 142 Americans dying every day from drug use.
  • Between 1999 and 2015, more than 560,000 people in this country died due to drug overdoses
  • In 2015, nearly two-thirds of drug overdoses were linked to opioids like Percocet, OxyContin, heroin, and fentanyl.

Placing the long-ignored problem of opioid addiction front and center and putting the weight of the Office of the President behind solving them represents real progress; however, what do those solutions look like? The commission suggests declaring a national emergency under either the Public Health Service Act or the Stafford Act, claiming such action would “empower the administration to take bold steps and would force Congress to focus on funding and empowering the Executive Branch even further to deal with this loss of life.”

The Commission is also proposing rapidly increasing treatment capacity and granting waiver approvals for all 50 states to quickly eliminate barriers to treatment resulting from the federal Institutes for Mental Diseases DRAFT 3 (IMD) exclusion within the Medicaid program. Other proposed solutions to combatting opioid addiction outlined in the report include, but are not limited to:

  • Mandate prescriber education initiatives with the assistance of medical and dental schools across the country to enhance prevention efforts.
  • Mandate medical education training in opioid prescribing and risks of developing an SUD by amending the Controlled Substance Act to require all Drug Enforcement Administration (DEA) registrants to take a course in proper treatment of pain.
  • Establish and fund a federal incentive to enhance access to Medication-Assisted Treatment (MAT).
  • Require that all modes of MAT are offered at every licensed MAT facility and that those decisions are based on what is best for the patient.
  • Partner with the National Institutes of Health (NIH) and the industry to facilitate testing and development of new MAT treatments.
  • Provide federal funding and technical support to states to enhance interstate data sharing among state-based prescription drug monitoring programs (PDMPs)

Finally, the commission called for use of big data analytics to create a national prevention strategy and much more. Time will tell if the money or political will exists to implement any of these ideas.