As COVID-19 engulfed the country, drug overdose deaths surged, and untreated substance use disorder (SUD) continued to cut short the lives of thousands of Americans. Data from the CDC show that drug overdose deaths in the U.S. are at their highest level on record, soaring to more than 87,000 deaths in the 12-month period ending in September 2020.
While it is easy to become desensitized to numbers on a page, the pain is all too real for the families like ours who have lost loved ones to the disease of addiction. You see, our sons, Max and Brian, fell through the cracks of an American healthcare system that was ill-equipped to handle their treatable disease.
Brian cycled through eight different addiction treatment programs. Not one of them offered care that was rooted in evidence or science. Throughout these struggles, both Brian and his family felt isolated, alone, and judged. Tragically, Brian died at just 25 years old.
Max had entered remission from opioid use disorder (OUD) after years of struggle. He had put his life back together. He was in college and studying pre-med with the goal of one day helping others enter recovery from addiction through medical support instead of punishment. Sadly, a major car accident one Thanksgiving led to surgery and pain. Without medical expert guidance on how to treat him safely, his dreams ended three days after Christmas at age 23 when he relapsed and died alone from an overdose. Just days before his death, he said, “Dad, why isn’t medical treatment available everywhere? People with addiction want to stop and get their lives back – and doctors can help, if they know how.”
Like Max and Brian, too many Americans struggle to access evidence-based treatment for addiction, including a severe OUD. While medications like buprenorphine are proven to be effective in mitigating severe withdrawal symptoms, preventing relapse, and ultimately keeping people alive, it is far too difficult to find a clinician who knows anything about treating OUD. According to a survey of healthcare providers in Massachusetts, only one in four said they received any training on addiction during their medical education, while more than half (falsely) believe that OUD is untreatable.
And while a recent report from the American Medical Association Opioid Task Force applauds the fact that more than 85,000 physicians and other clinicians now are trained and certified to treat patients with buprenorphine, we know that means more than 90% of them are still unprepared to treat patients with OUD, like our sons. Despite a decade-long epidemic and hundreds of thousands of overdose deaths, far too few clinicians are opting into the fight to save these lives.
Fortunately, bipartisan legislation has recently been introduced in Congress to help close the addiction knowledge gap, grow addiction medicine education, and answer those who say that learning about addiction is their barrier to treating OUD with buprenorphine. The Medication Access and Training Expansion (MATE) Act of 2021 would ensure controlled medication prescribers receive baseline education on treating and managing patients with OUD or other SUD. The education would go beyond safer prescribing of opioids, which many states already require, so that our nation’s healthcare professionals are better equipped to respond to an addiction crisis.
If it became law, the legislation would help normalize addiction medicine education across the nation’s health professional schools and residency programs by allowing these programs to help their students and trainees fulfill the education requirement through comprehensive SUD curricula — in addition to providing greater resources for this purpose. Finally, it would be easy for existing prescribers to do: many states already require them to engage in hundreds of hours of continuing education to obtain and maintain a license; dedicating just some of those hours to learning how to treat people with OUD or other SUD would be a simple but meaningful step. A hearing today in the House Committee on Energy & Commerce will include a discussion of the legislation.
Enacting the MATE Act is a critical piece to solving the puzzle of addiction in America. It represents the kind of big-thinking, systemic change we need to curb an epidemic that has cut short far too many American lives. For the sake of our friends, loved ones, and communities, we need Congress to take common-sense action and help our nation’s medical community close the knowledge gap when it comes to the treatable disease of addiction. We urge Congress to pass the MATE Act now. It’s too late to save our sons, but it’s not too late to spare countless other families from living with this pain.
James Baker, MD, MPH, is a practicing physician in Massachusetts and a member of the American Society of Addiction Medicine. He is the proud father of Max Baker. Gary Mendell, MBA, is the founder and CEO of Shatterproof, a national nonprofit focused on reversing the course of the addiction crisis in America. He is the proud father of Brian Mendell.