Commentary: Rules get in the way of life-saving opioid treatments

(Marco Arndt | AP file photo) In this July 20, 1986 file photo, Queen lead singer Freddie Mercury performs in Germany.

I recently saw “Bohemian Rhapsody,” the Freddie Mercury/Queen bio now in theaters. It was part interesting, part sad and part “inevitable.”

Freddie Mercury was part of a generation of talented, loved, gifted men and women who died because our government refused to even utter the word “AIDS” for the first five years of the pandemic, let alone put any money into finding at least medications to prolong their lives. If there is one consolation, it is this: Because of those who protested, fought and ultimately died, there are medications and no one needs to die young from this disease. There is funding to help people pay for life-prolonging medications now.

I was tearful in the theater because I couldn’t help but correlate the AIDS pandemic to now and a whole new generation of talented, loved, gifted men and women who have died. Men and women, and a lot of children, whom the world will never even begin to know. This time the government talks about their deaths all the time.

“The opioid epidemic.” Every day it’s on the TV; it’s on billboards; there are proclamations and town hall meetings; and the epidemic is used for TV ratings and re-election platforms.

But the government has not actually funded any treatment.

There are no miracle drugs being paid for to save lives. These miracle drugs have the advantage of being established and cheap to make, but redundant and burdensome rules and bureaucracy keep them from the people who would benefit. Methadone has been proven to work for more than 50 years, and Buprenorphine for more than 15 years. These medications to treat opiate addiction are evidence-based and proven to keep opiate addicts alive while they undergo substance use disorder treatment. For those few willing to treat opiate addictions in an outpatient setting, there are no free or low-cost state licenses, certifications or accreditations, nor any state or government funding to assist with these costs.

The government sends “prayers and thoughts” to the families of those who have died and at the same time charges those willing to help exorbitant fees for licensing. The feds — the Substance Abuse and Mental Health Services Administration, to be exact — make clinics pay more than $7,000 per accreditation cycle in a redundant process well covered by each individual state’s licensing regulations, the DEA and federal and state pharmacy boards.

In Utah, the only program that could help is Medicaid, but its administrative rules do not allow this help and do not allow patient choice when it comes to obtaining methadone or Buprenorphine.

Utah now has expanded Medicaid but, without changing the language of one administrative rule, Medicaid, as it stands, has deemed that those who seek these life-saving medications are forced to attend one clinic in Utah for full coverage. One clinic that has only three locations in the entire state.

There are 13 other clinics in Utah all willing to help, but because they are “for-profit” (a misnomer given the amount of fees and licensing the clinic pays), these clinics cannot be fully reimbursed by Medicaid, forcing clients to choose long wait lists, a “one size fits all” programming proven to not work for addictions, or paying half the required fees in “out-of-pocket” cash to stay alive.

Strangely, no commercial insurance pays for Methadone, precisely because it is in a clinic setting requiring counseling. Medicaid must change this one rule exempting Methadone/Buprenorphine clinics from the “county authority” clause currently in place restricting patient choice. If it does not, in 25 or 30 years, how will the world look back on this state and its failures toward our own people? How will this generation of politicians be judged by history for failing to stop the deaths? How will you look back on what you did or did not do to save a life?

Seanna Williams is a licensed clinical social worker and clinical director of True North Recovery & Wellness Center, a medication assisted treatment program in Orem. She has worked over 15 years with those struggling with addictions.