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How Trumpcare Could Cripple Addiction and Mental Health Treatment

How Trumpcare Could Cripple Addiction and Mental Health Treatment

Author: Justin Mckibben

The new Trumpcare plan, formally known as the American Health Care Act or AHCA was announced this Monday March 6th. This Trumpcare bill is the Republican Party’s long awaited plan to repeal and replace the Affordable Care Act, also known as Obamacare.

Since day one of the announcement we have seen quite a few varying opinions as to what this means for the people who were previously covered, and what it means for how healthcare altogether might change. Needless to say, not that much of the talk has been optimistic. As details emerge about Trumpcare some have become increasingly worried about the impact it will have on access to treatment for substance use disorder, especially for low-income Americans.

So what some are officials and experts saying about Trumpcare, and what it might mean for Americans struggling with addiction?

Early Predictions on Trumpcare

According to some early reports, 6-10 million Americans will lose health insurance. Not only that, millions of people in desperate need of help could be cut off from access to addiction treatment as a result of the bill.

In fact, according to one analysis, approximately 2.8 million people living with substance use disorder will lose some or all of their health insurance coverage if Obamacare is repealed. This conclusion comes from:

  • Harvard health economist Richard Frank
  • Sherry Glied, Dean of the Wagner School of Public Service at NYU

The publication The Hill reported in January that Frank and Glied predict that the federal government’s 21st Century Cures Act creates a recent investment of $1 billion to tackle opioid abuse. However, they state this provision would be- squandered if the new Congress rolls back recent gains in the quality and level of substance use and mental health insurance coverage generated by the Affordable Care Act (ACA) of 2010.”

Surely this is all “fake news” and “alternative facts” right?

Not so much. According to reports from the Washington Post Thursday, House Republicans admitted, after questioning by Massachusetts Democratic Representative Joe Kennedy III, that their the Trumpcare plan to repeal-and-replace would- “remove a requirement to offer substance abuse and mental-health coverage that’s now used by at least 1.3 million Americans.”

How does this happen? By attacking the expansion of Medicaid and the ‘essential benefits’ states are required to provide for.

Trumpcare Impact on Medicaid

Trumpcare’s plan to roll back Medicaid and health insurance tax credits are pretty distressing aspect of this reform. For all the Americans who rely on government assistance for addiction treatment this is a pretty huge deal.

Addiction treatment in the past is notably impacted by Medicaid. According to Truven Health Analytics, Medicaid was the second largest payer for addiction treatment, after state and local programs, in 2014.

Starting in 2020, Trumpcare is set to:

  • Freeze Medicaid enrollment
  • No longer require Medicaid to cover essential health benefits like addiction treatment

What is the point? To make it so the federal government pays less for Medicaid over time by shrinking coverage.

So if this is all the case, it is a terrifying reality. In a time when more Americans than ever desperately need addiction treatment, in the midst of an opioid epidemic that is tearing families and communities apart, the government’s Trumpcare plan stands to save money by stripping addiction resources from those relying on Medicaid?

Representative Kelly and Peter Welch, Democratic Representative from Vermont, attempted to amend the bill to restore the federal mandate for those ‘essential benefits’ but were voted down. Kenny is popularly quoted in the news recently for his statement,

“There is no mercy in a country that turns their back on those most in need of protection: the elderly, the poor, the sick, and the suffering. There is no mercy in a cold shoulder to the mentally ill… This is not an act of mercy — it is an act of malice.”

While Trump’s comments say he wants to give states “flexibility” with Medicaid to make sure no one is left out, many believe this is just adding the idea of paying more for less.

Senate Minority Leader Chuck Schumer vows to lead efforts to defeat Trumpcare, stating he believes it will “Make America Sick Again” and believes that it will create more drug addicts. In a report from The Hill Schumer attacks the bill saying,

“To make matters worse, this sham of a replacement would rip treatment away from hundreds of thousands of Americans dealing with opioid addiction, breaking the President’s word that he would expand treatment, not cut it.”

