March 14, 2018 – Former Congressman Patrick Kennedy has been a significant voice within the national debate concerning the opioid epidemic. The Democrat from the legendary Kennedy political family, himself a recovering addict, called for political and financial commitments from the federal government to combat the issue.
Kennedy has also tried to make the connection between addiction and mental health. During his time within the U.S. House of Representatives, Kennedy sponsored a bill that might require insurance firms to treat mental illness, depression and addiction similar to physical illnesses. The bill, often called the Mental Health Parity and Addiction Equity Act, was signed into law in 2008.
Kennedy can be a member of President Donald Trump's Commission to Combat Drug Addiction and the Opioid Crisis. He recently spoke with WebMD concerning the current crisis, his own experiences with addiction, and what America should do. Here is an edited version of the conversation.
WebMD: You have often said that if we had the need to finish this epidemic, we could do it today. If we had that can, what would we do?
Kennedy: When it got here to Zika, we had enough money. And we didn't even know treat or contain the virus. We were completely at midnight. But the cash was there.
In this case, we all know exactly what works, and yet it doesn't make any money. In this case, we're obviously losing over 200 people a day.
When HIV/AIDS struck, we were spending $24 billion a 12 months to fight a crisis that killed 53,000 Americans. And now we're losing way over that, a conservative estimate of 64,000, and we're not even near half a billion.
WebMD: Many of the individuals who read our work on opioids are concerned about how they may proceed to get opioids. These are individuals with chronic pain who will not be abusing these drugs but have been taking them under their doctor's guidance for years. In many cases, they already face major hurdles in relation to filling prescriptions. What should they do?
Kennedy: We are experiencing an enormous epidemic of real physical pain and we're experiencing an epidemic of perceived physical pain, combined with real psychological pain, which ends up in a whole lot of the overuse.
The fact is that there isn't a one size matches all solution. Real pain must be addressed on a regular basis with recent and emerging treatments. And there are several recent treatments. When we held our hearing before the Commission, we heard from several firms that they're dramatically reducing the necessity for opioids, from hospitals, particularly for surgical pain, because there are recent sorts of procedures. We heard from the pharmaceutical industry that we had several promising approaches within the pipeline. We need to seek out ways to treat pain aggressively.
When I used to be in Rhode Island, we did a survey of people that had lost family members in these hospitals. And there was a whole lot of outrage that they'd lost their family members in excruciating pain and that their pain was not being treated appropriately. I don't think anyone wants us to undergo those times again. I worry that the pendulum could swing back so hard that we find yourself ignoring the very legitimate need for pain management.
I fear the pendulum will swing back from overprescribing to underprescribing. We'll just must prescribe something different to maximise all of those options.
WebMD: There are countless stories of individuals hooked on opioids who've been taken advantage of in various ways, from addiction drug manufacturers driving up prices to so-called addiction treatment centers that stall addicts so long that their advantages or bank accounts are drained. How is someone who needs help alleged to get it?
Kennedy: It is basically the duty of the medical community to step up and help patients. We see this as an addiction or mental health problem, although it's a medical problem. The AMA (American Medical Association) has done little or no to advance this whole discussion. They have even did not help increase the prescription of buprenorphine, which [medically preferred] treatment for opioid use disorder. And, frankly, probably the most cost-effective. You could provide someone with year-round coverage for opioid use disorder, satisfy cravings, prevent overdoses, and supply cognitive behavioral therapy for mental health, all at a fraction of the price of flying to a rehab center or considered one of those dodgy treatment facilities in sunny locations.
The insurance industry must change into more proactive. Inpatient treatment is often not indicated for opioid use disorder.
Most of those facilities detoxify patients first, and everybody says that's the worst thing to do in these cases. There's absolute confidence of what to do here. We must get a few of these big medical societies and large insurers to stop whining and do what we all know works. (Insurers have been) too easy to accuse the present system of not being evidence-based. Well, in lots of cases, in fact, it's not evidence-based. That's since it was never paid for under normal reimbursement. Too little money was spent. And now they don't want to offer it anymore.
WebMD: What have you ever learned from your personal experience in recovery? What would you tell your younger addicted self, and what would you tell Patrick Kennedy on his first day of sobriety?
Kennedy: I might say that is by far a very powerful decision-making period of your life. And these worries about economic and profession security and worries about what people consider me – all of that's fleeting and can't be controlled by anyone. Deciding daily to make this your top priority is the most effective thing you'll be able to do to make sure your probabilities of having every thing you wish. It really is the one sure-fire answer that provides you the most effective likelihood of winning a medal like those Olympic athletes.
WebMD: What are you scuffling with today? I do know that former addicts of every kind say they will not be cured, but on the road to recovery. How do you take care of this in your day-to-day life?
Kennedy: I struggle with other things that would cause me to relapse into addiction. They revolve across the seven deadly sins. Anything that feels too good is something you will have to quickly query.
WebMD: The President's Opioid Commission: You've said it's a farce. What exactly is happening there? Does the White House have an interest in addressing this problem?
Kennedy: The Commission's work was good. We did a great job. The concept that we were organised to enable a daring response to this epidemic is a farce. It has now been revealed that from the outset there was no real interest in tackling this challenge vigorously.
When the President gave his speech on the White House after the commission, I believed this might really be something. His speech was very powerful. But then we waited and waited, and the subsequent thing that happened was a tax cut of virtually $2 trillion. They say we'd like $200 billion over 10 years if we're going to get anywhere near HIV/AIDS. Now we're passing a tax cut that's going to cost $2 trillion over 10 years. Don't tell us there's not enough money. It's about politics.
WebMD: What can we do to have the best impact in the subsequent two years?
Kennedy: We need a blueprint for a way we spend the cash from that final settlement. I believe there's little doubt that there will likely be a settlement. The query is just like the tobacco settlement: is a whole lot of it going to be wasted and not likely getting used for what could have the best impact? So I believe we urgently must be prepared and description our solutions. In the town of New York, the overdose rate is stagnant. Rhode Island has seen some great news recently by way of incarceration and treatment of incarcerated people.
The bottom line is that we have now a complete range of effective measures which have proven their usefulness. Drug treatment. Boom, right from the beginning. Ensuring that every one health care [professionals do] We conduct addiction screenings so we will see who's most in danger.
We have the [mental health] Equality Act that remains to be being ignored. There will not be a state on this country where insurers comply with the federal mental health and addiction law. If you can ever get insurance firms to spend what they really should on this issue, you'd see a dramatic change. And in fact, we'd like to take motion against these unscrupulous providers. [to make sure] They are literally developing the treatments which have the most effective likelihood of improving people's condition. That could make an enormous difference. Obviously, early intervention is the goldmine of all our future efforts.
That's something that Republicans and Democrats should get behind. … We are really relegating our country to a second-class country in the longer term, since the recent armies which might be going to remove our lifestyle will not be going to be military or economic. The recent armies are going to create depression, anxiety, and addiction. Those are the things which might be going to undermine our national security and push our country to a lower lifestyle.
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