House events, the courts, campaigns and more from the world of politics. All at tips. You can also stay current with the latest episodes of washington journal, and find scheduling information for cspans tv networks and cspan radio. Plus a variety of compelling podcasts. Cspan now is available at the apple store and google play. Scan the q. R. Code to download it for free today or visit our website, cspan. Org cspannow. Cspan now, your front row seat to washington, any tim anywhere. Host joining us from new york here to talk about his new series, the war on recovery,sta. Guest thank you for having me, happy anniversary span. Host thank you very much. How do you describe stat to people and how you are supported . Caller guest guest we are a health news websitehe boston globe umbrella, but if folks are interested in Premium Health content, we are there for audiences as well. Host you write a lot about addiction in the United States, look at recovery. The war on recovery is how you title it. How did you get interested in this topic . Guest i wanted to drill down on whats going on in the United States. We are obviously not handling our crisis well. 10,000 people dying each year of drug overdoses. 80,000 are drug opioid ■xoverdoses. The premise of the series is that essentially we have two really effective medications known to reduce the risk of ovey about half. Instead of doing everything we can to get these medications into the hands of the people, ie do the opposite, we make it difficult to access and place a lot of restrictions on use. People may know it by the brand name, suboxone. Thats the premise at many Different Levels we are restricting access to medications known to prevent overdose death and, of course, with over 80,000 people dying of overdose, its something that needs to happen urgently. Host lets start with the drugs themselves. How do they work . Guest they are weak opioids. A bit like a nic gum for someong to not smoke cigarettes. Essentially, if you try to stop using like heroin, fentanyl, or even a prescription painkiller, if you just stop cold turkey you will experience agonizing, debilitating withdrawal symptoms. So severe that almost no one successfully does it. Already true in the age of heroin. Now that the drugs on the street are almost entirely this ultra potent fentanyl, its doubly uell but impossible to just quit cold turkey. The medications essentially come in andind of the receptors in your brain, the same as heroin fentanyl. But they dont get people high if administered properly. For someone with addiction trying stop using illicit substances, the idea is that the medication leaves them clearheaded, free of withdrawal symptomsfreelife as family memb, students, employees, anything else. Host you said ifherly. Typically, how are they administered . Guest methadone is very effective to eaaddiction. Its only available at a special methadone clinic. In many cases they require patients to come in every day to get a single dose. You are essentially structuring her life around the ability to be at these clinics and in recent years more have with tak doses. Giving you three days, week, two weeks to takehome, keeping your fridge in little liquid bottles. But for the most part, people that go to methadone clinics have to comply with logistics in a way that a lot of Public Health experts believe is harmful to their recovery. Because obviously you want to be able to have a source of income, Stable Living situation, Stable Family situation. Any of us who wake . And go to work every morning can only imagine how difficult it would be if we added the requirement of going to a Medical Clinic every day at 6 a. M. , 7 00. Thats methadone. Bucher nor frame is much simpler. You can essentially get it prescribed by most doctors and you can get it from a doctor. Ho our guest is with us here through if you want to give them a call, eastern and central time zones, 202 7488001 for mountain and pacific. If you are a caregiver or medical professional, give us a call at 202 7488002, and you can text us02 7488003. The first part of the war on recovery is found online and you said it is conscious choices that are being made keep these drugs from people. Can you elaborate . Guest there are many Different Levels of American Society that in some ways work harder to deny the medications to people that need them than to provide access to them. A fewxamples. Until recently doctors required a special license to prescribe it. Even though any doctor who is a licensed prescri could of course provide patients highly addictive painkillers like oxycontin or any other opioid painkillers was a much safer, weaker medication used to treat addiction, those painkillers can cause the addiction themselves, so doctors had to jump through hoops to get a special license just to prescribed the medication treatment. Thats one example. I already mentioned the prescriptions around methadone clinics and how difficult it can be to receive care. ■ and nuanced example is that of narcotics anonymous, the 12 step program modeled largely after■n alcohols anonymous. I dont want to paint with too broad of a brush, there has been an evolution, different chapters the next, but in many cases these meetings, the organizational literature at a national medications, even though they are essentially the best tool that we have to help people stop using illicit opioids and prevt from dying of opioid overdoses. There is a view that people that use the medications arely abstin true recovery, but addiction doctors and many who use the recovery would essentially tell you that they have given them their life back and they are happy and thriving thanks to these medications. ■0so, there is a lot of stigma o this day that people that take the medications face. Host the group thayou himentioned, narcotics among narcotics aus, ve something called bulletin 29, saying thatembe are encouragattend meetings, but it raises the que do they have the