This is continuously troubling. When it comes to the fight against addiction, President Trump’s administration seems to be more focused on borders and “law and order” than providing resources. Trump did promise to work on creating more coverage options, but all the action taking place almost points the opposite direction.

Trumpcare Impact on Treatment Providers

This chain reaction wouldn’t just hurt those who need insurance by denying them coverage. Experts say Trumpcare also has the capacity to do damage to the treatment providers themselves.

Keith Humphreys, a drug policy expert at Stanford University, points out this issue directly. Humphreys notes that treatment providers, which tend to be small businesses in many parts of the country, may find it difficult to stay in business if clients lose coverage for addiction treatment. If less people are able to get coverage, less people will be able to get treatment. At the same time even bigger treatment providers could have trouble because it still has the capacity to reduce reimbursement rates for treatment services.

Thus, Trumpcare could affect both the supply and quality of treatment. In one interview Humphreys states,

“Most providers are small, mono-business entities that can’t absorb costs elsewhere in their care systems,”

“While hospitals will not go broke if poor people get less oncology care coverage, many [substance use disorder] treatment agencies will.”

But it isn’t just Democrats or University Professors or addiction experts speaking out. The AARP, the American Hospital Association, and the American Medical Association voice opinions against the overhaul of the ACA and the potential harm Trumpcare could do.

Even Republicans are speaking out against the danger that Trumpcare poses to addiction. Ohio Governor John Kasich is vocal with his own opposition to the bill saying,

“[Trumpcare] unnecessarily puts at risk our ability to treat the drug-addicted mentally ill and working poor who now have access to a stable source of care.”

Not to say that healthcare was ever perfect. It is noted by many doctors in the addiction field, as well as politicians and other experts, that there is already a treatment deficit. Approximately 10% of America’s population has what could be considered a substance use disorder, and only 13% of those people ever get treatment.

However, the miles of red tape Trumpcare might wrap around them could cut that number drastically. So even if these are unintended consequences, they are very real consequences just the same.

Obamacare was far, far from perfect. This is absolutely true. But is Trumpcare the best answer we can come up with?

As it now stands, Trumpcare may take so much away from those struggling with addiction and mental health that some experts are calling it dangerous. Having safe, effective and comprehensive treatment resources for these issues is extremely important to the preservation of life and the future of America. This is a matter of life and death. It is not the time for an ‘anything but Obamacare’ mentality… if the government expects a better plan, they need to make it happen. How about we put a hold on spending billions on border walls and expanding the nuclear program, and instead focus on healing Americans who need it most.

 If you or someone you love is struggling with substance abuse or addiction, think about who you want to be working with to find a real solution. Please call toll-free now.

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Why are Insurance Companies Focusing on Maintenance Drugs?

Why are Insurance Companies Focusing on Maintenance Drugs?

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Justin Mckibben

Addiction is not an easy problem to address. It is a complex issue with many variables, so of course there is no simple answer to fix it. There is no one-size-fits-all solution; no monopoly on the right kind of treatment. It is understandable that there is a degree of effectiveness with utilizing any medical means available to try and address addiction, but are maintenance drugs really the answer?

Surely medication assisted treatment is useful, and it helps a lot of people. Most inpatient treatment programs utilize some form of medication to ease withdrawal symptoms and other side-effects of long-term drug use. The detox period of treatment usually focuses on medically assisting someone struggling with drugs in this transition.

However, is getting people off of one drug by making them dependent on another really the best case scenario? It seems now insurance companies are putting more effort into using maintenance drugs to treat addiction. Is this really a better strategy?

Maintenance Drugs

Firstly, let us make a clear definition of what maintenance drugs are. Typically, the definition of maintenance drugs is along the lines of prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines.

