Those suffering from asthma, diabetes and heart disease can pick up medications to treat their chronic conditions at any number of pharmacies — without stigma. Yet, those with substance use disorder, another chronic condition, are treated differently even in accessing their medications.
“To have to go to an identified location every day to get medication for your chronic illness is just discriminatory on its face,” said Kevin Irwin, director of operations for the Seacoast-area Integrated Delivery Network, speaking specifically of methadone clinics that dispense a synthetic opioid as part of medication assisted treatment (MAT) for those addicted to opioids.
“Lots of people receive medications for chronic illnesses, whether it’s for a month or it’s for a lifetime or any time in between,” Irwin continues, “and we would never make people do that for their depression medication, for their diabetes medication, for their tobacco patch. Right? We would never make people do that.”
Irwin leads one of several regional networks, or IDNs, which aim to improve care transitions between providers, promote integrated physical and behavioral health as well as build mental health and substance use disorder treatment capacity. His work has led him to advocate for easier access to MAT services.
“It’s fundamentally discriminatory and in as much as it is discriminatory, it has a lot of built-in limitations,” he said. “A lot of people can’t, or don’t want to, or aren’t able to do that. Who the hell would want to?”
Methadone is not the only medication assisted treatment available in New Hampshire. In fact, methadone clinics are relatively rare in New Hampshire —there are only about a dozen throughout the state — because of the high regulatory hurdles that need to be cleared to start and maintain one.
Providers who have been authorized by the federal government, such as doctors, nurse practitioners and physician assistants, can also prescribe buprenorphine and naltrexone. The process for getting this medication requires weekly check-ins at first to refill the prescription. These visits are reduced as the patient stabilizes and ideally continues with treatment. But access to this therapy, and specifically to providers offering it, isn’t always easy to come by.
And access is critical to the $45 million hub and spoke opioid treatment model rolled out by the state earlier this year — the success of similar models historically relies heavily on MAT and easy access to it.Read the whole story at partner outlet NH Bar News