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September 22, 2018 01:00 AM

Rep. Matsui: Let's take additional steps to destigmatize addiction

Rep. Doris Matsui
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    Rep. Doris Matsui (D-Calif.)

    Addiction is a medical condition. This is a fact, yet despite our efforts to bring mental illness out of the shadows, the misconception that a substance use disorder is a reflection of a character flaw remains.

    Recently, the Harvard T.H. Chan School of Public Health and Politico released a poll showing that 37% of respondents believed that opioid addiction is a sign that someone has a personal weakness. This poll reiterates the findings of a 2014 study from the Johns Hopkins Bloomberg School of Public Health led by Dr. Colleen Barry, chair of the health policy and management department and co-director of the Center for Mental Health and Addiction Policy Research. As Barry stated, “The American public is more likely to think of addiction as a moral failing than a medical condition.”

    Rep. Doris Matsui
 (D-Calif.)

    SERVING SINCE: 2005

    HEALTHCARE-RELATED COMMITTEES: House Energy and Commerce Committee (Health Subcommittee, Communications and Technology Subcommittee, Digital Commerce and Consumer Protection Subcommittee, and Environment Subcommittee)

    Matsui is also co-chair of the Congressional Caucus to Cure Blood Cancers and Other Blood Disorders as well as the Congressional High Tech Caucus

    Congress has the ability—and the responsibility—to play a larger role in destigmatizing all addictions, including opioid use disorders, as part of our work to improve the behavioral healthcare system.

    While the House-passed opioids package, HR 6, took steps to expand treatment for individuals with a substance use disorder, it did so with a unilateral focus on opioid use disorder. If we are truly going to address the root causes of the opioid epidemic, we need to look at the entire spectrum of care. That means updating our systems to integrate behavioral and physical healthcare while funding services for patients who need crisis care as well as prevention and early intervention services.

    Substance use disorder is not limited to opioids, and addiction can co-occur with other mental health conditions like depression, eating disorders and schizophrenia. Therefore, changes need to be made across the system. If not, we are only legislating from crisis to crisis.

    The Excellence in Mental Health and Addiction Treatment Expansion Act, HR 3931, takes a more holistic approach by expanding funding for certified community behavioral health clinics. These clinics cover a broad range of mental health services, including 24-hour crisis care, increased integration of physical, mental and substance abuse treatment, and expanded support for families of people living with mental health issues. Eight states now have such clinics; because of the original Excellence Act that I co-authored, they've been able to hire more addiction specialty staff and successfully expand recovery services to more patients.

    Without this sustained investment, the care for people with a mental illness in our country is more likely to remain an exhausting and frustrating process of isolated, cyclical visits to emergency departments. When this happens, we are reminded that mental illness affects families and communities—the parents, siblings, grandparents, children and friends of patients are all integral to supporting their treatment, care and recovery. And when a patient is hospitalized, there inevitably follows a sequence of events that results in confusion for providers, families and patients about what information can be shared under the federal HIPAA privacy law.

    If we want to support the recovery of patients, providers need the best tools to engage with a patients' family and communities of support. That is why I included a provision in the 21st Century Cures Act requiring HHS' Office for Civil Rights to conduct education and awareness efforts on patient and family rights under HIPAA. A year later, this has resulted in the education of over 3,000 health policy lawyers, a strategy to conduct outreach to healthcare providers, and a funding opportunity to establish a Center of Excellence for Protected Health Information Related to Mental and Substance Use Disorders.

    What people still don't realize is that HIPAA does actually allow for information sharing when it is in the patient's best interest. We need to make sure that clinicians know that they can and should work a patient's loved ones into their care and recovery, just as we would if the patient had a disease like cancer.

    These legislative actions are only part of the larger solution. Expanding treatment will be most effective when a patient suffering from a mental health disorder can ask for and receive assistance from supportive communities without stigma.

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