2014 ASAM Government Relations Review

During 2014, ASAM engaged in many initiatives to increase access to addiction treatment, improve quality of care, and advance the field of addiction medicine. Some of the department’s work for this year includes: updating the state Medicaid survey, advocating for the increase of the buprenorphine limit, revising the ASAM policy statement Use of Naloxone for the Prevention of Drug Overdose Deaths, increasing chapter policy development, and contributing to the American Medical Association State Policy Roundtable.

Medicaid Survey / Addiction Treatment Access Research

As part of ASAM’s efforts to advance access to opioid addiction medications, it contracted the Treatment Research Institute (TRI) to update the June 2013 Patient Advocacy Task Force (PATF) survey and research report on insurance coverage of opioid addiction medications. The results showed that many states increased access to opioid addiction pharmacotherapies between 2013 and 2014, with Delaware, Massachusetts, and Texas making the largest strides. For more information, please see this ASAM Magazine article.

ASAM Policy Statement Use of Naloxone for the Prevention of Drug Overdose Deaths

In order to improve best practice addiction treatment, ASAM revised its April 2010 Use of Naloxone for the Prevention of Drug Overdose Deaths policy statement. This revision should greatly improve patient care and reduce the number of accidental overdoses, as it recommends “co-prescription” programs and on-site naloxone supplies for “rescue” dosing at addiction treatment facilities. For more information, please see the revised ASAM Naloxone Policy Statement or the following ASAM Magazine article.

National Practice Guideline

In 2014, ASAM began working with Treatment Research Institute to develop the “National Practice Guideline for Medications for the Treatment of Opioid Use Disorder” which will assist in the decision-making process related to pharmacotherapies and psychosocial treatments. The guideline is an important document for the addiction medicine field which follows other quality improvement efforts such as The Standards of Care and performance measures documents. For more information, please visit this ASAM Magazine article.

Raising the Buprenorphine Prescribing Limit

In July, Massachusetts Senator Edward Markey introduced The Recovery Enhancement for Addiction Treatment Act (TREAT Act), a bill that would lift the buprenorphine prescribing limit for addiction physician specialists and non-specialist providers that satisfy additional training requirements and practice in qualified treatment settings. ASAM worked with allied organizations to develop a letter of support for the bill. For more information, please visit this ASAM Magazine article.

State Policy Development

In addition, ASAM has been working hard to help states and chapters advocate for policies that support addiction treatment. In the fall, ASAM's consultant and media expert Sheila Strand held three “message manager trainings” to provide information about how to effectively communicate medical expertise and ASAM’s positions to reporters and other media representatives. In addition, a media toolkit was developed to support this effort. In total, 60 members have been trained which includes the media training held at the Annual Meeting last spring. More information can be found here.

ASAM also developed a web-based Education and Outreach Toolkit to support member and stakeholder outreach efforts on this issue. This toolkit includes ASAM policy briefs and fact sheets that can be used for advocacy purposes at the state and local levels. The chapters continue to work with federal and state legislatures and agencies to redefine benefits related to opioid addiction treatment, whether by educating lawmakers or by drafting appropriate treatment guidelines for use by payers.

ASAM successfully impacted policy at both the national and state levels. In 2014, the Centers for Medicaid and Medicare released a CMS Informational Bulletin regarding improving access to “medication-assisted therapy” (MAT) benefits; the directors of NIDA, CDC, SAMHSA and CMS published an article about “MAT” in the New England Journal of Medicine that mentioned ASAM’s report; and Trust for America’s Health, the National Alliance of Medicaid Directors, and the Institute for Clinical and Economic Review issued reports that also referenced ASAM’s study. More recently, the Department of Defense solicited ASAM’s input on the redesign of Tricare addiction treatment benefits, including the use of pharmacotherapies to treat opioid addiction.

ASAM staff will continue to support members by advocating for policies in 2015 that support the mission and goals of the organization, including improving access to addiction medications, quality of care through guidelines, performance measures and standards, and advocating for payer policies that ease the restrictions and barriers to treatment for addiction physicians and patients.