Addiction researchers and health-care providers shrieked in unison last week after Health and Human Services Secretary Tom Price suggested to a West Virginia newspaper reporter that medication-assisted treatment, in which people who are addicted to heroin and prescription opioids are provided suboxone or methadone to reduce cravings, is "just substituting one opioid for another." Charleston Gazette-Mail reporter Eric Eyre writes that "Price touted faith-based programs while showing less support for medication-assisted programs."
In response to Price's remarks, some 600 academics and medical experts signed a letter asking the secretary to reconsider his position and set the record straight on the value of medication-assisted treatment.
"Medication-assisted treatments meet the highest standard of clinical evidence for safety and efficacy. Indeed, the substantial body of research evidence supporting these treatments is summarized in guidance from within your own agency, including the Substance Abuse and Mental Health Services Administration, the US Surgeon General, the National Institute on Drug Abuse, and the Centers for Disease Control and Prevention," the letter reads. "Myths about medications are likely to reduce help-seeking and reinforce very damaging stigma, ultimately leading to avoidable harms."
The petitioners note that the 21st Century CURES Act, which Pres. Obama signed in Dec. 2016, earmarks $1 billion for state-based addiction treatment programs. Then-Rep. Price (R-Ga.) voted against the House version of that bill, but not because it contained language encouraging states to invest in medication-assisted treatment. In fact, he called the aims of the legislation "laudable," but challenged the fact that it created mandatory spending.
"There's no reason that these programs could not be authorized and then made, appropriately, a priority through the discretionary spending process," he said in a statement explaining his opposition to the bill.
While it's strange to see Price, a physician for more than two decades, tout faith-based rehab over medication-assisted treatment, it's stranger still in light of President Trump's decision to nominate Elinore McCance-Katz for Assistant Secretary for Mental Health. A licensed psychiatrist and medical school faculty member at Brown University, McCance-Katz worked at the Substance Abuse and Mental Health and Services Administration under President Obama, and would run the agency if confirmed. Price would be her direct report.
The kicker? In 2014, McCance-Katz gave an interview in which she said, "At this point, the use of MAT for individuals who have a history with a severe substance use disorder or have a chronic relapsing disease is really an ethical issue. Individuals need access to the treatments to help them recover. It is the right and ethical thing to do."
If confirmed, hopefully she can bring her future boss up to speed.