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Trump’s Opioid Plan Sparks Controversy

Friday, April 13, 2018 | By admin

President Trump presented an opioid plan calling for expansion of the use of Vivitrol in the federal criminal justice system. The plan is part of the current effort of the White House to curtail the country’s ongoing opioid epidemic. While Trump’s opioid plan addresses the needs of the vulnerable prison population, it is not without controversy.

Trump’s Opioid Plan Favors Vivitrol Treatment

Trump’s opioid plan centers on the use on naltrexone (Vivitrol) for federal inmates with substance abuse disorders. The controversy surrounding the medication is the fact that it is exclusive to one pharmaceutical company. Alkermes, a Massachusetts-based company, exclusively manufacturers and sells the drug. The company faces criticism for its allegedly aggressive marketing practices in promoting the drug. Despite costing more than $1000 a shot, Alkermes is promoted as the better medication therapy.

While Vivitrol is an effective medication, numerous studies have shown that medications such as Suboxone are equally effective in medically assisted therapy. Despite the results of these studies, Alkermes allegedly marketed Vivitrol to the criminal justice system. Additionally, it is alleged that Alkermes lobbied state and federal lawmakers promoting the effectiveness of the drug despite having no substantive proof.

Profits Over People?

The company’s marketing practices were investigated by California Senator Kamala Williams. According to information in an article published by The Fix, Harris alleged that in addition to marketing Vivitrol to judges and prison officials, Alkermes spent millions of dollars in direct appeals to government officials. Additionally, Harris’ investigation discovered that the pharmaceutical giant contributed to a number of congressional campaigns.

In her investigation of Alkermes Harris has sent a letter to company Chairman Richard Pops. The letter requested company data and communication on judges officials and drug courts to which the company assigned sales representatives. Also, Harris asked for a list and jails and prisons where the company provided free shots of Vivitrol to inmates

Harris also requested that Alkermes hand over any materials provided to participants or speakers for the company since 2010. Additionally, she asked for the amounts paid by the company to various associations including the American Society of Addiction Medicine, National Institute on Drug Abuse (NIDA) and Partnership for Drug-Free Kids.

In a statement regarding the investigation, Harris stated the following:

We are at the height of a crisis, and companies are taking advantage of pain in order to profit…We must hold these companies accountable for their deliberate actions that magnify the opioid epidemic and drive up the cost of drugs for Americans.

Vivitrol Treatment Continues to be Touted Despite Concerns

Trump’s opioid plan featuring increases in medication-assisted treatment is a positive step. While lauded, healthcare leaders state that medication use should be focused on  patients’ needs and not through government policies. Nora Volkow, the director of the National Institute on Drug Abuse, said the following:

We don’t per se favor one drug over the other, because some patients respond better to one or the other…It is clear that treatment in the prison system significantly improves outcomes, whether it’s [with naltrexone or buprenorphine]

Perhaps the biggest reason why Vivitrol is favored for MAT is its’ chemical makeup. Vivitrol is not opioid-based, and the potential for addiction is almost non-existent. The drug is an appealing alternative to other medications such as buprenorphine and methadone. While effective, these medications are opioid-based and have significant addiction potential. Additionally, Vivitrol is offered as a shot and diminishes the possibility of misuse.

Leo Beletsky, a professor of law and public health at Northeastern University, offers another reason why Vivitrol has favor:

“Methadone and buprenorphine have been shown on a variety of metrics to be far superior to Vivitrol — that includes safety, effectiveness, and cost…The reason Vivitrol is preferred is that it’s a medical version of forced abstinence. That is why it’s been the darling of those who rhetorically support medication assisted treatment.”

A Vivitrol-only treatment regimen is unlikely to be effective as the only medication choice. To offer recovering addicts more choices, MAT programs must offer other medications along with therapy and other interventions.

MAT Progams in Prisons Provide An Effective Treatment Model

Trump’s opioid plan to widen the availability of MAT programs in prison mirror programs implemented in two states. In the state of Rhode Island, offers methadone, buprenorphine, and naltrexone to inmates with opioid use disorder based on which medication is deemed to be most appropriate for each person’s unique needs.  Rhode Island’s approach is seen as a nationwide model for administering medication assisted programs within the prison system.  A similar system is also in place in Connecticut’s state prison system.

Kathleen Maurer, who oversees health services for Connecticut’s corrections department, said the following:

We favor an approach to patients with [substance use disorders] that offers the full range of medicines, including no medicine, as well as behavioral treatment like psychosocial counseling, and to provide patients with a full accounting of the risks and benefits of the treatment option…If we start someone on a medicine in our system, we have to make sure they have access to that medicine when they go home.”

While a multi-faceted MAT prison program is ideal, Vivitrol has gained traction as an important medication intervention in the fight against opioid abuse. Late last year, a NIDA study found Vivitrol to be as effective as buprenorphine in patients who were part of an extended treatment program. However, the drug was not as effective when used  for immediate treatment since patients need to detox for seven to 10 days prior to use. Given that fact, Vivitrol was seen as an ideal medication treatment option in federal prisons in because inmates would have already detoxed from substances.

MAT is Not a Cure

It is important to realize that MAT programs benefits everyone who suffers from opioid addiction. While President Trump’s opioid plan focuses on the prison population, medication-assisted treatment as whole has to be expanded. Of the 64,000 drug overdose deaths in American during 2016, two-thirds were opioid related. As the drug epidemic continues to claim thousands of lives each year, more treatment options need to be in place.

While many feel MAT programs simply replace one form of addiction with another, these programs are an effective tool in helping addicts get and stay sober. With therapy and other interventions, MAT programs bolster a person’s chance at sustaining their recovery. While more research must done, MAT programs give addicts hope of lifelong sobriety.

Is Medication-Assisted Treatment Right for You?

If you or a loved one are struggling with drug addiction, you want every available tool at your disposal. MAT programs are appealing, but you may not know if they are right for you. Don’t let questions and doubt prevent you from the treatment you need. Call the professionals at Medically Assisted Treatment toll-free today.

Our experienced staff will work with you in finding the right treatment options. We also provide the necessary tools and support you need to make the most informed decisions for your health. Begin your recovery journey today with the help of Medically Assisted Treatment.

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