Dr. Mark Sachar: Let’s unshackle opioid addiction treatment options

As referenced in a recent editorial in the Ocala Star-Banner, various agencies in Marion County are coming together to fight the scourge of opioid addiction.

Kudos to all involved, especially Ocala Police Chief Greg Graham and Marion County Sheriff Billy Woods as well as myriad local agencies involved at so many levels.

Solving the complex challenges of opioid addiction takes more than the proverbial village. It takes time, money and a communitywide commitment to prevent addiction, remove criminals from our streets, and recovery help to those who are addicted.

One such path, and a means of helping with recovery, is known as Medication-Assisted Treatment or MAT. MAT is a treatment protocol for those who suffer from addiction where a highly trained physician works with the patient and uses therapy, plus medication, to help break the bonds of addiction.

As a physician who works with opioid-addicted patients, I know that MAT is widely seen as the gold standard of care and, when properly deployed, can have astonishing results. In fact, President Donald Trump’s Commission on Combating Drug Addiction and the Opioid Crisis advocated for MAT treatment and called for states to expand, where possible, the FDA-approved drugs for this purpose. And there is some good news.

Recently, the State of Florida joined over a dozen other states and several large insurers in allowing more than just one pharmaceutical option for treatment. Why is this movement vital? Because, prior to this decision, doctors were limited to only one choice — a good choice, but not appropriate for all patients in all conditions. As I said, fighting the scourge of opioid addiction takes cooperation at many levels, as it is a complex social problem requiring a variety of approaches. Likewise, in MAT, we need choices too.

By providing more choices in MAT treatment, doctors will be better able to use our training and be able to deploy proven therapy/treatment options and, hopefully, save lives. But there is a hitch. The state’s largest insurer, Florida Blue, still allows only one treatment option for patients who want to avail themselves of MAT treatment, a single drug and its generic equivalent. This makes no sense. Our state and our people are suffering from an epidemic that we are finally starting to get under control, thanks to the hard work of people like those noted in your column. But this massive insurer has been reluctant to follow the lead of so many others. This simply must change.

That is why physicians, such as myself, are asking Florida’s health care outlier — Florida Blue — to join other states and the State of Florida in allowing physicians and patients the ability to have real treatment options to help break the bonds of addiction. And make no mistake, we are not asking Florida Blue to rely on unproven or “experimental” options — that would not be fair to anyone. We are talking about FDA-approved and clinically tested options. Specifically, the kinds that are used in this type of therapy are known as buprenorphine/naloxone class of medications and they are widely and effectively used to treat opioid dependence. There are several that are currently in use and are considered effective, but Florida Blue only insures one option.

It’s time that the state’s largest insurer unshackles the hands of physicians who are working to help break the cycle of addiction and save lives.

It is time that Florida Blue also recognizes what a growing number of states and even their own counterparts in other states are learning. Having more options, can and will save lives and that is a goal we should all share.

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Dr. Mark Sachar is a pain and addiction physician who practices in Ocala.