Opiates & the Senate Health Care Bill

When the Senate’s health-care bill died this week, it was worth noting the few who led the revolt.

Most were senators from states hardest hit by our epidemic of opiate addiction:

Maine (Susan Collins), West Virginia (Shelly Moore Capito), Utah (Mike Lee), Ohio (Rob Portman).

“I didn’t come to Washington to hurt people,” Shelly Moore Capito said.

Let’s leave aside how the bill would have done away with basic health care for millions of working folks and provided a tax cut for wealthy people.

One of the biggest problems with it, I think, was that it would have reversed Medicaid expansion and that meant taking away coverage for drug rehabilitation from hundreds of thousands of people, maybe millions of them.

I could not understand how that was a good idea.

It was also interesting to see how, as the debate progressed through the spring to now, a lot of people began to realize what they were losing.

In so many areas where Donald Trump did best in November’s election, areas he promised to make great again, there is a documented need for massive investment in more drug rehabilitation capacity, not less. That is not an opinion. What exists is saturated. Getting into rehab takes weeks, months. Many addicts have no resources of their own with which to seek treatment.

I wrote in another post that opiate addiction was the crucial element in Trump’s victories in several states that were in turn essential to his capturing the presidency.

Eight months later, the Senate’s health-care carnival emphasized my belief that this issue is one of the most potent political forces of our time.

In the spring of 2015, shortly after Dreamland was released, I received a call from Hillary Clinton’s campaign advisor for health issues. Hillary was feeling the ferocity of parents in Iowa and New Hampshire from all walks of life, horrified at their children’s addiction and not knowing where to turn. This surprised the candidate, her advisor told me.

I spoke with her for about ninety minutes. I told her that I thought this was the great silent issue in America today and whoever truly owned it, embraced it, treated it as a thing of the heart, would have a good chance of getting votes from unexpected places, but that this probably would not be felt in opinion polls ahead of time. Mrs. Clinton did some of that, but never enough, and in the end she wrote a position paper and that amounted to most of her campaign’s attention to opiate addiction. I might be wrong, but she didn’t seem to understand the latent power of the issue. Least she didn’t act on it. That was a huge mistake.

Politicians would do well to better understand the deep well of pain and anxiety surrounding, and thus the political power within, this issue. It’s not something expressed easily in polls. People aren’t likely to admit to a pollster on a phone that a loved one is an addict.

But it’s there and dims the view of the future of so many people, the prospects of so many towns and counties, the economies of so many regions, and thus is of paramount importance to them. Right up there with jobs – connected inextricably with jobs, in fact. In so many depressed areas, huge numbers of folks can’t pass an employer’s drug test.

Nor does it take many addicts for that foreboding to spread. A few cases in a small town, I think, are all that’s needed. People see it hit almost anyone and seemingly at random – like a plague – including families who before had no connection to the drug world or the criminal justice system. Soon everyone’s view of the future turns negative.

On top of that, today we have the increasing nationwide notoriety of the issue as compared with just two years ago. An awakening has taken place in those short years – a reckoning and a truth-telling when before there was subterfuge and fabrication.

Overall, this is healthy – for the families now telling the truth and for the country, I think.

But one effect is that the knowledge, and thus dread, has spread to even families untouched by addiction.

In that room where 13 of them put that bill together, Senate Republicans didn’t seem to understand that.

That was a huge mistake.

Because in the small towns or suburbs where folks live, they now know the high school’s quarterback has landed in jail again, and that their pastor’s daughter died from an overdose and that it wasn’t a heart attack after all.


Filed under Dreamland, Drugs, The Heroin Heartland

7 Responses to Opiates & the Senate Health Care Bill

  1. Scott

    Well, I’m in the middle of “Dreamland” (enjoying it) and the thing that occurs to me isn’t Medicaid expansion. It’s getting the Xalisco Boys the hell out of this country. And building an alligator moat between us and them so they don’t come back. Why isn’t that discussed? In the book Sam goes on and on about how the Xalisco Boys take the bus back & forth from Nayarit, loaded with cash and goods. Why do we make it so easy for these soulless predators? Why is stopping them not even discussed, while bankrupting our healthcare system is now apparently Option A, as well as B and C?

  2. Tori Miller

    I hope you will start to consider your language choices. We know words around substance use matter. I try to share as many articles I can on this subject, but I’m not with this one when you must already know the preferred language or should. I also feel it is irresponsible to not mention methadone and suboxone as options. People don’t have to wait months to get into rehab with these options available that are more proven when opiates are involved.

  3. Alice Caroll

    This is not a surprise to me at all. When I read articles online about opiate addiction the comments are always overwhelmingly “Users belong in jail” and/or “It’s their own fault they became addicted and I don’t want my money going to pay for their rehab. It’s their problem.”

