Policy Ideas

MAT or Medication Assisted Treatment is the use of medication coupled with treatment for an individual in substance use recovery. It is specifically used for opioid use disorder and the medication minimizes the likelihood of overdose by blocking receptors in the brain. 

MAT is essentially being used as a way to prevent death, or in other words prevent individuals from overdosing on substances. Yet, MAT does not necessarily allow for individuals to progress into full sobriety, in some cases it may be "required" for the rest of the individual's life. 

Other drawbacks to MAT include the potential for continued misuse of substances (as most MAT medications are opioids themselves), the potential for crossover into another addiction, the potential side effects from the medication itself, and even the medical supervision required when undergoing MAT.

Additionally, I have to bring up the puzzling bigger picture here. Major pharmaceutical companies advertised a pain medication to the world as non-addictive. Then, the population became addicted to this drug and made the corporations a lot of money because of the number of prescriptions written for opioids. In order to combat the opioid epidemic, they created, yet another, drug to try to help drug addiction within our country. Therefore, how can we trust these major corporations again? How can we continue to support corporations that clearly do not have the population's health as their best interest?

My policy idea is to place federal regulations on how MAT is prescribed, essentially trying to place regulations on these huge pharmaceutical corporations. I do not think MAT is necessarily a bad thing instead I think it is a wonderful harm reduction tactic and may be the difference of life or death for some individuals. Therefore, I absolutely think it has standing within the recovery space. That being said, I do not think it should be the go-to solution for all in the addiction recovery space. There should be regulations placed on who receives MAT, for how long they receive MAT, why they are receiving MAT instead of other options, and how much MAT they are receiving, etc. 

With this policy, we can hopefully improve the recovery success rates within the drug addiction community while still preventing overdoses and deaths the best we can. One con to this policy, could be that it makes it more difficult for individuals who need MAT to receive MAT. Yet, I think with these basic regulations, anyone who actually needs it, will receive it. Another hurdle of this policy would be to get the big pharmaceuticals companies on board. There are many lobbyists who work for the drug companies and could be a huge barrier to getting this policy passed. ​

02

Reduce Opioid Prescriptions Even Further

In 2011 and 2013, the GCOAT (Governor's Cabinet Opiate Action Team) in Ohio created new guidelines regarding prescription management of acute pain and prescribing guidelines for treatment of chronic, non-terminal pain, respectively. For acute pain, prescribers are to consider non-opioid therapies first and then if prescribing, they are to check the OARRS (Ohio's Automated Rx Reporting System) to make sure the patient is not being prescribed other opiates from other doctors. For chronic pain, prescribers are to also check the OARRS and to prescribe the equivalency of 80mg of morphine or less (as this has been the determined threshold to prevent overdose). 

While the OARRS and these broad guidelines have been incredibly helpful in helping to minimize the opioid epidemic over the years, we could prevent even more drug addiction by minimizing these prescriptions even more. 

There are a number of alternatives to treat both acute pain and chronic pain. Here are a few pharmacotherapy options, although there are a number of holistic options such as meditation, hypnotherapy, breathing, etc. 

In terms of management of pain with other non-opioid pharmacotherapy options, there are a number that have been found to be successful. A few examples are acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), amine reuptake inhibitors (ARI's), muscle relaxers, and membrane stabilizers.

In 2014, a doctor by the name of Sergey Motov headed the first "opioid-free" Emergency Department shift. Her method has been to use the (CERTA) Channels/Enzymes/Receptor Targeted Analgesia approach which uses a combination of non-opioid analgesics that works synergistically with the patient. This method along with the (ALTO) Alternatives to Opioids approach which pushes non-opioid options as first-line of therapy and educates on the effects and addiction potential of opioids, are wonderful options for doctors to utilize instead of writing opioid prescriptions. 

If these other options were used more frequently, we could make some real progress in ending the opioid epidemic. Therefore, my policy is to require these methods be used statewide in order to minimize the number of prescriptions given. All doctors should be given training on the ALTO and CERTA methods in order to be able to provide the best level of care for their patients. Additionally, there will be further regulations placed on opioid prescriptions, such as, limiting the number of pills/dosage in each prescription and creating a more lengthy/rigorous process for documenting opioid prescriptions given to sway doctors from wanting to prescribe it. 

With this policy, we hope to make a real difference within the drug addiction space in the state of Ohio by limiting the number of opioid prescriptions.

Again, this policy could have the potential con of making these substances less available to people who need them. Yet, my counterargument is still that if an individual needs a certain medicine, they will be able to get it under this policy. Instead, it will simply make these opioids less available to people who do not need them. Additionally, like the other policy, there is a chance these policies might not pass because of the power of the pharmaceutical companies wanting to continue to push their products.