O'Malley's Proposals for Addiction Treatment

[pinstikfartherin]

As someone who has witnessed firsthand the struggles of addiction in someone I love, including the difficulty in finding and affording treatment, the judgement from his family, and the fear of living a sober life, I really like O'Malley's comprehensive addiction platform.

ADDICTION TREATMENT

The epidemic of untreated substance use disorder is a crisis that claims tens of thousands of American lives each year. With deaths from prescription drug overdoses quadrupling since 1999, overdose-related deaths now exceed the number of traffic fatalities, suicides, or homicides. Yet our response has not matched the scale of the emergency. Proven prevention and treatment strategies are underutilized. Funding for treatment programs is insufficient. Outdated stigmas make too many people reluctant to seek care, and make too many communities unwilling to provide it. Millions of families are needlessly torn apart.

As Mayor of Baltimore and Governor of Maryland, Martin O’Malley brought all resources to bear to stop the epidemic of drug addiction and overdose. In Baltimore, Martin O’Malley expanded access to drug treatment to thousands of people while more than doubling funding for the city’s treatment system. His innovative efforts drove a 60 percent reduction in overdose deaths from heroin over 10 years—a program still cited as a successful national model.

In Maryland, Governor O’Malley made addressing addiction one of his Administration’s top goals. The centerpiece of this agenda includes forming an Overdose Prevention Council, which coordinates state agencies and local governments to collaborate on reducing overdose deaths. Under Governor O’Malley’s leadership, Maryland increased addiction treatment services by 45 percent, helped doctors identify and treat substance use disorder, and empowered pharmacies and first responders to stock and safely administer overdose-reversing drugs. Maryland also developed the nation’s first local overdose review teams, which review the circumstances of each overdose death to find lessons for prevention.

As president, Governor O’Malley will hold this same commitment to saving lives and addressing addiction. Drawing on his 15 years of executive experience, he will expand and improve addiction treatment, invest in recovery, improve coverage, and prevent substance use disorders before they start.

GOAL: REDUCE DEATHS FROM DRUG OVERDOSE BY 25 PERCENT BY 2020
As a nation, we have looked past people imprisoned by drug addiction for too long—despite having the tools to save them. They are our husbands, wives, brothers, sisters, and children. By focusing coordinated public health efforts on outcomes and holding ourselves accountable for results, we can save lives, spare families anguish, and rebuild our communities.

An O’Malley Administration will provide a new level of support and accountability for efforts to address addiction and overdose in the United States. Governor O’Malley’s ultimate goal as president is to reduce deaths from drug overdoses by 25 percent by 2020—an objective he first laid out in his 15 National Goals to Rebuild the American Dream.

As president, Governor O’Malley will take a public health approach to substance use disorders: developing and implementing a coordinated national strategy to reduce risky prescribing of pain medications, expanding access to effective addiction treatment, and investing in community resources for recovery.

Launch a National Dashboard on Overdose

To manage this strategy, Governor O’Malley will establish a national dashboard on overdose and addiction to monitor the problem, track our response nationwide, and target resources so that all Americans have access to critical services that support prevention, treatment, and recovery. This includes improving data collection and sharing information more quickly—with law enforcement, first responders and physicians, and other local leaders—so communities can respond effectively as soon as addiction and overdose challenges arise. This dashboard will guide $12 billion in federal investments and partnerships over the next decade, while providing a clear and transparent way for O’Malley to hold the federal government accountable.

The dashboard’s first use will be to reduce addiction to fentanyl—a highly potent and deadly narcotic increasingly laced into heroin—which was responsible for an unprecedented number of overdose deaths last year. The problem is especially acute in New Hampshire, where fentanyl took more lives than heroin in 2014. Within 100 days of taking office, O’Malley will direct his Administration to create and adopt a national fentanyl strategy—one that includes expanded prevention education, greater coordination with law enforcement, increased use of naloxone to reverse overdose, and robust treatment.

Stop the Over-Prescription of Pain Medications

The rapid rise in prescribing drugs to manage pain has contributed to the epidemic of opioid addiction. Physicians have an important role to play in reducing the inappropriate use of prescription drugs and helping individuals suffering from addiction reach treatment. As president, Governor O’Malley will:

Require Physician Training on Pain Prescribing. O’Malley will require all physicians seeking authority from the Drug Enforcement Administration to prescribe pain medications to first demonstrate that they have taken courses in appropriate prescribing. In Maryland, all physicians must complete required continuing medical education on prescribing controlled substances in order to maintain their license.

Strengthen Prescription Drug Monitoring Programs. O’Malley will reward states that implement effective prescription drug monitoring programs, and demonstrate that they canreduce addiction and overdose. These programs can help doctors and other health care providers access information that allows them to identify patients who are at risk of addiction, and connect them to the treatment they need. In Maryland, O’Malley did just that—launching a prescription drug management system that is linked to the state’s web- based health information exchange.