    When I read these posts it saddens me. What kind of a country are we? Where is our empathy? Are we so selfish that we don’t realize we are in this together?
    The Trumpcare bill isn’t a health care bill. It is a money transfer to the wealthiest Americans and it cuts care to over 22 million Americans. How does this make America Great? These politicians don’t realize that working Americans are tired of being ripped off by for-profit Big Pharma. They have been given carte blanche by Congress to charge whatever they want for medications. Most made 30% profits last year. Big Insurance provides no care and is a middle-man. They collude on pricing and also show 20-30% profits. Big for-profit Hospital conglomerates who can never give you a price on a procedure also collude on pricing and ration care. The average American can no longer afford this system of graft. They charge more yet the quality of care goes down. We rank 37th in the world by World Health Organization statistics.

    I am tired of watching my friends who are unable to afford insurance suffer because they can’t afford to go to the doctor. When you reach 60 the premiums and copays become astronomical forcing some to keep jobs they should quit as the work is making them sicker. But to have insurance they must keep the job.

    Americans need single-payer Medicare For All that would cover all citizens. Make it non-profit and negotiate pricing on Rx drugs. The rest of the modern world has this in one form or another, Germany has since the 1890’s! It is unconscionable to keep kicking the can while the people suffer and Congress can only think how to make this another money grab to help their rich buddies. That is shameful to say the least.

  4. Rebecca Glover

    In Virginia, effective Nov.1,2017: Medicaid and Medicaid MCO’s will no longer approve payment for Medication (Suboxone) written by physicians that are not an OBOT (Office Based Opiate Treatment) clinic or ARTS (Addiction and Recovery Treatment Services) provider. To provide the very best in Opiate dependence treatment. However, our clinic, which is neither of those, has over 300 Medicaid patients. There are only 4 OBOT, ARTS providers in Southwest Virginia. So a patient either gets the best treatment or NONE at all.

    • Mikst Granny

      Ms Glover, is that Nov 1st, 2017 date exclusive to Virginia or part of national legislation?

      In Jan 2011 many doctors/clinics in IL opted out of Medicaid in protest of its expansion and its low reimbursements which were already incredibly slow-pay.

      That fact was unbeknownst to me when I fired my doctor of almost 4 years in July of 2011 for attempting to unlawfully pass his unpaid Medicaid bills onto me & all others seen in his offices.

      Needless to say, I reported him & he of course retaliated by keeping my medical records & slandering me to other prospective doctors/clinics which landed me in ERs for 4 months being verbally abused by nurses & doctors until I pulled out the copies of MRI results, etc I luckily, had obtained at the time of services.

      A friend mentioned a clinic about 30 minutes from my home where I’d have to self=pay but was like night & day from my Medicaid paid treatment elsewhere. I was welcomed & cared for immediately, unlike Medicaid providers who felt it was they who did me a huge favor in accepting it.

      However, after 5 years & my doctor acquiring the clinic from the original physician who has retired it seems, he now acts like he’s doing me a favor by seeing me despite my paying him $125 a visit & my having to pay for my medications to the tune of $250-$350 a month on an $735 SSI monthly income, since he seemingly does know how to file a prior authorization form or prefers not to.

      Regardless, I told him several months ago, I could no longer afford him and wanted him to be aware that I would be looking for a new pain management doctor & he seemed okay with that initially yet more recently seems to be pushing me out the door.

      Unfortunately, I’ve been unable to find another clinic due to other socioeconomic issues such as lack of transportation, etc & I’m afraid of what kind of clinic I’ll end up with when or if I find one that accepts Medicaid given the extreme anti-opioid environment that now exists.

      The fact is, a lot of us who experience chronic intractable pain truthfully have no option but opioids & we too are treated quite poorly with folks in every area of our lives, including medical professionals we’ve seen for several years, who once said our pain was progressive needing medication adjustments & would be a life-long ailment, are doing 180 degree about-faces with their once compassionate concern for our well-being & sincere desire to relieve our suffering gone out of fear of the DEA & possible public ridicule.

      I’ve been a chronic pain patient for 17 years & suffered alone like so many others who are embarrassed to ask for help from their physician, especially if society treats pain as something to sweep under the rug like a weakness instead of the human condition we all share. I have been seen by some of the foremost pain management physicians in our region, who I’d still be seeing had it not been necessary to move further away from their offices.

      Yet, again when you’re a poor * solo * near elder * female * with disabilities * raising your youngest of 4 children alongside * 3 of your grands * in Section 8 housing * you sometimes must change doctors to be able to live in a nice home, in a great community with safe schools.

      Because I’ve lost friends & loved ones to addiction & suffer chronic pain, I think I understand the many sides of this issue. It’s hard for many pain patients not to not hold addicts responsible for the crackdown on opioids which has meant a loss of pain relief & physicians upon whom we depended upon for our improved functionality which can mean the ability to hold jobs & hold our families together while enjoying vastly improved quality of life.

      Everyone needs to acknowledge the pain others feel whether its emotional/mental pain or intractable physical pain they suffer, and understand that everyone deserves compassionate care & treatment as well as any therapy and/or medications needed to acquire a quality of life worth living.

      I would very much like to help facilitate a partnership between the pain community & that of the recovery community since we all know, there is strength in numbers by which a united demand for a single-payer universal healthcare system could not be denied & shall not continue to be!

      Pain Relief Of ANY Nature Is A Human Right!

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