Examples of common maintenance drugs are medications such as:

  • Fluticasone and salmeterol (Advair Diskus) which is used to treat asthma
  • Insulin glargine (Lantus) used to treat diabetes

If you consider these examples the point is that people use these medications to “manage” their illness, not to overcome or remedy it. So looking at the issue of addiction, there are some well-known maintenance drugs, specifically concerning opioid addiction.

These medications can be effective, but they also present a level of danger themselves. Even though doctors prescribe them to combat withdrawals, they actually can create their own devastating withdrawals, especially with long term use.

Aetna Aims for Maintenance Drugs

Aetna is one of the nation’s largest insurance companies. In a recent Aetna report, the company is prepared to remove a major restriction for patients seeking maintenance drugs for opioid addiction. The change is set to begin this coming March. Aetna is the third major health insurer to announce such a shift in policy in recent months, now in league with Anthem and Cigna insurers.

To be more specific, this insurance company will stop requiring doctors to seek approval before they prescribe particular medications that are used to combat withdrawal symptoms. One of these medications is suboxone, a well-known medication that many people use to fight opiate addiction.

The common insurance practice is known as “prior authorization”. The reason they are seeking to eliminate this policy is because it sometimes results in delays of hours to days before a patient can get the medications.

This new approach to regulation of maintenance drugs impacts all its private insurance plans, an Aetna spokeswoman confirmed.

Advocates of Maintenance Drugs

Addiction treatment advocates to support having expanded access to maintenance drugs. Dr. Corey Waller, an emergency physician who chairs the American Society of Addiction Medicine’s legislative advocacy committee, states:

“It’s a first-line, Food and Drug Administration-approved therapy for a disease with a known mortality. [For] every other disease with a known mortality, the first-line drugs are available right away.”

Essentially, the idea that parity laws require insurers to cover addiction treatments at the same level as other kinds of healthcare means these kinds of medication should be available for immediate access. This should be the same for all forms of addiction treatment.

Opinion: Treatment over Maintenance

While many would argue that maintenance drugs are a form of treatment, it is still a relevant argument that maintenance drugs are also imperfect and could actually be harmful if they become the cookie-cutter answer implemented by most insurers.

While harm reduction is understandable, and maintenance drugs can help people struggling with heroin or other dangerous opioids avoid other serious risks, the fact is many maintenance drugs include their own side-effects. Some often become subject to abuse themselves.

For instance, suboxone can be useful as a harm reduction tactic, but it can also be abused. Many people who have used suboxone as a long-term solution have found themselves battling suboxone withdrawal symptoms. The dangers of suboxone are very relevant.

The same, if not worse, has often been said about methadone maintenance drugs. While they may keep someone alive to get treatment, there should still be a strong emphasis on treatment itself. Maintenance drugs are most effective when part of a program. They are not a substitute for a treatment program.

Treatment should focus on finding solutions, not prolonging the suffering. Drug and alcohol addiction treatment should come from a holistic approach that addresses more than just physical ailments. Holistic treatment focuses on providing extensive and personalized therapy, combined with physical and emotional heal. If insurance companies want to focus on combining rational medical resources with comprehensive treatment, then this could be a great thing. However, if the focus becomes a quick-fix drug option opposing a full recovery through treatment, it only adds to the danger.

Maintenance drugs have support from the recovery community, but typically they must be accompanied by therapy and other means of treatment. Maintenance drugs are just that- drugs. They are often powerful narcotics, and are true to their title- “maintenance,” not a permanent solution.

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House Representatives Join Opposition to Delay Ban of Kratom

House Representatives Join Opposition And Urge Delay of Kratom Ban

Author: Shernide Delva

Recently, we wrote about how the Drug Enforcement Administration (DEA) made the controversial decision to ban kratom by making it a Schedule I drug. While the ban is set to go into effect by the end of this week, advocates of the herbal supplement refuse to go down without a fight. A bipartisan group of 51 House lawmakers recently joined the chorus of opposition to the DEA’s upcoming ban.

