The Case for Pharmacy Dosing of Methadone
The stigma around methadone use and the several important problems endemic to the system of methadone clinics in the United States are well-known, reducing the number of users who can benefit from the life-saving medication. These issues are important reasons why the promulgation of other forms of Medication-Assisted Treatment has been so important. At the same time, other countries have found great success in combating their own opioid crises through innovations in the way that methadone is prescribed, dispensed and viewed by the larger cultures. Kenneth Anderson highlights critical and important differences between U.S. methadone policy and those in other countries, and argues that there is a quick and inexpensive way to address our opioid problem. – Richard Juman, PsyD
The first question we should be asking ourselves if we want to solve the opioid crisis in the U.S. is this: are there any countries in the world that have been confronted by and went on to solve as big an opioid crisis as the U.S. currently has? The answer is yes. There are many countries in the world which had huge opioid problems, equal in magnitude to the current U.S. problem, which solved those problems and reduced overdose deaths and the number of new heroin users to almost nothing. Let’s look at Switzerland as an example.
From 1995 to 2012 Switzerland saw a 72% reduction in drug related deaths. These deaths were primarily due to heroin overdose. The death rates plummeted from 5.34 per 100,000 in 1995 to 1.51 per 100,000 in 2012.
Meanwhile, in the U.S., drug related deaths have skyrocketed. Data extracted from CDC WONDER shows that between 1999 and 2015, U.S. heroin overdose deaths increased 471%, going from a rate of 0.7 deaths per 100,000 in 1995 to 4.0 per 100,000 in 2015. U.S. overdose deaths due to any opioid (prescription opioid or heroin) rose 416%, going from 1.9 deaths per 100,000 in 1995 to 9.8 per 100,000 in 2015.
The percentage of young people who have ever used heroin has also plummeted in Switzerland. Between 1992 and 2012 there was a 92% reduction in young people (age 15 to 24) who had ever used heroin. This fell from 1.3% in 1992 to 0.1% in 2012. Meanwhile, according to the NSDUH, in the U.S. the number of young people who had ever used heroin increased 50% from 1.0% in 1992 to 1.5% in 2014. Why is Switzerland succeeding so well while the U.S. is failing miserably?
For the full article on finding less expensive ways to treat the opioid addiction crisis, check out the original feature article How to Solve the Opioid Crisis, Cheap over at The Fix.