IMI Blog


Opioid Crisis: Understanding the Medicaid Perspective

July 10, 2017


The Opioid Summit last month, followed by the release of two relevant IMI reports was truly an amazing experience.

Participants in a jam-packed room at the Senate Office Building, and hundreds of people who learned and participated by live-streaming, heard that effective treatment is available from current Medicaid programs for beneficiaries enrolled in Medicaid managed care organizations. At the Summit, the message of hope and bright futures was shared, especially when research based care and Medication Assisted Treatment are provided.

We also witnessed a tremendous act of Courage in Recovery. A mother in recovery, accompanied by two of her delightful children, described how face-to-face case management in her Missouri home town made all the difference in the world. Her Nurse Care Manager provided detailed information on the program, but the standing ovation truly went to the woman who had the courage to fight stigma, and share her journey of recovery so that others would know bright futures can be theirs.

After my trip back to North Carolina, I participated in a two-day state-wide opioid summit in North Carolina, provided a standing order for $100,000 worth of Narcan (a medicine to reverse the respiratory depression in opiate overdose) to be dispensed in our 23-county region, and reviewed the care of several members who succumbed to the chronic disease of Opioid Use Disorder. There is still opportunity for improvement.

We now know the science of addiction. “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.” (Principles of Addiction Medicine, R Reis, editor, 2009)

It is also clear that opioid misuse has led to an alarming epidemic in our country, with nearly 60,000 preventable deaths.  Law enforcement now recognized we will not “arrest ourselves out of the problem,” and the societal devastation of broken families and lost lives is heart-breaking.

Clearly, we need more access to care, more access to effective treatments, and an emphasis on early education/prevention.  Medicaid programs have proven that medication assisted treatment is a life-saver for those who have become addicted. The future will be brighter for all when we better address the many dynamics, including social determinants, that have contributed to our current situation.

At the Summit, Jennifer Moore PhD, RN, IMI’s Executive Director, explained in clear and eloquent words why the Summit was held.  “Opioid misuse is a social epidemic. Every age, from infant to elderly has this threat in their life. It knows no boundaries, race or gender. It can happen to anyone. It can happen to you. This isn’t good versus bad. This is about life. Saving lives.”

The Summit and two reports are another step in the right direction to implement needed clinical and policy based solutions to address the growing opioid epidemic in the United States.  I am deeply appreciative to all the national experts, partner organizations, and the staff of IMI who are helping to turn the tide.  We invite you to join us on the journey and to become a Recovery Ally.