The addiction and overdose crises in the United States are affecting us all. More than 2.5 million people are estimated to suffer from opioid use disorder. Nearly 50% of voters report having been close to someone with addiction or having been addicted themselves. Just last year, more than 106,000 people in this country died from an overdose — a record high. Inconsistent access to treatment, coupled with stigma, can deter people in need from seeking addiction care. Only 11% of people with opioid addiction received medication for opioid use disorder in 2020, according to the Substance Abuse and Mental Health Services Administration.
When I served as the director of the White House Office of National Drug Control Policy in the Trump administration, we made it our mission to expand access to buprenorphine, which blocks withdrawal symptoms and makes it easier for people with addiction to discontinue opioid use. Buprenorphine is safe to take at home and has been shown to reduce the risk of overdose significantly among people taking it for opioid use disorder.
But outdated federal regulations are hampering healthcare providers from being able to prescribe this lifesaving medication. Under current law, healthcare providers must obtain special permission, known as an “X waiver,” to prescribe buprenorphine. As a result, 40% of counties, many of them rural, do not have a provider, effectively rendering them without access to buprenorphine. According to the Department of Health and Human Services, of the 1,100 counties with great need, 56% were unable to offer adequate access to in-office treatment due to a lack of providers with the required waiver.
Under former President Donald Trump, my office supported removing, and ultimately removed, the X waiver by executive order. Unfortunately, the Biden administration has reversed the policy, determining that an act of Congress is needed to eliminate the waiver requirement. Now, the decision is in front of Congress. Last week, the House Energy and Commerce Committee introduced the Restoring Hope for Mental Health and Well-Being Act of 2022, which includes substance use and mental health bills and could expand access to treatment.
Congress should include the bipartisan Mainstreaming Addiction Treatment Act in the final legislation. It has more co-sponsors than 99.99% of bills in front of Congress, and it has bipartisan sponsorship in the House and the Senate.
The MAT Act would eliminate the X waiver requirement to prescribe buprenorphine and allocate funds for a national education campaign for healthcare providers. Including the MAT Act in mental health legislation is an important first step in turning the tide of the overdose crisis. It would remove an undue and outdated regulation on a crucial treatment for those suffering from opioid addiction.
The overdose crisis is a complex problem that will require a complex system of solutions. But a common theme throughout our response to the crisis should be to provide addiction treatment that people need, when and where they need it. Those suffering from addiction need access to the treatment and care that work best for them. And we must stand up and support them compassionately on their recovery journey.
During my time in the Office of National Drug Control Policy, we recognized that a whole-of-government approach was needed to end the overdose crisis and that our administration and legislators needed to coalesce around commonsense tactics to save lives. It won’t be immediate, and it may not be easy, but we owe it to the people to work together to keep our friends and family members struggling with addiction healthy and alive. By including the bipartisan MAT Act in mental health legislation, Congress can get our country on the path to recovery.
Jim Carroll is a partner at Michael Best & Friedrich and the former director of the White House Office of National Drug Control Policy.
