Legislation in Congress, co-sponsored by U.S. Sen. Richard Durbin - D-IL - could expand treatment choices for people with opioid use disorder.

Current federal regulations mandate that people battling addictions use government-approved treatment programs to receive methadone - a drug that curbs opioid cravings.

Senate Bill 644 would expand access through board-certified addiction specialists, who could prescribe methadone in a clinic or doctor's office.

Lindsey Vuolo - vice president of health law and policy at the nonprofit Partnership to End Addiction - said the measure would remove hardships for people who need help.

"The fact that methadone can be prescribed for pain without these restrictions really demonstrates that there isn't medical justification for these types of restrictions," said Vuolo. "And so, it's really crucial to make effective treatment low barrier - or ideally, no barrier - so that people who are in need of these medications can access them without undue restrictions."

Opponents of expanding methadone access have concerns about possible misuse, or that the drug could be distributed or sold illegally.

The bill is in the Senate Committee on Health, Education, Labor, and Pensions, and has been there since February. Nearly 3,300 people died from opioid overdoses in Illinois in 2022.

Under the current restrictions, the government-approved programs are the only option for people getting methadone treatment.

Vuolo pointed out that there aren't enough of these programs, and people receiving the treatment must undergo counseling - which can create even more hurdles to getting care.

"People have difficulty using their insurance to access care and can't afford to pay for the cost out of pocket, and lack of access to providers," said Vuolo. "There's a workforce shortage, so there aren't enough trained providers who are able to provide treatment for opioid use disorder and substance use disorder. Behavioral health in general, there's also lack of mental health providers."

The Illinois Department of Public Health says in 2022, the state's mortality rate from opioid use was 26 deaths per 100-thousand residents.

Expanded treatment for opioid addiction is now available in New Mexico.

The state's Department of Health is offering medication-assisted treatment for opioid use disorder in four regions around the state.

Josh Swatek, harm reduction program manager for the New Mexico Department of Health, said medication to treat the addiction should help reduce opioid cravings.

"This is really designed to help reach some of the most rural communities, to really create a safety net," Swatek explained. "Folks have options for substance-use treatment in their local communities."

Swatek noted more than 2 million people in the U.S. have an opioid-use disorder. New Mexico previously offered outpatient disorder treatment in Las Cruces, Albuquerque and Roswell but has now expanded treatment to 30 public health offices. He pointed out in 2022, the state recorded slightly more than 700 deadly opioid overdoses.

Swatek emphasized his department is focused on harm reduction -- acknowledging people use drugs for a variety of reasons -- but can also live healthy, self-directed and purpose-filled lives by adopting specific strategies. He added research shows people are five times more likely to enter substance treatment programs and three-and-a-half times more likely to succeed if they have first participated in harm-reduction programs.

"We're working closely with the New Mexico department of corrections," Swatek stressed. "They're going to be required to offer substance-use treatment as well in their facilities, so that when folks are discharged there's a plan. No matter where they are in New Mexico, we can hopefully continue their treatment in a public health office, if need be."

Swatek acknowledged those struggling with addiction often are stigmatized by their community and harm-reduction programs can minimize risks until they're ready to take steps toward treatment or recovery. He observed some patients have told researchers telehealth has helped them have a greater sense of autonomy and control over their treatment.


get more stories like this via email

Often celebrated in popular culture, Wisconsin's relationship with alcohol continues to give way to troubling statistics that center around excessive drinking and there are calls to step up prevention efforts.

The Badger State still ranks high for beer production.

Maureen Busalacchi, director of the Wisconsin Alcohol Policy Project at the Medical College of Wisconsin, said consumption levels for all types of alcohol overshadow market gains. For example, all Wisconsin counties exceed the national average for excessive alcohol use. In 2022, the state recorded more than 3,300 alcohol-related deaths.

"This has been an ongoing problem in Wisconsin, in part, I think, how our regulatory system works, how our culture works," Busalacchi observed. "There's maybe not as much enforcement of policies as there are in other states."

She pointed out binge drinking is a major problem, and boosting age compliance checks at places that sell alcohol could help curb the activity among young adults. Busalacchi sees hope at the local level with stronger enforcement at community events, as police agencies take notice of the ripple effects of people being overserved or minors gaining access to these products.

However, she reported people who have developed a drinking problem often encounter waiting lists for treatment programs.

Faith Gladem, executive director of the Harbor Recovery Center, a nonprofit in central Wisconsin emphasizing family support in transitioning to recovery. She said they are able to meet demand through their services but referrals for more intensive help can be an issue.

"When someone needs treatment, we do not have enough treatment beds in Wisconsin," Gladem asserted. "We do not have enough detox facilities that detox with dignity."

Her team wants to help foster a mindset in Wisconsin where alcohol is put on the same level as other substance use disorders. The State Council on Alcohol and Other Drug Abuse recommends more evidence-based education and Busalacchi added it is important to understand not just the short-term effects, such as traffic fatalities but the cumulative impact as well.

"The long-term impact of alcohol use can be cancer. It can also be high blood pressure, heart disease, liver disease, stroke," Busalacchi outlined. "And then there's the social and wellness issues; your family gets frustrated or you're losing work."


get more stories like this via email

More than 1,000 New Mexicans die from drug overdoses each year, and while there's been a slight drop in overdoses from opioids nationwide, it's mostly offset by those from cocaine and other stimulants.

James Besante, chief medical officer at the Santa Fe Recovery Center, said the opioid crisis is evolving - sometimes described as "waves." Now in its fourth wave, he said the nearly 4% decrease reported by the Centers for Disease Control and Prevention is good news, but doesn't reflect what he's seeing on the ground. He noted that it's common that multiple drugs are involved in overdose deaths.

"Increasingly we are seeing individuals overdose on substances other than opioids," he said, "where their substance has been adulterated with an opioid like fentanyl."

When the United States' opioid crisis was at its peak, New Mexico was sixth among the 50 states for overdoses - about 50 individuals per 100,000 people. If preliminary CDC data showing opioid deaths decreased in 2023 is confirmed, it would be the first annual decrease in drug-overdose deaths since 2018. Besante said any success is good news and offers hope to suffering individuals and families.

About 30% of New Mexico residents live in rural counties, which Besante said are medically underserved - with fewer treatment centers and providers prescribing life-saving medications.

"While in some areas of the country we've seen an explosion of tele-medicine, tele-addiction treatment - that has not found its way into very rural communities," he said, "and oftentimes the local pharmacy is not stocking the medications that are prescribed."

In 2021, almost 107,000 drug-overdose fatalities occurred in the United States. West Virginia was the hardest-hit state, approaching twice the number in New Mexico. Besante saif approximately 25% of clients at the Sante Fe treatment center are unhoused and don't have health insurance.