President Barack Obama, in his budget proposal released earlier this month, dedicated more than $1 billion in new funding to opioid addiction treatment over the next two years.
Couple that with the U.S. Food and Drug Administration’s announcement days later of a new, proactive response to opioid abuse, and it appears the federal government is ramping up efforts on all fronts to combat a class of drugs that caused nearly 29,000 overdose deaths nationwide in 2014.
Addiction treatment leaders in Oregon welcome the renewed focus on an issue that’s long devastated Oregonians, nearly 1 in 4 of whom received prescriptions for opioids in 2013.
“The push from the federal government is important because it reminds people that, ‘No, we’re not just saying this. Our federal partners want us to pursue these things and make it a priority,’” said John McIlveen, Oregon’s state opioid treatment authority, the state’s top opioid treatment regulator.
The largest proportion of new funding for opiate addiction over the next two years would go toward helping people get into treatment, complete treatment and sustain recoveries. It would also expand the addiction treatment workforce.
States would receive funds based on the severity of their epidemics and on the strength of their existing strategies to respond to them, according to the budget.
McIlveen said he expects severity would be based on the number opioid-related deaths and hospitalizations in each state. In Oregon, prescription opioids were involved in more drug poisoning deaths in 2013 than any other type of drug, including methamphetamines, heroin, cocaine and alcohol, Oregon Health Authority statistics show.
The president’s budget includes about $500 million to expand the availability of medication-assisted treatment programs.
A major problem in Oregon is the small number of providers with the credentials necessary to prescribe a medication used in opioid addiction treatment called buprenorphine. It’s commonly combined with naloxone, a drug that reverses the effects of other opioids, creating a new drug called Suboxone.
Congress in 2000 approved giving doctors special licenses to prescribe buprenorphine from their own clinics in an effort to expand the drug’s use, but only about five providers in Central Oregon currently can prescribe buprenorphine. McIlveen estimates statewide about 130 providers are actively writing prescriptions for buprenorphine. Unlike another widely used opioid addiction drug, methadone, which is mostly handed out and taken within federally designated clinics, buprenorphine can be prescribed and taken at home.
One of the barriers to getting more providers interested in medication-assisted treatment is opiate-addicted patients can be tough cases, said Rick Treleaven, the executive director of Redmond-based BestCare Treatment Services Inc., which provides substance abuse treatment.
“They’re often sort of a disaster as a patient and engage in a lot of socially unacceptable behaviors,” he said, “and so you need clinical backup.”
To that end, Treleaven is on a committee that’s trying to not only encourage more Central Oregon providers to get trained to perform medication-assisted treatment, but to find ways to give them more clinical support staff and to create a tight-knit referral system — such as from residential treatment directly into counseling.
In the meantime, Obama’s earmarked funding also would increase access to naloxone, which on its own can reverse opiate overdose. It’s commonly administered using IV injections or, more recently, as a nasal spray. It’s currently covered under the Oregon Health Plan, the state’s version of Medicaid, and, in some areas of the state, is stocked in jails and law enforcement vehicles. The Deschutes County Sheriff’s Office announced in October it would stock the drug in its jail and patrol cars.
McIlveen said moving forward he wants to see access to naloxone go beyond law enforcement and jail systems. One way to do that, he said, would be through a bill moving through the Oregon legislature sponsored by Bend Republican Knute Buehler that would allow pharmacists to dispense the drug without prescriptions.
“I think that would be very, very helpful,” he said.
— Reporter: 541-383-0304,