Opioid offensive ongoing.

Hanson, Karmen

Opioid overdoses continue to kill Americans at an alarming rate. Improving access to effective treatment for substance use disorders, including opioid addiction, would help combat this public health crisis. "Ensuring that people with substance use disorders have access to evidence-based care is essential to reducing opioid overdose deaths," says Cynthia Reilly, director of the substance use prevention and treatment initiative at The Pew Charitable Trusts.

The Trump administration announced in April that it will award a total of $485 million in grants to all 50 states, the District of Columbia and the territories to help improve access to treatments. "Opioids were responsible for over 33,000 deaths in 2015; this alarming statistic is unacceptable to me," Tom Price, secretary of the Department of Health and Human Services, said when he announced the grants. "We cannot continue to lose our nation's citizens to addiction."

Price said his department is committed to supporting the most clinically sound, effective and efficient prevention, treatment and recovery services. The department identified four areas for improvement: public health surveillance, pain management, access to treatment and recovery services, and the availability and distribution of overdose-reversing drugs. It will also support cutting-edge research.

Certain insurance policies and practices create barriers for people needing treatment as well as for the providers offering care. When insurance policies don't cover the costs of treatment, for example, patients often choose not to seek the medications and services they need to get well. The new federal grants will help states in their efforts to make the full spectrum of treatment and services more widely available.

The most effective substance-use treatments can involve a range of interventions, including talk therapy and cognitive and dialectical behavioral therapies, combined with drugs approved by the Food and Drug Administration. Finding the right combination of therapies is patient-specific and can be more difficult if some drugs and services are unavailable.

Even Medicaid doesn't cover all the services recommended by the American Society of Addiction Medicine in 37 states. Private insurance companies may not cover the most effective treatments either, but, when confronted with a parity violation, they often will change. Federal and state parity laws require most insurance plans to provide coverage for mental health conditions that's equal to coverage for physical illnesses. The federal requirements are part of both the Mental Health Parity and Addiction Equity Act of 2008 and the Affordable Care Act.

States and territories were awarded the new federal funds based on their rates of overdose deaths and unmet need for opioid addiction treatment. The grants range from a minimum of $2 million in several states to $44,749,771 in California.