Addiction treatment advocates call the new legislation a key to combating the opioid epidemic
By Jason Langendorf
March 2, 2021The reintroduction to Congress of the Mainstreaming Addiction Treatment (MAT) Act lays the groundwork for eliminating restrictions that prevent millions of Americans from receiving the most effective treatment for opioid use disorder (OUD), the medication buprenorphine.
Experts on the front lines of the opioid crisis agree that buprenorphine helps treat opioid addiction, yet under current law we are constricting practitioners’ ability to prescribe this medicine and, in doing so, limiting access to millions of Americans who desperately need help.”—Rep. Mike Turner (R-Ohio)
Last Thursday, Rep. Mike Turner (R-Ohio) and Rep. Paul Tonko (D-N.Y.) introduced the MAT Act to the 117th U.S. Congress, after the initiative had first been introduced in May 2019. Under current law, providers must undergo specialty training and apply for a waiver to prescribe buprenorphine, which is considered the “gold standard” of medication-assisted treatment (MAT) for OUD. The MAT Act would remove those restrictions and free up more providers around the country to deliver treatment.
“Experts on the front lines of the opioid crisis agree that buprenorphine helps treat opioid addiction, yet under current law we are constricting practitioners’ ability to prescribe this medicine and, in doing so, limiting access to millions of Americans who desperately need help,” Turner said in a news release. “In fact, over 40% of counties in our country do not have a physician who is licensed to prescribe this life-saving medicine.”
The Data Supports Buprenorphine
The data around buprenorphine is persuasive. According to statistics gathered by the nonprofit advocacy organization Shatterproof:
- People with OUD who take buprenorphine are up to 50% less likely to die when treated on a long-term basis.
- People with OUD who take buprenorphine have a reduced risk of HIV infection (54%).
- Individuals who initiate buprenorphine or methadone are 59% less likely to overdose and 26% less likely to visit the emergency department in one year compared with individuals receiving no treatment.
When the waiver requirement was created as part of the Drug Addiction Treatment Act (DATA) in 2000, the intention was to discourage the nonmedical use of buprenorphine, which has the potential for diversion. But, says Shatterproof vice president of state policy Courtney Hunter, what made sense then has become antiquated policy today.
“Fast forward 21 years,” Hunter says, “and we’ve got this huge crisis that I don’t think anybody at that time was able to foresee—that we would have the insane supply of opioids that we have, and that they would be as abused and addictive as they are.”
The urgency around the opioid crisis has only heightened since the MAT Act was first introduced in 2019. Although the legislation has bipartisan support, policy priorities and resource needs shifted dramatically with the spread of COVID-19. Meanwhile, the main drivers of addiction—isolation and a lack of access to treatment—have been amplified during the pandemic, leading to a spike in overdose deaths and opioid misuse.
Hunter says Shatterproof is advocating for both the MAT Act and MATE Act, which would standardize baseline substance abuse treatment training for all providers, as a sort of package policy deal.
“We’re not saying that we should get rid of the waiver without education at all,” Hunter says. “We’re saying we need to get rid of this waiver because we have a huge problem. And we need to expand access to treatment because this is our best tool in the toolbox.”
The Opioid Treatment Gap
According to data from the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2019 fewer than 1 in 5 people with OUD received the treatment they needed. Beth Connolly, project director of the Pew Charitable Trust’s Substance Use Prevention and Treatment Initiative, says the MAT Act can help address that enormous treatment gap and reduce the stigma surrounding the prescription and use of buprenorphine.
“By surrounding it with this waiver, it adds this mystery that it must be very complicated and it must be very dangerous,” Connolly says. “So you’re stigmatizing the medication, because it must be that if you have all these rules around it and I have to be specially trained and I have to have all of these other things in place, there must be something very dangerous about this medication. When, in fact, it is highly effective.”
