Linehan’s Addiction Policy Advisor Urges Caution on Suboxone Cap Lift

By John Lynds

Councilor Bill Linehan’s Addiction Policy Advisor, Jack Kelly, who is charged with working on ways to fund and expand drug treatment opportunities in the city urged caution to lawmakers looking to lift the cap on Suboxone prescriptions.

Suboxone, an opioid treatment medication much like methadone, is strictly regulated. However, in response to the horrific opiate epidemic plaguing Boston communities, the Commonwealth, and the greater U.S., U.S. Senators Elizabeth Warren and Ed Markey, along with urged U.S. Health and Human Services Secretary Sylvia Burwell, in a letter last week, to increase the current limit of 100 Suboxone patients per doctor to 500.

“This is great news, but we must proceed with caution in our excitement,” said Kelly. “For starters, we applaud Senator Markey and Senator Warren for responding aggressively to an issue that, until recently, has blatantly been ignored by public health officials – both nationally and locally.  However, their proposal to lift the prescription cap for prescribing such medicines as Suboxone and Vivitrol is only a “partial step” in the right direction.”

Kelly said studies have demonstrated that medicines such as Suboxone, Methadone and Vivitrol have saved people’s lives and have helped them on the road to recovery but added substance use disorders are not a moral failing but a mental health condition.

“By simply writing such a letter, Senators Markey and Warren give creditable credence to the nonsensical counter argument that treats any form of Addiction – not just heroin addiction – as some form of moral deficit,” said Kelly. “However, we must balance our excitement with a more detailed account of the proper treatment methods we prescribe.  As aforementioned, studies show that better access to these medicines does help some people access recovery.  But these medicines are in no way a cure for addiction. Additionally, it is dangerous to view them as a panacea to eradicating substance use disorder.”

Kelly, who is in long-term recovery from a heroin addiction – an addiction that left him homeless at the age of 19 and with a 3-page criminal record – he said he understands the unfortunate peaks and valleys of dealing with loved ones who are addicted to high-powered opiates such as heroin.

“For those families who have had to bury children or are still dealing with the daily horrific consequences of addiction, a “pill” to stop the pain and keep their loved ones alive seems like a godsend,” said Kelly. “Unfortunately, these appropriate solutions increasing access to life-saving medicines are not a cure and do not guarantee your loved one will stop using drugs in a harmful manner. What is missing, not only in current federal legislation, but also on local and state level discussions, is the tricky solution of raising more revenue.”

Kelly said peer-to-peer solutions like rehab and therapy are still a successful avenue to obtain long-term recovery.

“The biggest problem with peer-to-peer solutions is that they are costly,” he said. “We do not hear this being proposed in current discussions within the debate around the opiate epidemic.  The reason being is that such an approach, if done correctly – committing an opiate addict to at least three to six months of treatment in a facility – is simply too expensive for lawmakers and health insurance companies.”

For Kelly it seems the only solutions being offered are better access to more prescription medication.

“Without also mentioning peer-to-peer recovery approaches, we are short-changing not only the individual people dealing with substance use disorder, but society as a whole,” he said. “I find it rather suspect that the opiate epidemic started as a prescription drug problem. Why, then, do we turn to the same industry to offer the answer to the problem they helped create?”

Kelly has seen first hand how peer-to-peer programs have helped millions of people, including himself.

“I have been successfully been treated for heroin addictions without the assistance of long-term medication,” he said. “It is possible to be free of it all. Exercise, long-term therapy, peer-to-peer solutions, and yes, even harm-reduction medicine should all be a prescription to treat substance use disorder.  But not one solution will work individually.”

Kelly suggested that people who are advocating for better recovery services remain open-minded on all approaches to recovery – including more access to peer-to-peer treatment options. But more funding is needed to address the problem.

“Yes, everything we have mentioned will need additional revenue,” said Kelly. “The question we must all ask ourselves is, “Is it worth it?” I know where my family stands on that question.”

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