IHS announces requirements to increase access to Medication Assisted Treatment for Opioid Use Disorder

by Rear Adm. Michael Toedt, M.D., F.A.A.F.P. Assistant Surgeon General, USPHS, Chief Medical Officer

The Indian Health Service recognizes changing attitudes, beliefs, and
perceptions to ensure comprehensive, culturally appropriate health services
are available and accessible to patients that are diagnosed with opioid use
disorder. Opioid use disorder is a chronic disease and evidence
demonstrates that treatment is effective and recovery is possible.

Medication assisted treatment at IHS facilities are a comprehensive
evidence-based approach to recovery that combines pharmacological
interventions with substance abuse counseling, social and holistic services
that are supportive of cultural practices and beliefs. When medication
assisted treatment is prescribed at appropriate doses for opioid use
disorder it has proven to be safe and effective in relieving withdrawal
symptoms and psychological cravings, increasing retention in treatment,
decreasing illicit opioid use, and improving patient
survival
.

To ensure increased access to medication assisted treatment, IHS released
Special General Memorandum 2019-01
. All IHS federal facilities will identify opioid use disorder treatment
resources in their local areas and create an action plan, no later than
December 11, 2019, to provide or coordinate patient access to medication
assisted treatment, increasing access to culturally appropriate prevention,
treatment, and recovery support services.

These actions are intended to support American Indian and Alaska Native
communities in addressing the needs of patients with opioid use disorder
and improving health in tribal communities. IHS is committed to partnering
with tribes to increase access to medication assisted treatment.

Combatting the opioid epidemic remains a top priority at IHS and the U.S.
Department of Health and Human Services. The IHS supports improving
awareness surrounding opioid use disorder, reducing the stigma and negative
attitudes related to opioid use disorder, and increasing understanding of
effective programs to provide care for those with opioid use disorder.
Recently IHS has developed and released agency policy and educational
opportunities to help facilitate access to medication assisted treatment in
tribal communities, including the
Internet Eligible Controlled Substance Provider Designation Policy
. Additionally, IHS has added three Food and Drug Administration approved
medications to the National Core Formulary (
buprenorphine, buprenorphine/naloxone, and injectable naltrexone
) recognizing that these medications prescribed at appropriate doses for
opioid use disorder are safe and effective in relieving withdrawal symptoms
and psychological cravings, increasing retention in treatment, decreasing
illicit opioid use, and improving
patient survival and birth outcomes among women who have opioid use disorder and are pregnant
.

The
IHS National Committee on Heroin, Opioids and Pain Efforts
, or HOPE Committee, was established to promote appropriate and effective
pain management, reduce overdose deaths from heroin and prescription opioid
misuse, and improve access to culturally appropriate treatment.

Related content:

IHS Announces a New Policy to Expand Access to Medication Assisted Treatment in Remote Locations

The IHS Launches New Opioids Website

IHS National Pharmacy and Therapeutics Formulary

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