To give a quick overview:  Back in late August, the DEA announced it would prohibit kratom due to various reports of health implications associated with the use of the drug. The ban would temporarily add Kratom to the schedule 1 category of narcotics along with substances like Marijuana, heroin, and LSD.

The DEA made it clear the decision was due to kratom’s high potential for abuse and the lack of medical benefit of the drug. However, advocates passionately argue that kratom is useful for drug withdrawal and mental health issues like anxiety and depression.

Therefore, placing kratom in the schedule 1 category would effectively ban it from those who regularly use the drug. Many users find the drug useful in treating, pain, depression, high blood pressure among other ailments.

The ban sparked a broad range of controversy. Now, members of Congress have joined the chorus of opposition. A bipartisan group of 51 House Representatives just signed a letter urging DEA Administrator Chuck Rosenberg to delay the ban.

 “As our nation continues to combat the public health crisis of opioid abuse, the federal government has invested significant resources to develop alternative pain management strategies,” reads the letter.

The letter urged the delay to continue the federally funded study of kratom as a possible treatment option for opioid withdrawal. By placing kratom on the Schedule I category, the letter states it will “put a halt on federally funded research and innovation surrounding the treatment of individuals suffering from opioid and other addictions.”

While kratom is not for everyone, many find it a compelling alternative to prescription drugs.  Earlier this month, Susan Ash, founder of the American Kratom Association, revealed that her organization has been receiving thousands of calls from people across the United States concerned about losing kratom and resorting to prescription drugs instead.

“I am completely swamped,” Ash told The Fix. “I have thousands of people afraid of relapse. People are explicitly telling us they are terrified of losing their quality of life or even their lives.”

51 House Representatives Urges Delay On Ban

The House representatives’ letter to the DEA urges them to delay the ban and allow more time to consult with “consumers, researcher, and other stakeholders.”  When the ban was initially passed, the DEA did not allow any opposition in regards to their decision to ban kratom.

Instead, the DEA argued their decision was valid by citing a report by the Centers for Disease Control and Prevention which stated that kratom poisoning was the cause for 660 calls to poison centers across the country between 2010 and 2015.  The DEA argued that these numbers clearly indicated the need for the ban. They also pointed to 16 reported kratom-related deaths between 2014 and 2016 to further justify their decision.

Still, these numbers are far overshadowed by other drugs, both legal and illegal. Those in opposition point to the numbers of calls the poison control center receives over laundry pod poisonings. These calls far surpass the number of calls they receive in regards to kratom. Both the House lawmakers and kratom advocates think it is not a good idea to restrict access to Kratom when so many people are searching for safer pain relief alternatives rather than prescription pills.

“This hasty decision could have serious effects on consumer access and choice of an internationally recognized herbal supplement,” the lawmakers wrote in their letter.

Kratom does have the potential for abuse. However, it does have potential medical benefits. While the use of any drug is not ideal, the reality is harm reduction remains a crucial topic of discussion. Further research is needed before a ban on kratom is made. Do you agree with the ban?

Overall, if you are struggling with any substance abuse, legal or illegal, you need to research out for treatment. We have the tools to help in your recovery. Do not wait. Call today.

   CALL NOW 1-800-951-6135

Canada Approves Prescription Heroin to Control Drug Addiction

Canada Approves Prescription Heroin to Control Drug Addiction

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Shernide Delva

Canada has taken a controversial approach to fighting heroin addiction. The  Canadian government has just quietly approved a new drug regulation that will permit doctors to prescribe pharmaceutical-grade heroin to severe addicts.  Essentially, Canada’s strategy for treating addicts resistant to other forms of treatment is simple: let them have heroin.

While this is a first for Canada, other countries have similar programs. The approved regulation ensures that Canada’s trail-blazing clinic, Crosstown, in Vancouver, will be able to expand their special heroin-maintenance programs. These programs allow addicts to come and go as many as three times a day to receive prescription heroin from a nurse for free.

