Combat the coronavirus, but don’t forget the opioid epidemic
The coronavirus pandemic is a public health challenge of unprecedented proportions—one that requires massive resources to treat its victims and stop its spread. At the same time, we must not lose sight of the ongoing and deadly opioid epidemic facing our country, which continues to kill nearly 180 people every day, and has killed more than 400,000 over the past 20 years. Now, as we take on COVID-19, it’s critical for government and healthcare providers to adapt policies for controlled substances that will provide services to people battling substance abuse, a population that is particularly vulnerable at this time.
Social distancing in response to the pandemic is impacting the hundreds of thousands of Americans taking part in medication-assisted treatment (MAT), who must visit drug treatment clinics and other facilities every day in order to receive their addiction-withdrawal medication—primarily the drugs methadone and buprenorphine—as well as behavioral therapy and peer-based coaching. Patients are forced to travel to these sites to pick up their medicine, and then often face long lines and crowded waiting areas, thereby significantly increasing their risk of exposure to the coronavirus. These drug users are then likely to spread the disease among their communities of other drug users. Choosing not to receive treatment is also not a viable option, as doing so would lead to severe withdrawal symptoms. In many cases, access to outpatient care is being limited, and some patients are simply being turned away.
These issues are being addressed head on by the Drug Enforcement Agency and the Department of Health and Human Services. In a prudent move, these agencies have relaxed stringent, long-held regulations limiting access to these critical opioid-based addiction-withdrawal medications. For example, in order to reduce the number of return visits to the clinic, methadone patients are now being provided with four weeks’ worth of take-home doses, with no state or federal sign-off required.
Buprenorphine, a drug that must be taken daily, is now being treated more like a non-addictive medication that can be prescribed by any physician and simply picked up at a pharmacy by the patient. Or, after an initial consultation, the drug can be prescribed through telemedicine after an initial consultation, rather than through subsequent in-person personal evaluations. This also reduces patients’ potential exposure to the virus. In addition, signing up for Medicaid in New York State can now also be done online through telehealth, making it easier to participate in the program’s free drug treatment.
Overall, these critical policy decisions can keep substance abusers supplied with the medications they need while reducing the risk of exposure to the coronavirus. But, as we look ahead to a time when COVID-19 is no longer a threat, let’s seek to retain the regulatory changes that enable wider access to treatment, while also ensuring access to the full range of behavioral treatment services and peer support to reduce the incidence of drug overdose and aid lasting recovery.