Addicts pay the price for DOH actions
Active opposition of the use of life-saving medication-assisted therapies is robbing us of medical care for those who suffer most
The federal government recently made significant progress in addressing the opiate addiction and overdose epidemics that are sweeping the country, and that have long been a public health and human disaster for New Mexicans.
Congress, despite its fierce political divisions, just passed a law that will increase access to buprenorphine (more commonly known by its trade name Suboxone) by allowing nurse practitioners and physician’s assistants to prescribe buprenorphine. This will be especially important for states with large rural populations, such as New Mexico.
Buprenorphine and methadone, known as medication-assisted therapies, are the evidence-based and most effective treatments for opiate addiction — both addiction to opioid pills, such as oxycodone, and to heroin.
These medications, when combined with counseling and treatment of other co-occurring mental health and medical conditions, offer the best hope for people who are addicted to opiates to be able to return to a healthy and fulfilling life.
Therefore, it is scandalous that the leadership of the New Mexico Department of Health is actively opposed to use of these life-saving treatments. The medical director of Turquoise Lodge, the only combined medical detoxification and rehabilitation facility in the state, located in Albuquerque, has refused to even discuss his unorthodox approach to opiate addiction treatment with representatives of the Bernalillo County Opioid Accountability Initiative, including the author.
The Turquoise Lodge hospital administrator stated that they were “philosophically” opposed to the use of buprenorphine, even in the face of overwhelming medical and public health evidence of its effectiveness.
People undergoing a “social” detoxification at the Bernalillo County MATS program are no longer treated with buprenorphine, as they were previously, because of this doctor’s medically unconventional beliefs. The Department of Health rehabilitation hospital in Roswell also has a medical director who refuses to provide or to refer patients for medicationassisted therapies.
The leaders of the DOH in Santa Fe are aware of these disturbing practices at the state rehabilitation facilities and yet they continue.
Detoxification and rehabilitation are opportunities to educate and to offer treatment with buprenorphine or methadone. The vast majority of patients will benefit from referral for long-term maintenance treatment with medication-assisted therapies. This is consistent with the medical approach to treating opiate addiction as a chronic brain disease.
Like other chronic diseases, such as diabetes or high blood pressure, we can offer chronic medication, counseling and management for diseases that can be controlled, but often cannot be cured.
So-called abstinence approaches to opiate addition have been shown to be ineffective for most people and almost always result in relapse to drug use and, often, to a tragic overdose death.
This was not always the way things were at the DOH. Ten years ago, the DOH helped to initiate and actually funded a methadone program inside the Bernalillo County Metropolitan Detention Center that is still operating. DOH buprenoprhine treatment programs were once operating in several public health offices, but were eventually defunded and most were discontinued, even in the midst of a worsening crisis of addiction and deaths.
As part of the new federal government initiatives, millions of dollars in block grants will soon be going to the states for effective drug treatment that includes methadone and buprenorphine. How can the N.M. DOH be trusted to rationally allocate these funds and to provide leadership in addressing this drug crisis when their own drug treatment facilities continue to ignore the best medical approaches to addiction?
The state Legislature and the Medical Board should investigate these deplorable practices and assure that the DOH follows addiction treatment guidelines that have been put forth by recognized experts in public health and addiction.
The people of New Mexico are entitled to the best medical care for our family members, neighbors and friends who struggle with this dreadful disease.