More than 100,000 Americans died from drug overdoses between April 2020 and April 2021. That news was no surprise here in Tennessee. Our state ranks the sixth hardest hit in the nation by drug overdose deaths, and seventh specifically by opioids, driven primarily by fentanyl and heroin overdoses. This deluge was predictable. Almost every measure of substance misuse and mental health among adult Tennesseans worsened in the five years before the COVID-19 pandemic, which has only exacerbated these issues in our state.
While our society has been tempted to view addiction as little more than a manageable vice, we now know that it is a chronic disease that can affect anyone. And the US Senate can act today to help people struggling with opioid use disorder.
Food and Drug Administration-approved medications for OUD — buprenorphine, methadone and naltrexone — are the gold standard of treatment. Evidence shows they help people stay in treatment longer, reduce illicit opioid use and infectious disease transmission, and decrease overdose deaths.
Unfortunately, outdated red tape, rooted in stigma about addiction, prevent these medications from being widely available. Right now, federal law requires that all clinicians undergo training and obtain a license before they can prescribe buprenorphine. As a consequence, only about 18% of people with OUD received medication treatment in 2019, and nearly 30% of counties have no prescribing clinicians. No other prescription medication faces these hurdles, including the opioid pain relievers that played a pivotal role in starting the crisis.
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Congress can fix this. The US House of Representatives just passed the Mainstreaming Addiction Treatment Act, legislation that would immediately remove training and licensing barriers and help increase access to buprenorphine treatment across the country. I serve as the chair of the United Ways of Tennessee State Association, and we have consistently advocated through our United We Heal Initiative. Last month a group of United Way leaders from across the state met with Sen. Marsha Blackburn, who has already signed on as a co-sponsor, and we’re counting on Sen. Bill Hagerty to support it, too.
It’s crucial to clear up misconceptions around this life-saving medication. Though some lawmakers and clinicians are worried about diversion of buprenorphine, where people with OUD might seek out the drug for recreational rather than medical use, the Drug Enforcement Administration suggests the opposite is true. In addition, studies show that buprenorphine misuse among people in treatment for OUD has actually been on the decline, but when it does take place, it’s among those who are seeking to manage their disorder but can’t access treatment.
Greater availability of evidence-based care is especially important to people of color in Tennessee. Since 2014, the rate of drug overdose among Black residents rose by over 270% compared with about 58% for white residents. In the US, white middle-class patients are more likely to receive buprenorphine than their Black counterparts. This may also be due to areas with higher Black populations having fewer treatment programs that accept Medicaid payment for medication treatment or even provide it in the first place. Removing excessive buprenorphine requirements could help mitigate fears that it is a dangerous drug and encourage more health care practitioners to provide OUD treatment.
You would be hard pressed to find a Tennessean who has not been touched by the opioid crisis. More than ever, we understand addiction to be a tragic, deadly disease that knows no geographic or demographic bounds. Fortunately, we have evidence-based treatments that work and federal legislation ready to make them more accessible. Senators, now is the moment to ensure more lifesaving medication reaches the Tennesseans who need it.
Matt Marshall is the president/CEO of United Way of West Tennessee and serves as a team member on the city of Jackson’s Recovery Court.