Losing the ACA would turn back progress against the opioid crisis
The opioid epidemic has created one of the worst public health crises we have seen in decades. In the U.S., we lost more than 70,000 individuals in 2017 to drug overdoses. Imagine how much worse this blight on our country would have been were it not for the greatly expanded health care coverage 24 million Americans received under the Affordable Care Act.
In North Carolina we experienced about 1,800 deaths last year from opioids alone. That’s not counting the many more nonfatal overdoses, emergency room visits and untold lives devastated by addiction or by living with someone battling addiction. North Carolina has not expanded Medicaid eligibility. With expansion, 500,000 additional individuals could gain Medicaid coverage.
On Dec. 18, the 5th Circuit Court of Appeals found the Affordable Care Act’s individual mandate unconstitutional, and now tens of millions of Americans are one step closer to losing their medical insurance. Few will feel the blow as quickly and painfully as people who have been battling addiction to opioids.
As a medical director in Duke’s Population Health Management Office and as a leader for Medicaid policy development in our state, I see every day the benefits of secure, affordable access to health care for patients struggling with opioid use disorder (OUD).
Currently, 55% of adults under age 65 who are receiving treatment for OUD use Medicaid to pay for doctor visits, labs, counseling, and the medication that greatly increases their chances of achieving and maintaining sobriety. Without this treatment and support, 9 out of 10 people in recovery would relapse back to active drug abuse. Withdrawal from buprenorphine or methadone treatment causes extreme discomfort and the craving, caused by the brain changes brought on by addiction, can quickly become overwhelming.
Overdose death rates are starting to come down thanks to great determination on many fronts. Critical to these efforts is access to effective treatment. Overturning the ACA only takes coverage away from those who need it most. Now is not the time to strip people of a lifeline.
In fact, now is the time to expand coverage. Of the 2 million people in our country with opioid use disorder (OUD), only about 1 in 3 are receiving any form of addiction treatment.
Living with OUD creates misery not only for the individual but also for their families and loved ones. North Carolinians must do everything they can to ensure that people can access the care they need, whether it’s through the ACA or some alternative, so we can move forward to improve and expand coverage. Too many of us can’t live without it.