right to limit participation in meetings . Theyd elieve so, that it is common practice for na to encourage the addicts still using to listen and speak with breaks. This is not meant to alienate or embarrass, but to preserve atmospheres of recovery. There is more on the website, but i saw that one part and you did say it was a nuanced approach. Can you elaborate in light of that . Guestt want to cast every meeting in the same light, many are increasingly supportive of this approach, known as medicatedt. But in the language you just cited, i heard the phrase still using, i believe. I think thats very telling in terms of the phenomenon we are discussing because of course there is a huge difference between, you know, smoking fentanyl you band, you know, wae morning and taking, you know, a pill or a sublingual fda and manufactured under tight regulations by a pharmaceutical w exactly whats in it. Those things are clearly just not the same and one is, e is likely to help enable your recovery and enable you to go about life as anybody else can. Thats not just narcotics anonymous. Its more broadly true. People view these medications as sometimes. Tom price, president Donald Trumps first Health Secretary infamously kind of rerred to medication assisted treatment as substituting one opioid for another, which in a technical and medical sense is true, but at the same time, again, taking an fda of fda medication is far safer and allows you to live a happier, healthier life than, you know, using fentanyl several times aitude that remains pervasive throughout American Society. Host lev facher, who report addiction in the United States for stat news, you can find it online. 202 7488000astern and central time zones, 202 7488001 mountain and pacific. For those of you with a speci. Paul, you are on with our guest, go ahead. Caller thank you for take my call. I had a couple of questions. I currently take opioids and i have for quite a few years. Ive got five major third test had five major surgeries, arthritis. You haveindtion. Is there a government formula that says x amount of milligrams is safe forguest yeah, i figurd get some from patients with pain, its a huge subplot in my opinion. For those who may not know, you know, in t mand, you know, aboue ago, there was of course a huge prescription opioid oversupply problem driv large part by Companies LikePurdue Pharma and the medication oxycontin. Of course, the government respon to that was to really restrict opioid prescribing and really encourage a change in the medical culture to prescribe fewer opioind good. I remember how many vicodin i got when i got my wisdom teeth but there are also a lot of pain patients who have been taking oil opioids for years and havent overdosed or had adverse effects and suddenly those folks have found access to their medication restricted by doctors who are worried about crackdowns from the Drug Enforcement administration or patients overdosing. So, there e taking prescription opioids who lost access to those medications and because they had become physiologicallyenon themg heroin, now fentanyl. There is a convincing argument that severe restrictions in the wake of the drugs crisis, it surely exacerbated the overdosed problem. But yes, there centers for Disease Control that specified amount they believe is safe but they stress that it is not onesizefitsall and that doctors and clinicians should use discretion. And im not a medical professional, so i dont want to quote an amount of opioids, but there is government guidance on that, yes. Host john is in tennessee. Good morning. Caller good morning, thank you. According to what i see on cnbc, there is a Pharmaceutical Company called vertex that is working on a nonopioid painkiller and has shown partial results. Evidently, it is not addictive that it is an effective painkiller. Im curious about it. Wondering if you know anything about it. Guest there has been a big effort to develop nonopioid i will admit, i dont know the specifics of this particular drug candidate. I will say that we are essentially talking, about two separate issues. One, how do we treat pain, how do we treat it in ways that are not going to give people access es of potentially addictive medications . Of course, there is this welcome effort to■ develop nonopioid painkillers to avoid another oxycontin situation in the future. However, there already is a Huge Population of people taking either prescription opioids for pain or illicit opioids because they havedent or addicted to those drugs. So, there is the pain question butler is also the russian of what we do with the huneed opioe addicted to illicit substances and, latter category, if people want to stop using, their best bets are these two medications, methadone and buprenorphine. Has there been an official position taken on these drugs . Guest the director of the nof g abuse is a huge opponent of their use. Proponent of r us■ buprenorpy to die, 59 percent less likely if youre taking methadone. The Agency Position is that these are effective medications. Director for the first piece series, war on recovery, she told me that she believes if we made access universal, essentially if we provided it to everyone in the country who needed it, we would deaths falld she stressed that was a conservative estimate, saying universal access, 40,000 fewer people, at least, would die, every single year of opioerdose. Host there was an announcement earlier this year that hhs expanded some of that access to telehealth means. Can you elaborate on if hhs has taken a position on grting more access . Host guest hhs has gone back and forth on access to buprenorphine through telehealth. They in the Drug Enforcement adminiration and the Drug Enforcement administration dont always see eye to eye, another thing we will cover in role of w enforcement, jails, prisons, the court systems, and restricting access, but there has been a debate over how freely doctors should be able to prescribe