We must mobilize as a nation to address the epidemic of opioid addiction. According to data published by the Department of Health and Human Services, some 11.4 million people misused prescription opioids in 2016. Some 2.1 million people had an opioid use disorder. And, tragically, nearly 50,000 people died from an opioid overdose. The federal government should be leading a multi-pronged approach to deal with opioid addiction. It is not too late to stem the tide. As President, I will make ending this epidemic a key goal of my administration.
As a critical first step toward ending this crisis, we must improve access to addiction treatment. There are a number of ways to accomplish this, starting with getting states to rework their Medicaid programs to boost reimbursements paid to providers of addiction treatment services — as Virginia has implemented with their Addiction and Recovery Treatment Services program — because addiction treatment providers are generally underpaid by health insurers. The federal government is already required to play a role in assuring that mental health and addiction are covered by health insurers under the Mental Health Parity and Addiction Equity Act (MHPAE) — which requires that restrictions on and insurer’s requirements for coverage of mental health and substance use disorders are no more restrictive or onerous than those set for other medical and surgical benefits — but the Act is largely unenforced. Unfortunately, it was written without a mechanism to monitor and evaluate its effective implementation, so it must be amended and updated as soon as possible. The Affordable Care Act did improve coverage for behavioral health patients, but the parity protections of the MHPAE do not extend to Medicare, traditional Medicaid, or certain bare-bones catastrophic coverage plans currently offered. We should extend parity protections so that people in such plans are also able to access mental health and substance abuse treatment.
We also need to increase funding for training programs to help clinicians better understand the complexities of addiction care, and we need prisons to improve access to addiction treatment, including all available medications. Furthermore, the national database on opiate distribution should be made public, and law enforcement agencies need to start utilizing it to better determine where to focus their limited resources. We should also change federal law to allow doctors and scientists to expand research into the potential of certain controlled drugs to complement traditional substance abuse and other mental health treatment, including psychotherapy and cognitive behavioral therapy. Anti-drug laws should never be an impediment to sound scientific research, but especially not during a public health crisis such as this one. If these otherwise illegal substances can be safely used to help patients beat addiction, as the limited studies conducted thus far seem to indicate, we must quickly figure out how to make them readily available.
Perhaps most critically, we need to hold corporations accountable for their role in the epidemic, and then we need to use fines levied against them to fund drug treatment programs and increase federal support for mental health programs. We also need to deal with the corruption that has largely seen the Justice Department fail to pursue criminal charges against pharmaceutical company executives and drug distributors. The revolving door between the Justice Department and the Drug Enforcement Agency, and the pharmaceutical companies and their lobbyists, has resulted in law enforcement decision-makers going easy on corporate executives so they can maintain their chances of scoring a lucrative job with the corporations once they leave government. I therefore support a new division in the Justice Department to be called the Office of Public and Corporate Accountability to deal with exactly this kind of insidious and thus far intractable subversion of the rule of law — and not only through levying fines, but through criminal prosecutions. People are dying in our streets. It’s time those responsible — be they doctors, pharmacists, drug company executives, distributors, lobbyists, law enforcement agents, or other government officials — are held accountable.