Report on opioid monitoring misleads

Editor's note: The Herald story referenced can be found here

To the Editor:

New York, along with the rest of the nation, is in the middle of a deadly opioid epidemic. Recently, the Centers for Disease Control and Prevention reported that the average life expectancy of Americans continued a three-year decline driven by deaths from overdoses. The rate of overdose deaths involving opioids other than methadone increased by 45 percent from 2016 to 2017.
Meanwhile, opioid treatment programs are on the front lines, providing life-saving, medication-assisted treatment, including all three FDA-approved medications for opioid-use disorder. Unfortunately, only three out of 10 survivors of overdoses receive follow-up treatment with medication. Yet a June 2018 study in the Annals of Internal Medicine found a 60 percent lower death rate for survivors who received methadone. OTPs save lives every day.
The New York state comptroller’s recent audit of OTP services as they pertain to the I-Stop prescription-monitoring program is misleading and poorly conceived. It found that OTPs are not checking I-Stop every time take-home medication is dispensed, but ignored that there is no evidence for this practice in OTPs. In contrast, OTPs adhere to federal standards and follow established policies and procedures for checking I-Stop to ensure patient safety and coordinated care with other treatment providers.
Also, patients receiving medication-assisted treatment at OTPs may require opioid medication to treat pain. A patient might undergo surgery, for example. This was not factored into the audit. Moreover, it must be noted that more than 41,000 people currently receive treatment at New York’s OTPs, but the audit used a sample of only 25 patients. This sample size would not be adequate in any other research capacity.
Essentially, this report disparages an entire field based on incomplete information, and at the same time perpetuates the stigma of addiction. Government should be working to increase access to effective treatment, not creating more barriers. Hopefully, this report will not dissuade patients from seeking the life-saving treatment they need.

Allegra Schorr
President,
Coalition of Medication-Assisted
Treatment Providers and Advocates