Back in May 2016, Canada was in the beginning stages of legalizing prescription heroin. Health Canada explained in a news release:

“A significant body of scientific evidence supports the medical use of diacetylmorphine, also known as pharmaceutical-grade heroin, for the treatment of chronic relapsing opioid dependence,”

Health Canada continued stating they were considering the idea of legalizing prescription heroin since several other countries have used it and found it effective.

“Diacetylmorphine is permitted in a number of other jurisdictions, such as Germany, the Netherlands, Denmark, and Switzerland, to support a small percentage of patients who have not responded to other treatment options, such as methadone and buprenorphine.”

Lowering the Cost of Addiction?

Furthermore,  Dr. Scott Macdonald, a physician with Crosstown Clinic, explained that heroin maintenance programs are much cheaper for taxpayers than paying for the cost of drug addiction. A person battling drug addiction can cost the tax base $45,000 Canadian Dollars (around $35,000 in U.S. dollars)  per year in crime costs, health care costs and more. On the other hand, prescription heroin in a Vancouver clinic costs around $27,000 or $21,000 in American Dollars.

The government ensures that this type of treatment is for a small minority of users “in cases where traditional options have been tried and proven ineffective.”  The purpose is to give health-care providers access to a wide variety of life-saving treatments options.

In 2005, Crosstown Clinic conducted their first clinical trial of prescription heroin and has operated ever since.  The clinic provided diacetylmorphine to 52 addicts under a special court-ordered exemption. They expect that number to double over the next year if supplies can be obtained.

The Case for Prescription Heroin

A regulation like this will raise controversy. However, studies in the past argue the benefits of using prescription heroin over harm-reduction treatments such as methadone. The studies found that patients stayed in treatment longer and relapsed less in comparison to those who received methadone.

Furthermore, researchers found that those receiving diacetylmorphine had a longer life expectancy compared to those receiving methadone.  When it breaks down to costs, prescription heroin costs society less.

Researchers also found that those receiving diacetylmorphine had a longer life expectancy than who received methadone. Crime costs reductions occur with both options. When it breaks down to costs, methadone therapy costs society $1.14 million, compared with $1.09 million for prescription heroin.

“The question I get most about heroin-assisted therapy is whether we can afford the increased direct costs of the treatment,” co-author Dr. Martin Schechter of the University of British Columbia said in a news release. “What this study shows is that the more appropriate question is whether we can afford not to.”

A Two-Sided Argument

Still, many remain solidly against the option. Collin Carrie, a Conservative member of Parliament, stated that his party adamantly opposes the use of prescription heroin.

“Our policy is to take heroin out of the hands of addicts and not put it in their arms,” he stated.

However, Scott Macdonald reiterated that the patients considered for these treatments are long term users. Typically, they have been on heroin for decades and have tried treatments like methadone with repeated failed attempts.

 “Our goal is to get people into care,” he said.


When it comes to addiction, the entire world is seeing an outstanding amount of deaths related to drug overdoses. Treatment options like these are controversial, but unfortunately, they need to be a topic of discussion.  Still, the best option remains learning to live a clean, sober life in recovery. Do not let your addiction go on for too long. There is time and hope for you.  Do not wait. Call today.

    CALL NOW 1-800-951-6135

International Overdose Awareness Day 2016

 

International Overdose Awareness Day 2016

(This content is being used for illustrative purposes only; any person depicted in the content is a model)

Author: Shernide Delva

Today, August 31, marks International Overdose Awareness Day. On this day, the goal is to raise global awareness of overdoses and reduce the stigma of drug-related deaths. This day is intended to acknowledge the grief felt by friends and family who have suffered the loss of a loved one due to a drug overdose.

The Shocking Reality

The tragedy of a drug overdose is preventable.  Today is a day to spread awareness to others about the disease of addiction.  Drug addiction is a global phenomenon; however, the United States, in particular, is facing a major drug epidemic. More deaths were reported from drug overdoses in 2014 than any other year on record. Deaths from overdoses are up among all genders, races, and nearly all ages. This is a disease that does not discriminate.