buprenorphine by telehealth. As of now you can get a prescription without ever visiting a doctor in person. You can see them over video chat and they could write you a prescription and they cod e is e by telehealth. For the most part people need to go to the clinics in person just to get a single dose. Certainly, there have been efforts by the Biden Administration to expand access to the medications. Early in his presidency, the white house set one goal was that by the end of his first term would be to make access for methadone and buprenorphine. Here we are is obviously not going to happen, but yes, hhs and the bite administration have taken steps to access. Public Health Experts tell you that for the most part they have not fast enough. Host this is lev facher joining us from statin news, looking at opioid addiction and recovery. Kevin, your■l■o next, mhigan. Ty call. Im a guy with permanent nerve damage done by a doctor. E because it doesnt take into of account a guy who people who rely had a buddy who lost a leg. A year ago they cut off his opioids. He had a quality of life, taking one opioid per day. He has now passed. When you have a war on opioids and all doctors are scared to give them out people in pain, wh we shouldnt have to do and we should have to fight. Whenever there is a hearing on opioid■2 have never seen anybody there who is a pain, has to deal with the pain, because they have taken their opioids away. There has got to be a middle there. 2 of people who are chronic opioid usersd and some of them are probably just sick of being in pain. 24 7, you are hurting, ok . But can you get a doctor to help you out . No, they are scared of the government. Thats not good. I would like to hear your response. Thank you very much. Host thank you, kevin. Guest ■ we just mentioned this, theres a Huge Population of chronic pain patients in this country who rely on opioids to treat their in some cases they are also physiologically dependent on those opioids in a way that hasnt crossed the threshold into addiction. These are different concepts. There is the physiological dependence and then there is addiction, a psychiatric diagnosis about yo behavior related to substance use. Yes, there are tons of people in this country who regularly take prescription oaddicted in a medd psychiatric sense to opioids. Offs a huge problem that peopl■ from pain medications they have relied on for years. There is anecdotal evidence, yes, that it has led tin suicid. Certainly, there is thought that restricting pain medication for people wholong time has led to e in overdose. When people regularly use opioid painkillers and are suddenly cut f, usually not a practical ask to make of someone. A lot of people end up using heroin instead. Now that the drug supplies fentanyl, they use fentanyl. As you can imagine you are way more likely to od on fentanyl then a Prescription Medication you picked up at your local rite aid. Absolutely, that is a huge issue and i agreet get enough attentn from policymakers. Host las vegas, go ahead. Caller my question goes to an article that you posted recently about private sectors overtaking methadone clinics. I was just wondering if the People Manufacturing it are actually infected and those■o e sectors, in overtaking the methadone clinics. Caller heing to an art guest hes referring to an article i published this morning about the increase of private equity inethadone spaces. One third of them are owned by private equity firms, two thirds are run as forprofits. That is a big shift from a the majority of clinics were run by Government Agencies or local nonprofits. As far as i am aware,dication, e moneymaker because it is a very common, generic medication. There is no patent or anything particularly specialized about manufacturing or selling methadone. I think the bigger financia the clinics operate and the fact that they build to dispense the medication and hire patients to participate in counseling, drug testing, and sometimes other services as well. They bill for those. It large forprofit industry. In that story we reported that Acadia Health care, only about 17 methadone clinics. They call it a comprehensive treatment center. I believe that even that 17 accounted for half year. Yes, in some senses methadone business. Ave become big i do think that this is more about them getting reimbursement for the services they provide as opposed to a huge profit margin on the physical medication itself. Host that was part three, introduced today. In part two you introduce us to rebecca smith, who goes to her clinic every morning to get her treatment. You also describe why she has to go guest right. We were in detroit, michigan, and as you say we spent time patient named rebecca smith, who really was the model of what you would want recovery from opioid addiction to look like. She had beeny for five or six years. She was active in her church. Had great relationships with her kids and grandkids, working a steady job. She credits this with helping she had been going into the clinic. She met every week and met counselors, picking up medications to take home. She deliver life. She attended she had a small amount of white wine as a part of a toast they were making. She mentioned it to her counselor. A small amount of alcohol showed up on her drug scr i should note, this is not someone who has ever had a problem with alcohol. The clinic has never been worried about her alcohol use. But the clinic upon learning of this stripped her the takehome privileges, which they call them , making her come in every to come in every single morning, this woman doesnt own a car, has had a knee rep [captioning performed by thenat, ts caption content and accuracy. Visit ncicap. Org] [captions Copyright National cable satellite corp. 2024] washington journal is available to watch at cspan. Org. We take you las vegas to the house about to gavel in. The secretary mr. Speaker, i am directed by t p states to delivo