ABINGDON, Va. — U.S. Sen. Tim Kaine discussed responding to drug addiction issues Wednesday but said he’s still learning that Suboxone abuse is a problem is this area.
Kaine, D-Va., is seeking re-election and holding a series of more than 20 events this week to kick off his campaign. On Wednesday, that included a roundtable discussion with health care administrators and providers at the Southwest Virginia Higher Education Center in Abingdon and a lunchtime visit to the Burger Bar in downtown Bristol.
Kaine told the group his campaign will focus on three health priorities — urging Virginia lawmakers to expand Medicaid, finding ways to stabilize and improve the federal Affordable Care Act and focusing on solutions to the nation’s drug addiction problems.
While part of Wednesday’s discussion focused on opioids, Rebecca Holmes, clinical director of Highlands Community Services Board, said her agency is dealing with an overwhelming issue with Suboxone — a controlled substance prescribed for those battling addiction.
“Fifteen or 20 years ago, we were raising the flag that OxyContin was an issue. It’s important not to forget fentanyl is an issue, heroin is an issue; in this part of the state, the problem is Suboxone,” Holmes said. “It’s a great intervention when it’s appropriately prescribed and monitored and regulated.”
Among the challenges, Holmes said, are the large volume of prescriptions and navigating regulations on federal funding for addiction programs.
“Some of the biggest concerns are the amount of prescriptions they are able to offer. Those [prescribers] that are less than legitimate are offering the maximum federal dosage allowable per individual per day,” she said, adding that the drug isn’t meant to be a lifetime treatment.
“The federal guidelines require that you run a program for drug court, that your program not in any way prohibit the use of medication-assisted treatments — specifically buprenorphine and methadone — that you are not requiring folks to be off the medication, that you’re allowing them to operate as a physician has prescribed it — which is not theoretically a bad thing,” Holmes said. “Unless you’re looking at the situation we’re in where you have very few and far between prescribers who are legitimately trained and using that medication for withdrawal management, not as lifetime maintenance or cash flow.”
Kaine said he was surprised that Suboxone abuse is such a problem in Southwest Virginia.
“Just within the last month have I become aware of how big a problem it is,” Kaine said after the meeting. “Medically assisted treatment is very, very important if you do it right. But if you do it wrong, you’re simply giving them medications they can sell to others and you’re creating more problems than you’re solving. That deals with the regulation of prescribers, acknowledging the good of MAT [medically assisted treatment] but you’ve got to prescribe and regulate it the right way. That’s new data that I can take back as we work in this bill. If we ignore this problem, we’ll make a mistake.”
After the meeting, Holmes said the problem has “skyrocketed” over the past eight years because too few clinics in this area are prescribing the correct amounts and providing the necessary monitoring and therapy.
“Ideally, Suboxone is intended to be a medication that allows them to control their addiction and their use so they can build the skill sets needed to maintain sobriety and recovery. It wasn’t intended to be a lifetime medication. It has become that; it’s very profitable. It doesn’t include a lot of therapy in a lot of clinics so it’s one of the biggest challenges we deal with,” Holmes said.
Kaine compared the nation’s addiction crisis with the Vietnam War.
“In the Vietnam War, 58,000 Americans died. Last year, 64,000 people died due to overdoses. So this is a war that is going on in all of our communities, and we ought to think about it that way. We ought to think about it with that sort of sense of gravity and urgency. But there ought to also be an urgency around solutions.”
The Senate Health and Education Committee, on which Kaine now serves, is about to begin writing new regulations to add to the Comprehensive Addiction and Recovery Act.
“It’s a good time to have this discussion because it’s a good time to add to what we might do,” Kaine said. “We just passed a budget that increased money for treatment of addiction by $3 billion over existing money — much of it for prevention and treatment and a good bit for research as well.”