After an early celebration with my family, I celebrated my actual birthday in a unique way. I traveled to New Mexico to be with 25 New Mexico-based emergency room and intensive care physicians to learn from national experts of new research findings in understanding the molecular biology of addiction and new pharmacological advancements in the treatment of opioid addiction.
I went to New Mexico because it has become a national leader in turning around the alarming rates of opioid overdose deaths that are ravaging America. As recently as 2014, New Mexico was second only to West Virginia in the number of opioid deaths per capita. Over the next four years, with much planning, intention, policy changes and new treatment offerings, the state’s opioid death rate has stabilized and has begun to drop while much of the rest of the country’s rates of opioid deaths increase.
New Mexico has done many of the same things we have done in Oklahoma to combat opioid overdose deaths such as the development of closer tracking of opioid prescriptions before physicians write another prescription, intervening when physicians are overprescribing opioids and the use of Narcan by first responders to prevent a death when there is an opioid overdose.
I asked what has made the difference in New Mexico’s recent improvements in opioid overdose deaths? The uniform answer from the physicians I met — full Medicaid expansion.
First, New Mexico used full Medicaid expansion to provide coverage to uninsured adults, including those with addiction and mental illnesses. Then, the state provided Medicaid coverage of the newest age medications that ease the symptoms of opioid withdrawal and help with maintaining abstinence from illicit opioids with daily use of, for example, Buprenorphine. These medication assisted treatments have a 60% improvement rate in opioid addiction recovery. Next, New Mexico provided health care coverage to begin these modern medication treatments for opioid withdrawal and stabilization beginning in the emergency room. The state went one step further and allowed physicians with 8 hours of advanced training to prescribe these advanced medications without prior authorization from an outside reviewer.
Imagine that: Full health care coverage of those with addiction trying to get out of their own personal and family hell, with access to new medications that help ease opioid withdrawal and greatly help maintaining abstinence from illicit opioids without the need for prior authorization. The result — saved lives, families reunited, people going back to work and emergency rooms no longer overrun with patients demanding opioids, or in full blown opioid withdrawal or fighting for their lives because of opioid overdose.
I have yet to meet an Oklahoman who has not been touched by addiction or mental illness — among themselves, their family or their close friends. Oklahoma is making progress in many areas for those with mental illness and addiction. Yet, we continue to underfund woefully the needed innovative services for these brain diseases. Our neighbors to the west have used full Medicaid expansion to fund creative new services that are working. We should as well.
Dr. Gerard Clancy, M.D., is president of the University of Tulsa.