Jocelyn Woods, MA, executive director of the National Alliance for Medication Assisted Recovery (NAMA-R), has a lot to say about NIMBY-ism. As the lead advocate for OTP patients, she shared her thoughts with AT Forum.
“Research was conducted decades ago showing that methadone reduces crime and public health problems,” she said. “Even more importantly, for the majority of methadone patients, if they were homeless, they find a place to live. They find work and begin to pay taxes, take care of their children, repair relationships with their family, and begin to live pretty normal boring lives.”
This transformation usually occurs within the first year of treatment, something Ms. Woods finds “pretty remarkable, considering that many have no work history, and legal entanglements that are often barriers.” They do it anyway. The reason, said Ms. Woods, is that most patients enter methadone treatment because they are “tired of the lifestyle, waking up sick in the morning and having to find a way to purchase drugs.” After a few months in treatment, they become stable on their medication, and see opportunities before them that they never had before.
They are not “loafers.” The struggle these new patients have before them is enormous. They will face discrimination in health care, education, employment, life insurance, family welfare and the court system, and criminal justice. “To succeed, you have to have a ‘never-give-up attitude,” said Ms. Woods. “There are a lot of very smart people being held back just because of the medication they are taking.”
It’s clear that society thinks it knows everything about opioid addiction and how to treat it, and that’s the problem, said Ms. Woods. “They don’t realize that they don’t know the answer.”
Ms. Woods would like the federal government, which itself does not espouse NIMBY, to “step up and create a massive public relations program to educate the public about opioid addiction and the effective treatments for it,” she said. “Only the federal government can do it right. But they’ve tried only campaigns that were ineffective and a waste of money.”
States also have a responsibility to make sure that adequate treatment is available for everyone who needs it, she said. “Both methadone and buprenorphine treatment is so inexpensive in comparison to the alternatives.”
In addition, the federal government’s aggressive campaign to discourage physicians from prescribing opioids for pain has had a very negative effect, said Ms. Woods. “We need to be smarter than that,” she said. “Limiting prescriptions to pain medication is not only imprudent, but self-defeating, because people will find a way to relieve their pain or they will commit suicide.”
She called the Drug Enforcement Administration “out of control” in its shutdown of pain treatment centers “without considering what could happen next.” What happened was that many valid pain patients attending the clinic were in crisis. It didn’t take long for heroin dealers to step in.
“You cannot stop an epidemic by limiting pain medication or illicit opioids,” she said. “The only way to get it under control is to provide pain medication for those that need it, and addiction treatment for those that need it. And to do this NIMBY cannot be tolerated.”