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Under a first-of-its-kind agreement with the federal government, California’s county-run Medicaid programs are slated to begin covering a full set of addiction treatment options recommended by the American Society of Addiction Medicine, including opioid addiction medications. In California, which was among the first states to expand Medicaid, as many as 370,000, of the 2.9 million people newly eligible for Medicaid, may be in need of treatment. Among the low-income adult population served by Medicaid under the Affordable Care Act, the rate is much higher: An estimated 13 percent of newly eligible Medicaid enrollees suffer from addiction.
Of those, almost one in 10 were hooked on painkillers - 1.9 million - and more than half a million were hooked on heroin. Substance Abuse and Mental Health Services Administration. Nationwide, about 21.5 million people 12 and older, or 8 percent, had some kind of substance use disorder in the past year, according to a national survey by the U.S. We need to get more involved in fixing it,” said Kelly Pfeifer, a physician with the California HealthCare Foundation, which advocates for greater availability of addiction treatment and prevention. “We doctors are the ones who caused this epidemic by overprescribing pain medications. “They worry they’re going to make people sick when they start taking it.”īut an increasing number of physicians are starting to push for greater use of buprenorphine. “I really think doctors are scared of prescribing it,” Eagen said. Most doctors claim they don’t have the training or the time to treat high-maintenance opioid addicts in their busy practices, despite urgent calls from federal and state officials. When the National Institute on Drug Abuse funded the research that led to buprenorphine’s development more than a decade ago, it hoped that office-based prescribing of buprenorphine, which comes in a soft tablet and dissolvable film, would mean greater access to addiction medication nationwide.
But even here, federal prescribing restrictions and lack of information keeps many doctors from entering the fray.
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With its long history of providing drug treatment and free health care to uninsured residents, San Francisco is particularly well-equipped to battle the opioid and heroin epidemic. They’re the easiest patients I have.” Unrealized Potential “When the patient is handed back to me, I know that the person is not at risk for imminent relapse. When they’re too busy with other patients, they rely on a small medical team at a county-funded center in the nearby Mission District to screen patients and, if the medication is appropriate for them, determine the correct dose.Īt this central “induction center” on Howard Street, a half-time doctor, two nurse practitioners, a behavioral health counselor and two administrators have been providing screening and initial care for low-income opioid and heroin addicts since 2003.Įagen said working with the Howard Street team makes her life easier. Getting patients started on the medication can be time-consuming.
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Most doctors with a license to prescribe buprenorphine seldom - if ever - use it.īuprenorphine is the primary addiction treatment tool for Eagen and the seven other staff physicians at the Tom Waddell Urban Health Clinic. But because of a federal law, fewer than 32,000 doctors are authorized to prescribe buprenorphine to people who become addicted to those and other opioids. physicians can write prescriptions for painkillers such as Ox圜ontin, Percocet and Vicodin. Food and Drug Administration-approved opioid addiction medicines like buprenorphine offer a far greater chance of recovery than treatments that don’t involve medication, including 12-step programs and residential stays.īut as the country’s opioid epidemic kills more and more Americans, some of the hardest-hit communities across the country don’t have enough doctors who are able - or willing - to supply those medications to the growing number of addicts who need them.
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By eliminating physical withdrawal symptoms and obsessive drug cravings, it allows her patients to pull their lives together and learn how to live without drugs.Ĭlinical studies show that U.S. For those addicted to opioid painkillers or heroin, buprenorphine is a lifesaver, Eagen said. Many suffer from mental illness or are substance abusers. As a primary care physician at a public health clinic here in the Tenderloin, she sees many of the city’s most vulnerable residents. Kelly Eagen witnesses the ravages of drug abuse every day. Even as the country’s opioid epidemic worsens, relatively few doctors are prescribing the drugs. A prescription for Suboxone, one of the medications proven to be effective against drug addiction.