White House Opioid Commission Interm Report Recommendations May Make the Nation’s Drug Problem Worse

The White House Opioid Commission’s Interim Report shines a bright light on America’s opioid epidemic; 142 people dying from drug overdose every single day. The Center for Network Therapy (CNT) estimated that the cost of the drug epidemic exceeds $1 trillion every year. (Read CNT’s recent press release on this topic here.) Dr. Indra Cidambi, leading Addiction Medicine expert and Medical Director at CNT, New Jersey’s first licensed outpatient detoxification facility, fears that many of the recommendations may not help much and some may actually make the drug problem worse.

Dr. Cidambi analyzed the interim report’s recommendations and explained why:

  • Increasing inpatient treatment capacity constitutes an expansion of a failed model: The report recommends Medicaid limitations for inpatient treatment be removed. However, the drug epidemic is proof that the traditional inpatient treatment modalities have largely failed even people with private health insurance not subject to such limitations. “So more of the same may help on the margin at best, but supporting nascent addiction treatment modalities such as the Ambulatory (Outpatient) Detoxification is the key to delivering far better outcomes in an economic manner,” says Dr. Cidambi. The outpatient model incorporates an individual’s living environment into treatment, which helps deliver better results.
  • Increasing opioid prescriber education may not stop the creation of new addicts: “65% of opioid pain prescriptions are written by Family Doctors and Nurse Practitioners, not pain management specialists,” notes Dr. Cidambi. “While educating these prescribers is important, a better alternative would be limiting the ability to prescribe opiate pain medications only to physicians with specialized training in pain management (such as surgeons, oncologists and orthopedic and pain management specialists). We need to stop creating addicts as a more comprehensive opioid curriculum is worked into the medical education system.”
  • Medication Assisted Treatment (MAT) is not a panacea: MAT primarily consists of prescribing buprenorphine or methadone and, to some highly-motivated individuals, naltrexone in order to address cravings and withdrawal symptoms for individuals afflicted with the disease of addiction. “Recklessly expanding the number of prescribers…

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