So now that we have a good understanding of what treatment looks like, the importance of treatment to the opioid epidemic, and how it's being used in places like Rhode Island, I want to share with you the eight recommendations that our group developed after reviewing the evidence on treatment for opioid use disorders. So first off we feel it's very important that there be a waiver from patient caps for buprenorphine treatment for clinics that implement evidence-based models of care. So again, we know from Dr. Olsen that buprenorphine is an effective treatment. It's one of several effective medication-assisted treatments that we know works. Buprenorphine currently is subject to a federal cap, so providers are restricted and the number of patients that they can treat with buprenorphine. This is a rule that has many people scratching their heads about. We're not really sure why it is that this cap exists. It's unprecedented in terms of patient care. We don't have limitations on the number of patients that clinicians can treat with other types of medications, and given their urgency of treatment needs in our current environment, having caps on patients for physicians who treat with buprenorphine is really something that needs to be re-examined critically and lifted from our perspective. In addition, we also recommend that all state-licensed addiction treatment programs that admit patients with opioid use disorders permit access to buprenorphine or methadone. Again, these are evidence-based treatment protocols. We know that medication-assisted treatment works and if addiction treatment programs are licensed by the state, we are recommending that those licensees be required to adhere to what is the best available evidence with regard to treatment and include within their programs people who are being treated with buprenorphine or methadone. We also recommend that a public education campaign be developed and disseminated with the goal of educating the public, educating policymakers, educating clinicians, and law enforcement, and other front line responders about the important role of treatment in addressing opioid addiction. Medication-assisted treatment works. We have decades of research and experience with medication-assisted treatment to back this and we need to be using medication-assisted treatment to address opioid addiction in our communities throughout this country. Our last three recommendations include educating prescribers and pharmacists about how to prevent, identify, and treat opioid addiction. So even though we're decades into this epidemic, there is still far too little known about the available evidence. We have strategies to prevent opioid addiction from taking hold, we have ways to identify by looking at the available data where addiction might be a problem, and we certainly have effective evidence-based ways to treat opioid addiction. But unfortunately, some of the people who are best positioned to deliver those types of interventions simply aren't aware of the evidence-based that supports for instance, medication-assisted treatment. So the need to educate those front line prescribers and pharmacists about some of the basics of opioid use disorders, how they arise, strategies to prevent them, and perhaps most importantly how to effectively treat them needs to be a priority. So our group also recommends establishing access to opioid agonist treatment with buprenorphine and methadone maintenance in jails and prisons. As we just heard from Dr Nicole Alexander-Scott, Rhode Island has realized tremendous gains with this strategy. We know that people who are entering our correction systems have opioid use disorders and it just makes sense to provide them with the best available care to treat those disorders while they're under stay care. We also recommend that initiation of buprenorphine in emergency departments settings and during hospital stays be incentivized. So again, when patients with opioid use disorders are present in emergency departments or are in hospital, it makes sense to treat this disease as well as the other diseases that they may be presenting for. Again, the evidence shows that medication-assisted treatment that medications like buprenorphine can be extremely effective in terms of treatment protocols for people with opioid use disorders. It just makes sense to provide treatment to people in hospital, in the emergency department, and in our correction facilities when they're presenting and under our care. Those are the recommendations related to treating opioid use disorders. I hope that you found some recommendations that resonate with you and identify some opportunities that you can take to your communities to advance treatment care within the populations that you serve. Thank you very much for joining me in this discussion of treating opioid use disorders.
