By Ed Coghlan
“We need to take chronic pain, as a disease, at least as seriously as opioid abuse.”
That’s how nationally recognized pain physician, Dr. Richard Radnovich, described President Obama’s Proposed $1.1 Billion in New Funding to Address the Prescription Opioid Abuse and Heroin Use Epidemic with the National Pain Report Tuesday night.
“While I am glad there is going to be more research on opioid abuse, where is the proportional investment in pain research?”, the noted Boise Idaho physician asked. “Most reliable data suggests that less than 5% of pain patients abuse their opioids. The Institute of Medicine Committee on Advancing Pain Research, Care, and Education estimates the economic costs resulting from chronic pain are at least $261 billion, in 2010 dollars.”
The President has made clear that addressing the opioid overdose epidemic is a priority for his Administration and has highlighted tools that are effective in reducing drug use and overdose, like evidence-based prevention programs, prescription drug monitoring, prescription drug take-back events, medication-assisted treatment and the overdose reversal drug naloxone.
A well-known and articulate spokesperson about the nation’s health care system and its approach to treating chronic illness is skeptical about President Obama’s proposal.
Terri Lewis, Ph.D, told the National Pain Report:
“What is missing from this approach? Funds to address the distinct need for research into effective continuation of treatment protocols for persons who suffer from the more than 200 readily identifiable health conditions that generate chronic pain syndromes are strikingly omitted from this budget. While a mention of CDC’s effort to implement guidelines for primary care support to persons with chronic pain is given a nod, in fact there is no mention of funding for the need for medical education of health care professionals, continuing education for practitioners currently in place, and no mention of the fact that skilled treating providers with broad skills across disciplines are needed – particularly in rural areas where integrated services are largely absent.”
The President’s FY 2017 Budget takes a two-pronged approach to address this epidemic. First, it includes $1 billion in new mandatory funding over two years to expand access to treatment for prescription drug abuse and heroin use. This funding will boost efforts to help individuals with an opioid use disorder seek treatment, successfully complete treatment, and sustain recovery. This funding includes:
- $920 million to support cooperative agreements with States to expand access to medication-assisted treatment for opioid use disorders. States will receive funds based on the severity of the epidemic and on the strength of their strategy to respond to it. States can use these funds to expand treatment capacity and make services more affordable.
- $50 million in National Health Service Corps funding to expand access to substance use treatment providers. This funding will help support approximately 700 providers able to provide substance use disorder treatment services, including medication-assisted treatment, in areas across the country most in need of behavioral health providers.
- $30 million to evaluate the effectiveness of treatment programs employing medication-assisted treatment under real-world conditions and help identify opportunities to improve treatment for patients with opioid use disorders.
This investment, combined with other efforts underway to reduce barriers to treatment for substance use disorders, will help ensure that every American who wants treatment can access it and get the help they need.
Second, the President’s Budget includes approximately $500 million — an increase of more than $90 million — to continue and build on current efforts across the Departments of Justice (DOJ) and Health and Human Services (HHS) to expand state-level prescription drug overdose prevention strategies, increase the availability of medication-assisted treatment programs, improve access to the overdose-reversal drug naloxone, and support targeted enforcement activities. A portion of this funding is directed specifically to rural areas, where rates of overdose and opioid use are particularly high. To help further expand access to treatment, the Budget includes an HHS pilot project for nurse practitioners and physician assistants to prescribe buprenorphine for opioid use disorder treatment, where allowed by state law.