Support Patient Education on Pain. O’Malley will develop an effective public campaign on pain drug addiction, modeled on previously successful efforts to reduce patient requests for unneeded antibiotics. By increasing public awareness around this quiet tragedy, O’Malley help patients understand that there are many other ways to manage chronic pain, beyond risky opioid medications.

Expand Access to Treatment

As the Mayor of Baltimore, Governor O’Malley led an effort that reduced heroin-related deaths by more than 60 percent—by expanding the resources for treatment, and focusing on therapies that worked. As president, he will ensure that states and local governments have the funding, support, and information they need to save lives:

Expand Access to Naloxone. Naloxone is an effective reversal drug used to treat overdoses from both prescription opioids and heroin; its increased use may already be saving hundreds of lives in New Hampshire. O’Malley will set a national goal of training and equipping all first responders to administer naloxone in areas with significant numbers of overdose fatalities. O’Malley will also bring together the FDA, industry, and others to make sure a readily-available and inexpensive supply of naloxone is available. In particular, that means focusing on those who need the most support—such as the friends and family of people with substance use disorders. In Maryland, O’Malley worked to ensure that pharmacies stocked naloxone, developed training programs for family and community members, and signed legislation and an executive order to expand use of the medication.

Equip All First Responders. Ensuring that first responders can carry and safely administer naloxone is an important first step, but not a sustainable solution. That’s why O’Malley will work to ensure that—whenever hospitals or first responders treat overdose—they can quickly direct patients to effective addiction treatment options. Emergency rooms are our first line of intervention, and must be empowered them to provide access to lasting care.

Increasing Funding for Effective Therapies. Existing federal investments to support comprehensive drug treatment systems pale in comparison to the need. O’Malley will work to greatly expand federal grant programs, increasing the number of grants and incentives for innovation in each state. This includes providing resources and technical assistance to states willing to overcome barriers to expanding care, like New Hampshire.

Expanding Coverage of Proven Treatments Under Medicare and Medicaid. Medicare pays for pain medications that can lead to addiction, yet many states do not reliably cover treatment medications as part of comprehensive treatment programs. In Maryland, O’Malley ensured that Medicaid covered medications to reverse overdose and treat addiction. As president, he will support regulations and legislation to expand coverage of evidence-based, medication-assisted treatment for opioid dependence under Medicare and Medicaid, helping tens of thousands of people afford the treatments they need to recover.

Assuring Every Veteran Access to Treatment Within 12 Hours. The demands of military life, combat, and the return home can be complicated dramatically by addiction and related disorders. Mental and substance use disorders caused more hospitalizations among U.S. troops in 2009 than any other cause. O’Malley would set a new national goal for helping veterans access proven therapies for treating addiction—in every community.

Improving Data Collection and Access. Federal, state, and local partners need accurate and timely data in order to address addiction spikes as they occur. Yet currently, federal overdose death data is only available a year or more later. O’Malley will launch a new national emergency surveillance program on addiction and overdose deaths, as he also did in Maryland. This effort will feed into his new national dashboard.

Investing in Community Resources for Recovery

In Maryland, Governor O’Malley supported innovative services for individuals in recovery to help them gain employment, as well as contribute to their families and their communities. As president, O’Malley would:

Implement a Public Health Response to Addiction. Incarceration is an inadequate—and in most cases inappropriate—response for people in need of treatment for substance use disorders. O’Malley will provide individuals with the care and support they require outside of the justice system, as detailed in his criminal justice reform plan. He will also establish federal guidelines for law enforcement on how to best serve people in crisis, support state Crisis Intervention Training for police officers, and ensure that people leaving prison or jail have the support they need—including substance use disorder treatment—to successfully reenter their communities.

Support Community Recovery Services. Recovery from addiction is holistic, involving not only clinical treatment but also resilience, support, and longer term care. O’Malley will provide a new level of support for community-based recovery for individuals suffering from mental illness and addiction, making urgent new investments across the country in housing, supported employment, and outpatient treatment.

Fight the Stigma of Addiction. We have long understood addiction to be chronic brain disease, yet negative associations persist—preventing too many of our neighbors from seeking care, and leading some communities to avoid providing treatment altogether. O’Malley will launch a national campaign to reduce the stigma associated with drug addiction, opening up a path for all Americans to seek treatment and recovery.

In your opinion, is there anything he should change? Improve?

A couple of detailed things I'd like to see related to this issue::
- Opiate treatment funding for low-income individuals who don't qualify for medicaid, can't afford ACA policies, or other such situations. Here it's over half of a rent payment per month.
- Grants for individuals who really need inpatient treatment to get clean but cannot afford it.
- Greater and easier access to treatment options. We're lucky to live near a city in a state with few options.

[FSogol]

1. Great plan from the candidate of great plans.

O'Malley also doubled the money going into addiction treatment while Governor of Maryland. Info on all his plans can be found in this thread:

http://www.democraticunderground.com/12813600

[bigtree]

2. k&r

[firebrand80]

3. Federal funding for State drug court programs and treatment facilities

For many people with addictions, hitting "rock bottom" is sitting in jail charged with a crime that carries the possibility of going to prison. I think we have a unique opportunity to get people to get serious about getting into treatment and getting clean at this point, but the resources at the state level are inadequate.

