Colorado Medical Society

http://www.cms.org/articles/prescription-drug-abuse5/

Prescription drug abuse

Thursday, September 01, 2016 12:30 PM

Overdoses from heroin, prescription drugs and opioid pain relievers last year surpassed car accidents as the leading cause of injury-related death in America, according to the Centers for Disease Control. Heroin overdoses have more than tripled in the last five years, receiving increased attention nationally and within the state of Colorado, one of the hardest-hit states.

New bipartisan legislation opens new funding streams in the fight against this epidemic. The Comprehensive Addiction and Recovery Act (CARA), S. 524 and H.R. 953, was introduced by Sen. Sheldon Whitehouse (D-RI) and Rep. Jim Sensenbrenner (R-WI), and passed Congress on July 13. It was signed into law by President Barack Obama on July 22.

This federal legislation authorizes the attorney general and secretary of Health and Human Services to award more than $181 million in grants to address the national epidemics of prescription opioid abuse and heroin use. Funds must be appropriated every year through the regular appropriations process.

The new law:

Rob Valuck, PhD, RPh, chair of the Colorado Consortium for Prescription Drug Abuse Prevention, said that while there are many useful pieces in the new law, the two biggest disappointments are that it’s severely underfunded and there isn’t much funding targeted for treatment and prevention.

“The problem is very complicated and has so many different dimensions to it. There are so many places where you could focus your efforts and all are worthwhile in some way. That’s why you see legislation like CARA, which is a whole bunch of different pieces put together. It’s a hodgepodge.”

Additionally, with the consortium leading the effort in our state, Colorado leaders are already either aware of most of the recommendations in the bill or already actively working on them. “What we’re hoping for is more funding, especially for things like more Naloxone so that high-risk people have an opportunity to get into treatment.” The treatment gap – a term for the number of people who need care and are ready and able to access it but who cannot get care – stands at 80-85 percent in the U.S., down from 93 percent two years ago, Valuck said.

Because of the treatment gap, the consortium is urging Colorado physicians to be trained to provide medication-assisted treatment (MAT) with Suboxone (buprenorphine and naloxone). Physicians need only to fill out a form and complete an online eight-hour training module available through the American Society of Addiction Medicine (ASAM) to start seeing these patients, Valuck said. Access the ASAM Buprenorphine Course for Office-Based Treatment of Opioid Use Disorders training at www.asam.org/education/live-online-cme/buprenorphine-course. This method can be more convenient for patients without ready access to a methadone clinic, which requires daily visits, because Suboxone prescriptions can be written for a week or month supply.

This effort will be bolstered by an AHRQ grant awarded to the University of Colorado Denver. This project will expand access to MAT across 24 counties in Eastern and Southern Colorado, providing rural primary care practices with comprehensive training and support for delivery of MAT in their practices using face-to-face practice coaching and an ECHO tele-training model.

Learn more about the work of the Colorado Consortium for Prescription Drug Abuse Prevention on their website, www.corxconsortium.org.