https://www.buzzfeed.com/danvergano/health-care-opioid-addiction-treatment?utm_term=.tmYOlpp71#.ow63zvvyM

Dan Vergano

Medicaid currently covers 3 in 10 people with an opioid addiction, and faces a proposed $830 billion cut. The new health care bill would, as written, be “a death sentence for millions of Americans,” said one treatment advocate.

Many people addicted to prescription painkillers and heroin — some 2.6 million nationwide — would face tougher odds of recovery under a draft Senate health care bill released on Thursday, according to addiction experts.

In the midst of a nationwide overdose epidemic, the draft Senate bill would provide only $2 billion

for recovery treatment programs for one year — even less than the $45 billion over 10 years offered in the health care bill that passed the House in early May, which had itself faced criticism as too paltry.

“It is a death sentence for millions of Americans,” Gary Mendell of Shatterproof, a nonprofit that advocates for addiction treatment, told BuzzFeed News. “It is mind-boggling to me that our lawmakers would take treatment away at a time when people need it most.”

NBA

Addiction is clearly a disease that doesn’t get the recognition and appreciation that it deserves.  Perhaps the answer to this conundrum is that we need to learn to tighten our belts and learn to do more with less.  I think methadone treatment centers should be abolished.  Buprenorphine outpatient treatment, perhaps with the video monitoring initially for Directly Observed Therapy (DOT) would work better.  Multiple episodes of inpatient treatment don’t seem to work.  Perhaps we need to use a “carrot AND stick” approach.  Make BUP very easily available, get rid of methadone clinics completely–just stop the funding!  Give addicted folks the opportunity for BUP AND Intensive Outpatient Treatment; Once.  Inpatient treatment for 28 days.  Once.  After that, set up something similar to the CCC during the Great Depression with camps for addicts to be put to work and be self-sufficient.  They can have access to their drug of choice but must be kept onsite AT ALL TIMES if they “choose to use”.   It would be safe, supervised, funded by the folks working on site. Eventually they’d probably get tired of being cooped up and genuinely WANT to get clean.  Once somebody has been clean for a predetermined period of time, they can leave the camp with an employable skill learned at the camp.  If they relapse, it’s immediately back to the camp, more time under supervision (longer than before, it’s a relapse and needs more time to ingrain the 12 steps etc. of good recovery).  This would be revenue neutral or better.

Dr. Raymond Oenbrink
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