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Editorial: Medication-assisted treatment of addicts must be expanded

Here’s a snapshot of the problem America, including Western New York, confronts in responding to the opioid crisis that afflicts the nation: While more than 900,000 doctors in the United States are licensed to prescribe addictive painkillers, only 43,500 are trained to prescribe a drug that can help treat the addiction.

That’s a more than 20-to-1 disadvantage, and doesn’t account for those who become addicted through their own reckless use of narcotics rather than through a prescription written to counter chronic, intolerable pain. It’s why it is important for government to support efforts to increase the number of health professionals who can prescribe and manage the use of the drug, buprenorphine.

Statewide efforts on meeting that need are underway in Western New York, where the University at Buffalo’s Research Institute on Addictions is leading a program to train medical professionals in medication-assisted treatment, which is considered the only approach with real hope of success. Those high-needs areas include Erie and Niagara counties.

Meanwhile, Erie County has trained more than 150 community doctors and other health professionals to use buprenorphine. It is also working with emergency medicine specialists to train physicians to start opioid treatment in hospital emergency rooms. The idea is to build on a 2015 study that found opioid addicts who were treated with buprenorphine in the emergency room were more likely to stick with treatment after they left.

Here, the effort is to establish formal connections between emergency departments and addiction treatment services. In that way, hospital doctors know the high-risk patients they counsel or treat with buprenorphine have a link to further treatment and counseling.

But the key is to license more doctors to prescribe buprenorphine and manage those patients, and there are hurdles that need to be overcome. First of all, the newly authorized health professional needs patients to treat. But, more significantly, those patients have to be monitored. This isn’t “take two aspirins and call me in the morning.” That’s a challenge, Kenneth Leonard, director of the Research Institute on Addictions, told The News. It’s especially difficult for single providers.

Also challenging is the microscope under which prescribed opioids have necessarily come. Some doctors, understandably, don’t want to deal with the extra layers of hassle. Yet, their help is needed. Public policy either needs to be explained better or changed to give doctors more leeway in treating their patients. Medical schools need to take on this matter as they train new doctors.

Clearly, the task of easing the opioid crisis will require a multilayered and intertwined approach. The traditional “stovepipe” array of independent agencies working in isolation, and sometimes at cross-purposes, is deficient in any setting and, in this case, is lethal. It is important not just to help those who have become addicted, but to stanch the flow of new addicts through more careful use of opioid painkillers and development of new treatments for severe pain.

Advocates for better treatment of those addicted to opioids are making strides as the terrible cost of this scourge becomes clear. Erie County recorded 301 opioid deaths last year, about triple the 103 deaths that occurred in 2012. Fatalities this year appear to be on track to match last year’s figure. And the crisis is unfolding all across the country.

It’s good to see UB and Erie County take the lead in confronting this crisis. It would be better still if there were a sense of a more comprehensive approach that looked at all the potential contributors and how they can best be used today and 10 years from now.

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