The nation still has not turned the corner in combating the opioid crisis, and the effort to make treatment more widely available should include helping physicians overcome barriers to offering evidence-based interventions, former New Jersey Gov. Chris Christie said Monday in an interview with Behavioral Healthcare Executive.
Christie discussed the importance of making all three approved medications for opioid dependence an option for every patient—which was a recommendation of the President's Commission on Combating Drug Addiction and the Opioid Crisis that Christie chaired. He then said in reference to prescribing medication-assisted treatment, “The process for physicians is incredibly cumbersome.”
Christie rejects the notion often shared in the specialty addiction treatment sector that generalist physicians have no interest in treating individuals with addictions in their practices. “They have the education to do it the right way,” he said.
Prior to addressing an audience at Foundations Recovery Network's Moments of Change conference in Palm Beach, Fla., Christie predicted that opioid overdose deaths nationally will continue to rise this year, with signs of hope for a flattening out of death rates in 2019.
Despite some indications of increases in use of other drugs in the general population, Christie said, “We need to focus right now on the opioid issue.”
Asked to identify which component of the newly adopted federal opioid legislation could have the greatest impact in addressing harmful use and overdose, Christie said, “There is no silver bullet in this.” But he cited funding support for treatment and for efforts to block the flow of deadly fentanyl into the country as two important elements.
In his work with the Trump administration's opioid commission, Christie saw firsthand several examples of innovative responses to the opioid epidemic. He cited efforts at the Louis Stokes Cleveland VA Medical Center to offer vulnerable military veterans a number of non-opioid pain treatment options, including several that insurance companies will not yet reimburse.
Christie also mentioned efforts in states such as Massachusetts and North Carolina to offer comprehensive support to pregnant and postpartum women with opioid dependence. He emphasizes that these initiatives are coming to life under both Republican and Democratic administrations, a reminder that partisanship tends to dissipate when a governor faces a rising number of deaths in a state's population.
Responding to wide-ranging questions from Behavioral Healthcare Executive, Christie took aim at other impediments to progress, including:
The inability to reach a consensus on patient confidentiality protections that some believe interfere with comprehensive and integrated care. “To think that a surgeon treating a patient might not know that the patient has an opioid addiction is just outrageous,” he said. Leaving it to the patient to self-disclose isn't the answer, he said, because many patients remain in denial about their problem.
The actions of opioid manufacturers that played an important early role in fueling the crisis, with the possibility that they eventually could face the kind of global settlement that occurred with tobacco companies that were sued by state governments. “Their presentations were breathtaking in their audacity,” Christie said of the opioid makers.