Top health officials: Use money from opioid lawsuits to bolster treatment and prevention

Every 15 minutes, a baby is born suffering from opioid withdrawal syndrome. Physicians, hospitals and health systems are taking extraordinary steps to keep these babies and their mothers healthy amid the opioid crisis.

For example, the Mothers in Recovery program at Memorial Healthcare System in Florida is helping pregnant women who are trying to overcome drug addiction. Since its inception in 2015, according to internal data, MIR has treated over 134 women and maintained a 92% success rate of babies born drug-free. These outcomes are attributed to an emphasis on immediate access to treatment and a multidisciplinary approach to care. The program provides integrated treatment — obstetrics, maternal fetal medicine, behavioral health, social services and peer support — with a focus on the health and well-being of mom and baby.

Early, immediate intervention works

Physicians at ChristianaCare in Wilmington, Delaware, meanwhile, recognized that early intervention in the emergency department and inpatient settings could help patients struggling with drug and alcohol misuse. Dr. Terry Horton saw an opportunity for early intervention through peer counseling, and with Project Engage, patients in recovery share their experience and help guide those entering treatment.

“When someone raises their hand for help it is a fleeting moment and you have to be there to grab that hand,” Horton says.

Since 2008, Project Engage has seen 10,000 patients; about 24% accepted treatment, whereas almost none did before.

Other examples can be found in almost every state, city and community. In some areas, evidence-based services have been started after health care professionals witnessed the unmet treatment needs.

Despite these efforts, patients still face many obstacles on their path to recovery. Some insurers have made it difficult to access care, and stigma often keeps patients from seeking treatment. Government funding alone is inadequate, but additional resources may become available from the opioid litigation cases working their way through courtrooms across the country.  

Pending settlements in cases filed against opioid manufacturers, wholesalers, pharmacies and distributors offer another path forward — a path that should lead toward additional funding for research, education, prevention and treatment of overdose, opioid use disorder and pain. 

Judges and juries are being asked to hold companies responsible for their alleged misconduct. A tentative settlement was reached Monday in a large group of cases consolidated in Ohio. In this and other lawsuits, whether they settle or go to trial, we strongly urge courts and juries to ensure that all funds received from the defendants are directed to help treat patients.

Not what you think:We thought we knew what drug addiction looked like. Then our nephew died in our house.

In 2017, almost 48,000 Americans died from drug overdoses involving opioids, according to the Centers for Disease Control and Prevention. More than 2 million Americans struggle with an opioid use disorder. 

Providers have been on the front lines, caring for those addicted to opioids and their families from the beginning. They have done so whether those patients and their families could pay for care — and many of them could not. We need to continue to expand our treatment efforts. Yet, the prevalence of illicitly manufactured fentanyl, methamphetamine and cocaine threaten to overwhelm available resources.

Apply settlement money to treatment

The lessons from the national tobacco settlement are clear: Unless there is a dedicated commitment to promptly put judgment awards and settlement funds directly to providers —  where they are assured of being used for prevention and treatment of opioid addiction — it won’t happen. The support of the courts is needed to make sure this history does not repeat itself.

A personal tragedy:The opioid crisis hits home. Mine.

This was a system failure recognized far too late. Pharmaceutical manufacturers relentlessly promoted opioids to physicians as pain panaceas that were safe and systematically minimized the risk of addiction. Patient satisfaction surveys mandated by the federal government that influenced payment rates were also a factor, as they unintentionally encouraged this kind of pain medication on demand.

Even insurance coverage, which is more available for prescription opioids than for alternative methods of treating pain, played a role. Illegal pill mills contributed significantly to the epidemic.

Physicians must absolutely be judicious in prescribing, and most were trying to do their best for their patients. These same physicians are still working to ensure patients have access to appropriate treatment and are not deterred by the ongoing stigma against those with opioid use disorder or pain.

The opioid epidemic has contributed to one of the first declines in life expectancy in decades. Taking the steps above will help offer relief to overwhelmed communities and get patients the support they need when they are receptive to it — in the “reachable moment,” as Horton puts it, that is crucial to recovery.

Dr. Patrice A. Harris is president of the American Medical Association and chair of the AMA Opioid Task Force. Brian Gragnolati is president and CEO of Atlantic Health System and chair of the board of trustees of the American Hospital Association. Follow Dr. Harris on Twitter: @PatriceHarrisMD