Out of these shocking numbers, three out of five drug overdose deaths involve opioids. Overdoses from opioids such as prescription opioids and heroin have nearly quadrupled since 1999. Overdoses from opioids killed over 28,000 people in 2014. Half of these deaths were related to prescription opioids.

Between 2013 and 2014, the number of drug overdoses increased a total of 6.5 percent. The year 2014 had a total of 47,055 drug overdoses in the United States. These numbers continue to climb as the prescription painkiller epidemic continues to be a major issue.

To spread the message of awareness, International Overdose Day focuses on commemorating those who have been affected by drug addiction. While today is intended to encourage the message of prevention, it also aims to encourage a message of hope.

Principles of Harm Reduction

The Harm Reduction Coalition affirms that “we will not end the overdose crisis until we place people who use drugs, along with their families and friends, at the center of our policies and strategies. “

The coalition aims to accomplish this task by ensuring that those who use drugs and their loved ones have access to information intended to treat and support them without the fear of stigma or arrest.

Furthermore, naloxone remains one of the most powerful tools in preventing opioid overdose deaths. Naloxone is a medication that works to counteract the effects of an opioid overdose.  Recently, there has been a push to increase the access the public has to naloxone. In many places, naloxone can now be purchased via pharmacies like CVS, and even in school nurses offices.

Still, according to the Harm Reduction Coalition, the United States is in a state of emergency.

“ We can no longer accept incremental progress; we must demand urgent action to save lives.”

Five Areas Needing Improvement

The Harm Reduction Coalition calls for immediate action in these five areas to increase access to naloxone:

  1. Funding: Congress should fully fund the President’s request for $12 million in Fiscal Year 2016 to the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide grants to states to support broader naloxone access.
  2. Cost: The rising cost of naloxone by manufacturers in recent years is a deep concern. This increase threatens to limit the distribution of naloxone, especially by community-based programs that reach those most vulnerable to opioid overdoses. When prices increase, it directly increases the likelihood of more overdose deaths. Therefore, the coalition calls upon naloxone manufacturers and developers to price their products responsibly to ensure the best possible distribution.
  3. Access:Despite improvements in the access to naloxone, access remains limited and inadequate. Prescribers and health care professions play a vital role in ending the overdose crisis. Therefore, there should be an effort by all parties to develop guidance, education and training, resources, and support tools aimed at increasing awareness and access to the drug.
  4. Availability:Many states are working to make naloxone available through pharmacies through arrangements and agreements. These efforts should increase and broaden to ensure the widest availability of naloxone.  In addition, the Food and Drug Administration should develop, facilitate and expedite the regulatory pathways needed to ensure naloxone can be sold over the counter. Over-the-counter naloxone should be available to the market by 2018.
  5. Awareness: Despite the rising number of overdose deaths in the past decade, there still is not a national awareness campaign to educate the public and those most at risk about the signs and symptoms of opioid overdose. Countless anecdotal reports suggest that the lack of awareness is a critical factor in many preventable overdose deaths. Therefore the HHS and CDC must develop broad national awareness campaigns; that spreads information on how and where to obtain naloxone.

Ways to Raise Awareness

In addition to the guidelines suggested by the HHC, the International Overdose Awareness Day website aims to raise awareness through innovative technologies like there overdose aware app. The app raises awareness amongst those who are experiencing drug use and their families. The app shares information on what an overdose is, and the main overdose symptoms.

The website also has an area where those who have been directly affected by drug addiction overdoses can write a tribute to their story and grieve anyone they have lost. These tributes are where many share the impact drug use and overdoses have had on their family and friends.

How are you spreading awareness of International Overdose Awareness Day? If you are struggling with drug addiction, do not wait for it to progress into an overdose. We can help you get back on track. Please call toll free.

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