A nonprofit publication of the Kentucky Center for Public Service Journalism

Michael Fletcher: Pass House Bill 121; get addiction treatment into the hands of those who need it

In 2019, every Kentuckian knows someone struggling with addiction and we are well aware that this epidemic is wreaking havoc on our communities and in our country. As an Addiction Specialist Physician practicing here in the Commonwealth, I look into the eyes of these people every day. My patients are filled with determination to beat an illness that has devastated their career, their family and their body.
But to get to this point, many had to first hit rock bottom. We’ve all seen the viral photos illustrating the results of this terrible disease – individuals laying on the floor of the supermarket slumped over the wheel with a child in the backseat or splayed across a sidewalk.

Fortunately, rock bottom can be the beginning of recovery, but only if treatment is available when someone is ready. Unfortunately, individuals struggling with addiction must often endure unnecessary delays or denials for the treatment due to prior authorization requirements. These avoidable administrative burdens delay access to care putting Kentuckians at serious risk for relapse, overdose, or even death. It’s time we put a stop to this!

Rep. Kim Moser has introduced House Bill 121, which removes prior authorization requirements for medication-assisted treatment (MAT). This bill accomplishes something extremely important yet incredibly simple for patients: ensuring treatment is ready when they are.

I’ve seen too many individuals with a substance use disorder (SUD) thwarted by a treatment system that is confusing and fragmented. This broken treatment system forces many to give up before they can even begin. This is not how we treat other health conditions, so why do it when it comes to SUD?

I’ve had many patients ready to begin treatment only to have my best clinical recommendations blocked by insurer-mandated prior authorizations. And not only do these requirements hinder treatment, they also add hours of administrative work for physicians. This time would be much better allocated to caring for the thousands of Kentuckians in desperate need of SUD treatment.

I am grateful that Kentucky has already invested millions of dollars and man-hours to address the opioid epidemic. And, certainly, we want to continue to work smarter to eradicate this public health care crisis. So why impede those ready to begin treatment with a needless administrative roadblock?

There’s no doubt that removing barriers to MATs will save lives. I have seen MATs work for countless patients, and I’m not alone. Research shows that those who receive MATs are 75-percent less likely to die from addiction than those not receiving medications.

As the opioid epidemic continues, we’re learning more about what works and where the treatment system can be improved. Right now, here’s what we know: MATs work and those with SUDs need access to treatment the moment they are ready to begin recovery.

I urge members of Kentucky’s General Assembly to quickly pass House Bill 121 this session. When one American is dying every 19 minutes from a drug overdose, a simple change like this one should be easy. 

Michael Fletcher, MD, is graduate of the University of Louisville School of Medicine and is Board Certified in Anesthesiology, Pain Management, and Addiction Medicine.  He is the CMO for Addiction Recovery Care Centers and is the President of the KY Society of Addiction Medicine.  Dr. Fletcher is a current member of the KBML as well.

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