By Lauri Cole and Christy Parque
New Yorkers are dying every day from an epidemic that is preventable, treatable and from which they can recover. Despite everything we know about the effectiveness of access to prevention, treatment and recovery services, the opioid crisis has intensified its deadly grip on our communities, families and personal lives. We believe that while an important step forward was made with the establishment of the Opioid Stewardship Fund included in the state’s final budget, significant opportunities to end the crisis were missed by not creating a new surge of resources supporting expansion of the behavioral health field.
The Opioid Stewardship Fund, first proposed as a surcharge by Gov. Andrew M. Cuomo, and in final negotiations supported by the Legislature and the executive as an account to be paid into by manufacturers and distributors of opioids, imposes a long-overdue mandate on those manufacturers and distributors to help fund opioid-related addiction services. This is an important development, and one many advocates fought hard to have included in the final budget.
A closer read of the budget language, however, shows the state has leeway in deciding how the funds from the account are spent, creating worries that some funds may not go directly towards behavioral health services and access. Advocates are also concerned that the $100 million in revenue the fund collects may be used to offset existing costs for the state Office of Alcoholism and Substance Abuse Services, rather than bringing an infusion of additional funding to support the creation of new services and capacity.
The facts about the opioid epidemic tell us that this response will not be enough to turn the tide. In 2016 alone, nearly 4,000 New Yorkers died from an overdose or chronic drug use. These deaths are preventable, but not if we continue to implement half-baked measures. More must be done now to fully fund our behavioral health care system and to support its underpaid and critically overburdened workforce.
Those dealing with an addiction should have access to services on demand and they should have health insurance that pays for those services. Data show that over 60 percent of New Yorkers visiting the emergency room or hospitalized for opioid-related issues are covered by Medicaid, making Medicaid coverage a critical resource for accessing treatment. Yet, Medicaid enrollment and expansion efforts are threatened at the federal level with actions like the president’s recent executive order to assess safety-net programs, including Medicaid, to focus on instituting work requirements or potentially impose loss of benefits. These actions could threaten Medicaid coverage for thousands with opioid-related addiction issues.
Medication-assisted treatment (MAT) is the gold standard in effective care for opioid addiction, yet prescribers are held to arbitrary patient caps and access to MAT is severely limited in many regions. Naloxone, the life-saving overdose reversal drug, is not utilized as widely as it should be – leading to a surgeon general advisory encouraging naloxone to be carried by more Americans and training on how to use it to be more widespread.
These barriers in access to care often mean treatment is denied for individuals and families desperately seeking services. These barriers mean more communities struggle to find solutions, more families are devastated and more people die.
We implore lawmakers to work together and take bold actions to match their rhetoric about the need to end the opioid epidemic. The Opioid Stewardship Fund was a first step. Let’s move forward now to bring the infusion of resources needed to expand behavioral health services, support our workforce and end the opioid scourge.
Lauri Cole is executive director of the New York State Council for Community Behavioral Healthcare. Christy Parque is president and chief executive officer of the Coalition for Behavioral Health.