I'd like to see more drug court programs, more treatment facilities, "secure" treatment facilities (places that are treatment/jail hybrids), and more drug treatment programs within prisons.

[pinstikfartherin]

10. Living here in good old Alabama...

We don't like to raise taxes or spend money on anything, so federal help is a must in our case. I worry about Hillary's plan of "for every $1 spent, feds will send $4" because we would simply rather not spend it period. Living in a state with a bunch of judgemental religious people doesn't help. Heck, we wouldn't even expand Medicaid. perhaps in the form of grants for facilities? I don't know, but I worry about tying help to my state's willingness to pitch in. I don't know how O'Malley's would work, but I would hope it'd be something more likely to get help to states like mine.

[riderinthestorm]

4. This is really good. Just possibly the policy proposal that tips the scales

My suggestion - no incarceration for any addict (unless they've committed a crime).

Treatment. Period.

[Lilith Rising]

5. All really good stuff there. I'd like to

see a guarantee that those (at least) who seek help voluntarily will not face having their children taken from them and a public awareness campaign that points out that guarantee so that more people who want help will come forward.

[pinstikfartherin]

11. Great point.

It's amazing how many addicts keep it together for work, around family, etc., but really struggle at home. I tell people who like to speak ill of addicts in general that it's very probable they know someone struggling with addiction that just hides it very well.

[Lilith Rising]

12. In my case I functioned quite well. I wasn't mean or

abusive or neglectful but I knew it (alcohol) was ruining my physical health. I knew I needed medical observation to go through detox because DTs can actually kill you - sometimes it's not so simple as going to AA meetings.

In any case I did finally end up in the hospital because my liver was shutting down and they kept me there for a week to monitor my detox. I don't drink anymore and I'm grateful I was able to have the medical care I needed.

[pinstikfartherin]

13. I'm glad you got the help you needed in the end.

People really don't realize how many hide addictions.

My SO hid it from his family since before we got together and we've now been together 8 years. They didn't find out until early this year that he had a problem and was on methadone maintenance...and he's been on it for about 7 years because he simply didn't trust himself not to relapse. It was a strange turning point when he lost his job this year, had to get off his Adderall (which was his "drug of choice" since being on methadone), and was truly sober except for taking methadone. He was scared. He hadn't been actually sober since he was a teenager because he like to party up until he got addicted to opiates. He was scared going to family functions and spending time with people because he was, well, sober and didn't know how to act.

I'm so thankful that despite it taking 7 years he is finally in a good place. It's been rough on our relationship, but he's a good man whose addiction has been our only issue...and the fact that he's consistently stayed in treatment rather than relapsing? I can handle that. We're finally on a road to total sobriety from even MM now because he's ready and has realized life is good without drugs. I want the same thing for others.

[askew]

6. I think the items you mentioned are good improvements.

This is a great plan overall by O'Malley. He did a lot to tackle addiction while Mayor of Baltimore and Governor of Maryland. I'd like to see him get a chance to scale these solutions up to a federal level.

[one_voice]

7. The only thing I

worry about is while we're so careful not to over prescribe pain medications we leave people that suffer from chronic pain in pain.

There's seems to be a stink eye associated with anyone that suffers from a chronic pain condition that isn't a 'big name' condition. Everyone is so worried about addiction that sometimes people are left to suffer. We cannot do that either.

As a person that suffers from chronic pain condition--muscular & neurological I know what it's like to go into a doctors office and have that doctor give you the 'side eye'. I'm lucky to have good physicians that are familiar with my condition and actually listen to me, they let me participate in my health.

I'm not currently taking any narcotics for pain (on a regular basis we use other meds) but that was my choice. I was on them for years. I have some in the house for when it gets to the point I'm at my end of my rope. I handle my pain in a way that's best for me. Everyone is different, everyone's pain is different and everyone handles pain differently.

Outside this concern I like what I'm reading.

[pinstikfartherin]

8. I completely agree.

I also think doctors partially did this themselves in some ways, to be honest. Take my SO, for instance. He was in a car wreck and injured his back. He had no permanent back injury evidenced, and instead of limiting his use of opiates and trying to wean him off to see how the injury was healing, he just threw pain meds at him. This was much easier for the MD because instead of taking insurance, he did his own office fee that covered things in the office. This meant that SO coming back again and again just to get pain pills was in his best interest. Of course, SO is also to blame because he wound up medicating his back pain and a bad breakup with the pills.

There's got to be a balance, and we've got to make sure people understand that there are those in serious pain. Perhaps the campaign for awareness and fighting the stigma will help? I'm not sure. It seems to be either one way or another: people don't even realize there's an epidemic of prescription opiate abuse or they think that those who need it are just drug seeking. Reality is so much more complicated and we have to treat it that way.

[elleng]

9. Happy you found this and like it, as a person with some experience, pinstikfartherin.