Obama Administration Puts Big Money Into Transforming Heroin Treatment Industry

The White House is calling for more than a billion dollars in funding to transform opioid treatment in the United States, two top administration officials announced on Tuesday.

Until recently, the heroin treatment industry has been driven by the philosophy of "abstinence," which insists that any form of medication is merely a crutch for an addict, and he or she ought to instead go cold turkey. The opposing view, now being pushed by the established medical community, views medication-assisted treatment that relies on FDA-approved medicines such as buprenorphine and methadone as an addict's best chance of recovery.

The administration pledged on Tuesday to put the weight of federal funding behind medication-assisted treatment, or MAT. Health and Human Services Secretary Sylvia Burwell and drug czar Michael Botticelli announced an enormous boost in federal funds to combat the spiraling heroin epidemic.

Burwell said the new initiative's aim is "closing the treatment gap." Last January, The Huffington Post published an investigation highlighting the deadly consequences of this gap.

Of the 2.2 million people who need treatment for opioid addiction, "only about 1 million are receiving it," Burwell said, adding that the new funding "would help make evidence-based treatments available to all those seeking help for their opioid dependence. Expanding access to medication assisted treatment or MAT, as it's commonly called, is an important part of our strategy."

The federal government will spend a full $920 million in cooperation with the states most effected by the crisis. The funds will be doled out "on the strength of [a state's] strategy to respond to it," according to a statement from the administration.

If a state refuses to embrace MAT, its application for federal money is unlikely to be approved. While hard-line advocates of abstinence are unlikely to be persuaded that MAT is a preferable option, the amount of money at stake will make it much more difficult to continue opposing it.

Another $50 million in National Health Service Corps funding will go to treatment providers to help them implement MAT, and $30 million more will go toward evaluating the effectiveness of treatment programs that employ MAT. Some funding will also be used to provide MAT in prisons.   

As the map above illustrates, the gap between the need for medication-assisted treatment and the ability to access it is at crisis levels.  HuffPost reported in December:

One way to explain the stubbornness of the epidemic is to look at the availability of the maintenance medication buprenorphine, sold most commonly under the brand name Suboxone. Taking the medication (or methadone), along with counseling, is an opioid addict’s best chance for recovery, public health experts say. But in the U.S., doctors cannot treat more than 100 buprenorphine patients at a time.

Nearly half of all 3,100 counties in America have no doctors certified to prescribe buprenorphine by the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration, according to a Huffington Post analysis. Hundreds of counties have very few certified doctors. In places like South Dakota , which has just 27 bupe-certified physicians, some people drive hundreds of miles outside the state to fill prescriptions.

"We need to do more, particularly as it relates to people accessing treatment," Botticelli said. He and Burwell said the administration approach would also include efforts to reduce the over-prescribing of opioids and to expand the availability of naloxone, an overdose reversal drug.