At a time when the idea that politicians can get something done has become a joke, there is an area in which action is taking place: the mobilization against heroin and opiate dependency.
That need was made clearer than ever last week when staggering national statistics for 2015 revealed that drug overdose deaths rose 11 percent to 52,404 — 77 percent of them as a result of overdoses of heroin, painkillers and the synthetic opioids fentanyl and carfentanyl. That means that in 2015, opioid overdoses killed more people than car accidents (37,757) and gun violence (36,252).
Last week, Congress funded the 21st Century Cures Act. It paves the way for more prevention and treatment of addiction, as well as monitoring of opiate prescriptions for pain. President Barack Obama says he will sign the bill and approve $500 million for its first year. That’s a huge advance from this summer, when both chambers passed a bill that included treatment and prevention, but didn’t fund them.
What changed? Members of Congress went home to run for reelection and found what President-elect Donald Trump was seeing, particularly in swing states like Pennsylvania, Ohio and New Hampshire: communities ravaged by addiction, reeling in pain.
In New York, lawmakers and Gov. Andrew M. Cuomo made significant strides in 2016, passing measures that increase access to addiction treatment, add prevention programs, limit the overprescription of opioids and crack down on insurance-company practices that make needed treatments hard to obtain. But more will need to be done: Federal statistics say there were 3,009 overdose deaths in the state in 2016, a 20 percent increase over 2015.
New York also sought a waiver that could save lives and money if the federal Centers for Medicare and Medicaid Services will approve it. The state wants to use Medicaid matching funds to treat sick and addicted prisoners in the 30 days prior to their release from prisons and jails. The plan would reduce emergency department visits, hospitalizations, overdoses and recidivism, without increasing costs much. Prison health care is already publicly funded, but this would set prisoners on the path of care they’ll need to stay on when released.
In the first two weeks after release, former inmates are 12 times more likely to die than the general population. Much of this risk is attributed to overdoses and other addiction-related problems. They are also quite likely to end up back in jail or hospitalized. But studies show that inmates with addictions fare far better when they set up a continuum of care before they are released, including medically assisted treatments like methadone, suboxone and vivitrol, care coordinators, counseling and rehabilitation programs.
Early in 2017, New York will begin giving eligible prisoners Medicaid cards before release. That did not require federal approval, but beginning and arranging Medicaid-funded treatments before release does.
New York asked for the waiver this summer, and a public comment period brought hundreds of responses, nearly all positive, from advocates and the public. But no action has been taken, and with a new White House administration and party on its way in, there are fears in the treatment community that the plan may stall.
That can’t be allowed to happen. On the campaign trail, Trump promised increased addiction treatment. Politicians are grasping the seriousness of the situation. The death totals are heartbreaking.
Combating the opioid epidemic must go beyond party and politics. Approval of this Medicaid waiver is necessary to save lives and money — and to give addicts a real chance. — The editorial board