What comes next for the war on drugs?
The problem of treatment: Congress needs to solve the drug war and protect taxpayers from future collusion with the public – a bipartisan analysis
There are three pieces of legislation floating through Congress that could save lives and money and also help to dismantle the nation’s failed drug war. The Medicaid Re-entry Act, EQUAL (Eliminating a Quantifiably Unjust Application of the Law) Act and the MAT (Mainstreaming Addiction Treatment) Act all have bipartisan support and could be passed during the lame duck session of Congress. Lawmakers have to act on them.
There are many reasons for that including stigma and lack of knowledge about how addiction drugs work. There is not enough doctors willing to treat addiction. Lawmakers will have to figure out ways to ensure that addiction treatment continues to enjoy the same reimbursement rates as other chronic conditions, if they are to drop the D.E.A. waiver. But eliminating the waiver would still be a crucial step in the right direction. The prescription drugs that caused the current epidemic should not be easier to access than the medications that could help alleviate it.
The House has already passed the bill as part of a broader mental health package.
The American Health Care System and the Challenges of Treatment for Addiction: A Comparative Study of the Cases of Covid, Paxlovid, and Other Treatments
Some doctors refuse to treat patients with addiction because of their views about stigmatizing it. Many doctors lack confidence in treating addiction because they do not have enough training or access to specialists who can help. Drug users can also resist treatment. Experts say that some people think of the medications as just a way to replace one drug with another, though they don’t agree because drugs that cause harm can help.
Some of the problems are specific to addiction. But others are broader. Obesity and mental health conditions are often undertreated, too. People don’t always get their annual shots, so flu seasons are worse than they need to be. Americans misuse health care frequently, but underuse is also a problem.
Often, people, including doctors, have outsize fears about the downsides of some treatments, especially new ones. Paxlovid has drug interactions that are a real problem but largely manageable with Covid. With opioid addiction, patients make the mistake of thinking of a prescribed medication, like buprenorphine, as just another drug, even though it can save their lives.
Problems can befall through the cracks of the American health care system. France can use its universal health care system to encourage use of new treatments by guaranteeing their availability and pushing for their use. In the U.S. system, there is no centralized authority, so medical authorities struggle to coordinate care even when the best practices seem clear.
One of the reasons life expectancy fell in 2020 and 2021, was because of drug overdoses, which are a major public health problem. In addition, the US has the lowest life expectancy of any country and spends far more on health care than any other country.