Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to Axios Closer for insights into the day’s business news and trends and why they matter

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Stay on top of the latest market trends

Subscribe to Axios Markets for the latest market trends and economic insights. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios NW Arkansas

Stay up-to-date on the most important and interesting stories affecting NW Arkansas, authored by local reporters

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sarah Grillo/Axios

Public health experts agree that if the U.S. is going to get the mounting opioid crisis under control, it will need to do a much better job providing addiction treatment. And they have three over-arching ideas for how to do that — some of which Congress and the Trump administration are working on, but some of which still need more attention.

Why it matters: Overdose deaths continue to climb, yet the number of people suffering from opioid use disorder who receive treatment is still low — it was less than 30% in 2016, according to the Kaiser Family Foundation.

Get people into the system

The problem: People with opioid use disorder frequently end up in a hospital, or in the criminal justice system, but those institutions often just handle the crisis in front of them and move on. They should act as a pipelines to help get people into treatment programs, experts said.

  • "It’s not as if people with opioid use disorder aren’t involved in the health care system, it's that their addiction goes under the radar," said John Hopkins' Caleb Alexander.
  • A recent study found that only 30% of people revived by an EMT or in an emergency room after an overdose received medication to help treat their underlying addiction.

The solutions: The justice system could offer or require addiction treatment more often, and doctors could be better trained to recognize and respond to addiction.

  • "Right now we have silos of care outside of medicine. Methadone and [buprenorphine] clinics should be right next to emergency rooms," said Stanford's Anna Lembke.
Make the most effective treatments available

The problem: Experts agree that medication-assisted treatment works — and that it works even better when paired with psychotherapy and long-term care. But those services aren't always accessible.

  • “Any of the major leaders in this movement will tell you that 50% of the providers out there do not practice the evidence-based medicine," said Patrick Kennedy, a former congressman who is now a mental health advocate.
  • Many doctors aren't prepared for patients with opioid use disorder, and few medical schools teach addiction medicine, the New York Times recently reported.

The solutions: "Increasing the oversight to ensure that all folks get access to MAT + evidence based psychosocial treatment as a condition of insurance reimbursement, especially with Medicaid, would be a good first step," said Jay Unick of the University of Maryland.

  • Congress' opioid bills would let doctors prescribe MAT to more patients at the same time, and would provide loan repayment as an incentive for providers to work in facilities that treat substance use disorder.
  • Expanding telemedicine would also increase access to treatment for people who don't live near a qualified provider.

"Dispense at pharmacies and syringe exchanges. Make it free. These medications should be cheaper and easier to access than heroin. Not the other way round," said Leo Beletsky, a Northeastern University law professor.

Make treatment more affordable

The problem: Insurance often doesn't cover addiction treatment, and even if it does, it doesn't cover it long-term. Federal law requires insurers to provide the same coverage for mental health services as they do for physical health, but those rules are often poorly enforced.

  • "Until there is real parity and doctors and/or hospitals are incentivized to provide this treatment, they will continue to prescribe pills and do procedures and surgeries, because that is what pays," Lembke said.

The solutions: Experts suggested more stringent enforcement of state and federal mental health parity laws, which should lead to better-designed insurance plans.

  • "The barriers are inadequate networks of addiction medicine, pain medicine and related mental health and cognitive behavioral health services," said Jack Deutsch of the American Medical Association.

Medicaid plays a big role here, too. Medicaid paid for more addiction treatment than all private insurers combined in 2014.

  • More states should adopt the Affordable Care Act's Medicaid expansion, experts said.
  • The House's opioids bill would also roll back a federal ban on Medicaid funding for treatment facilities that have more than 16 beds.

The bottom line: The opioid bill Congress is working on chips away at several of these issues, but there's much more work to do, and by many institutions other than Congress.

Go deeper

SoCalGas agrees to $1.8 billion settlement for 2015 gas blowout

An evacuee with a Save Porter Ranch sign outside Southern California Gas Company's Aliso Canyon gate in Porter Ranch in January 2016 as the gas leak continued. Photos: Al Seib / Los Angeles Times via Getty Images

Southern California Gas Company and its parent company announced Monday they've agreed to pay up to $1.8 billion in settlement claims over the 2015 Aliso Canyon natural gas storage facility blowout.

Why it matters: Some 100,000 tons of methane, ethane and toxic chemicals poured into the air for 112 days, forcing over 8,000 families to evacuate from their Los Angeles-area homes and sickening many with headaches, nausea and nosebleeds, per the L.A. Times.

Updated 5 hours ago - World

North Korea fires short-range missile to sea, slams "hostile" U.S. policy

North Korean leader Kim Jong-un. Photo: API/Gamma-Rapho via Getty Images

South Korea's Joint Chiefs of Staff said Tuesday that North Korea's military had fired a short-range missile toward its eastern sea, per AP.

Why it matters: North Korea's ambassador to the United Nations defended the latest launch in remarks to the UN General Assembly, demanding the U.S. and South Korea end their "hostile policy" against the country.

Arizona Judge: Adding mask mandates ban to budget bill unconstitutional

Arizona Gov. Doug Ducey (R) Photo: Michael Brochstein/SOPA Images/LightRocket via Getty Images

An Arizona judge ruled Monday that the state's ban on mask mandates in schools, and other measures put into the state budget by Republicans, are unconstitutional, the Arizona Republic reports.

Why it matters: The sweeping ruling voids a ban on vaccine requirements for public universities, community colleges and local governments, and strikes down some non-COVID-related measures like a ban on teaching critical race theory in classrooms and anti-fraud measures for ballots.