By State Sen. Erin Houchin (R-Salem)
As our state faces an increasing drug epidemic that is nearing crisis levels, we must take action. We must combat drug abuse on all fronts, including prevention, treatment, and enforcement. However, we must do so responsibly.
There are a few different treatment options in Indiana, including methadone clinics and Office-Based Opioid Treatment facilities (OBOT). These facilities offer treatment to opioid addicts through medication that seeks to curb cravings and reduce withdrawal symptoms, and aid in the road to recovery. Methadone clinics receive Medicaid funding, and are closely regulated, both at the state and federal levels. They are also under a moratorium, with nineteen clinics currently operating.
Like methadone clinics, OBOTs also receive Medicaid funding. However, unlike methadone clinics, OBOTs are largely unregulated and able to proliferate widely in our communities, while using tens of millions of dollars in Medicaid funding. There are currently around 450 of these facilities in our state, and many are owned by out-of-state companies, without so much as an Indiana licensed physician on site. They distribute opioid replacement medication without even modest regulations, or a path to wean qualifying addicts off drugs completely.
OBOTs commonly use a drug called buprenorphine, which is known by the brand name Suboxone. While it offers hope for recovery to some, buprenorphine does not come without the risk for abuse. According to Indivior, the largest manufacturer of Suboxone, “buprenorphine can be abused in a manner similar to other opioids.” Unregulated distribution of these drugs is irresponsible, and it is dangerous. Suboxone film is highly and easily trafficked into our jails and prisons, and is also sold illicitly on our streets.
This session, I authored Senate Bill 398 with the goal of imposing modest regulations on OBOT facilities, similar to the guidelines methadone clinics must follow. While I want these patients, who are among our most vulnerable Hoosiers at their most vulnerable time, to get access to quality care, I don’t believe we can assure the public that is happening under the current framework. I have no doubt there are providers who are prescribing these treatment drugs responsibly, but I am equally sure there are bad actors. Carelessly throwing new drugs pushed by pharmaceutical companies at a drug problem without safeguards is a recipe for a new epidemic if we don’t take action.
SB 398 was amended by the Senate Health and Provider Services Committee into a summer study committee, but I will continue working with various stakeholders as the bill proceeds through the legislative process.