President and co-founder of Cut50
Van Jones is president co-founder of Cut50, an initiative of The Dreams Corps to safely reduce the prison population by 50 percent over the next 10 years, and recognizes the connection between effective addiction treatment and reduced recidivism. A Yale-educated attorney who is committed to advocating for social and environmental justice, Van is founder of The Dream Corps, Rebuild The Dream, Green For All, the Ella Baker Center for Human Rights and Color of Change. He has been honored with numerous awards and spotlighted on several lists of high achievers, including: the World Economic Forum’s “Young Global Leader” designation; Rolling Stone’s 2012 “12 Leaders Who Get Things Done;” TIME’s 2009 “100 Most Influential People in The World;” and the Root’s 2014 “The Root 100.”
CARA is an important first step, but work remains for Congress and HHS
The Comprehensive Addiction and Recovery Act (CARA), headed to the the President for signature, is a step in the right direction but still falls short on a number of important provisions to adequately address the scope of the problem.
We are encouraged that the bill authorizes nurse practitioners and physician assistants to prescribe medication for recovery, which will help ease some of the waiting list issues patients face. It also authorizes the Department of Health and Human Services (HHS) to exempt certain forms of recovery medications, such as implantable devices, from the arbitrary caps on the number of patients that health providers can treat– an immediate action that we urge HHS to take. However, the fact remains that we should not have these caps at all for any certified providers. Public policy that prevents healthcare providers from practicing medicine according to the clinical guidelines, which includes buprenorphine, is an injustice.
Because the CARA bill does not include any new funds to implement the interventions it contains, Congress should and must act through the appropriations process, including state block grants, to ensure the programs authorized in the bill can be implemented. However, granting money to states to treat those in need should be a bridge solution to the real barrier, which is a lack of insurance coverage in both the public and private insurance markets. Congress should use its leverage when appropriating to require Medicaid and other state-run insurance programs to cover recovery medication, as many states currently do not. Florida, for example, is among the leading prescribers of buprenorphine, but only eight percent of those prescriptions are paid for by Medicare or Medicaid.
The CARA bill falls short in many areas due to the fear, bias and stigma many have about treating addiction. If we are serious about addressing the opioid epidemic, we will eliminate barriers to effective recovery treatment and treat the addicted brain the same way we treat any other organ in the body – with medication that has been scientifically proven to work.
AOR Statement on HHS Announcement to Raise Cap on Number of Patients Physicains Can Treat Using Evidence-Based Buprenorphine
HHS action is a modest step in the right direction. However, this solution is still not sufficient to address the scope of the epidemic and Congress still needs to take additional actions.
“Today’s HHS announcement to raise the caps on the number of patients that physicians can treat with the opioid recovery medication buprenorphine from 100 to 275 is a modest step in the right direction. However, this solution is still not sufficient to address the scope of the epidemic and Congress still needs to take additional actions.
With more than 2 million people addicted to opioids, doctors need to be able to treat all of them – meaning these caps need to be removed entirely. Anything less would hand tie physicians from practicing medicine according to the clinical guidelines, which includes buprenorphine. If the political realities of the day make that impossible, raising the cap to 500, as the TREAT Act proposed, is a much more appropriate response.
Additionally, physician assistants and nurse practitioners need to be able to treat opioid addiction with recovery medication as well, after receiving appropriate training. The CARA conference committee has a tremendous responsibility to the American people this week to take meaningful action that is appropriately funded to ensure all those who are living with the disease of opioid addiction can receive the most effective treatment, and that’s treatment with recovery medications.”