The Break Free Foundation supports reducing barriers to effective substance use disorder treatment, including eliminating the DATA 2000 waiver required to prescribe buprenorphine. The buprenorphine requirement should be eliminated because (1) it has failed to meet its ostensible purpose, which is to prevent unscrupulous prescribing and diversion and (2) it has limited access to an effective opioid addiction medication during an unprecedented opioid epidemic.

With preliminary estimates of 191 people dying every day from an opioid overdose in 2020, access to effective treatment is more critical now than ever before.

The differential treatment of buprenorphine versus other narcotic pain relievers is driven by stigma rather than science and results in discrimination against patients with OUD. There is no clinical justification for imposing a patient limit, training and administrative requirements associated with prescribing buprenorphine. In fact, providers who prescribe oxycodone, a DEA Schedule II drug, or who prescribe methadone or buprenorphine for pain are not subject to these same restrictions. The only difference is that the patients to whom buprenorphine is prescribed are undergoing treatment for addiction. Given the effectiveness of buprenorphine in treating OUD, a life-threatening disorder, and the limited access to care, we find it unconscionable that the government would single out this treatment with patient limitations.

The waiver requirement has created the perception among providers that it is difficult or challenging to treat substance use disorders (SUD) and co-occurring illnesses, perpetuating stigma and discouraging providers from engaging in the practice. Increasing access to evidence-based SUD treatment is essential to address our nation’s addiction crisis and it is evident that the buprenorphine waiver requirement obstructs this goal.

Medications for Opioid Use Disorder (MOUD)

Medications approved by the Food and Drug Administration (FDA) and prescribed by a health care provider are an effective and, for some conditions, a critical component of addiction treatment. Medications for the treatment of opioid use disorder (MOUD) are the most effective, potentially lifesaving, treatment for opioid addiction. Studies show that these medications reduce drug use and overdose rates and help retain people in treatment longer, which is associated with better outcomes. These medications have also been shown to reduce criminal behavior and infectious disease risk and improve occupational, psychological, and family functioning.

Unfortunately, there is a widespread misconception among providers, policymakers and the public that “abstinence-based” or “medication-free” treatment– is best.

FDA-approved medications to treat opioid addiction include methadone, extended-release naltrexone and buprenorphine, which is often combined with naloxone. Extended-release naltrexone blocks the effects of opioids so people do not get intoxicated (high) if they use. Methadone and buprenorphine reduce cravings and withdrawal symptoms and allow individuals to improve their functioning in everyday life. When taken as prescribed, these medications do not cause the feeling of intoxication associated with opioid misuse. Because these medications have different mechanisms of action, different side effects and risks, and are available in different health service locations, the medication that is best for any individual will vary.

Methadone has been proven effective through over 40 years of research. The length of treatment with MOUD depends on the duration and severity of the addiction, the patient’s physical and psychological health and preferences, and other factors affecting recovery.

Recovery Training for Healthcare Professionals

Across the nation, we are experiencing an addiction crisis. Addiction must be fully integrated into the healthcare system in order to be properly addressed in a holistic manner.

To achieve this, we firmly believe that all healthcare professionals must be trained and certified in the basics of addiction. The Break Free Foundation supports efforts to increase addiction education and harm reduction services among healthcare professionals, including mandated provider training.

The separation of recovery care services from the mainstream healthcare community is evident in the minimal education and training that healthcare providers receive in relation to addiction.

Due to this lack of training, many healthcare providers do not feel confident in their abilities to treat a patient with a substance use disorder (SUD) or a co-occurring illness and tend to differ to stereotypes and misconceptions about such individuals as those held by the general public.

To ensure that people with addiction receive the treatment they need, healthcare professionals must be trained to treat SUDs and co-occurring illnesses as they do any other complex disease and should no longer be allowed to dismiss addiction care as being outside of their professional expertise.

Safer Consumption Services Act

In the United States we are experiencing a drug overdose epidemic, with the lives of 107,500 souls lost in 2022 due to a fatal drug overdose, that is 294 people lost every single day. In 2022 in NYC, we lost 2,000 people to an overdose. Meaning every four hours, a New Yorker died.

No one should die from a drug overdose, fatal overdoses are preventable with the use of Narcan, otherwise known as naloxone, Fentanyl testing strips, and other life saving harm reduction services.

There are currently 120 Overdose Prevention Centers operating in ten countries around the world. There has not been a single overdose fatality at any OPC.

At OPCs, those suffering from a substance use disorder or co-occurring disorder are offered clean needles, access to life saving resources, access to support groups, and qualitative care from medical professionals in the case of an overdose.

OnPoint NYC says its OPCs were visited 48,284 times by 2,147 people as of Nov. 2022, with 633 drug overdoses averted. The city massively under-estimated the need of OPCs, originally projecting that they would only save between 100 to 130 lives each year.

Despite all of this data, there are some who are opposed to OPCs because of a lack of understanding or perhaps a lack of compassion for the recovery community, causing a lack of willingness to work with harm reduction advocates and peers within New York.

Representative Nicole Malliotakis said in an interview with PBS NewsHour that OPCs are nothing more than “a community center for heroin addicts to go and shoot up...” Her comments are derogatory and diminish the addiction crisis and the everyday struggle anyone suffering from an SUD faces.

By meeting people where they are and acknowledging that illicit drug use exists in our society, the SCS Act recognizes that a one-size-fits-all approach to recovery will not mitigate the drug overdose crisis. But rather, it will add another tool to the toolbox to help end overdose and increase overall public health.

It should also be noted, that those who enter into OPCs, are more likely to seek out recovery and detox services, with 30% of the regulars entering into a treatment facility or detox center to seek out long term recovery.

Far too many lives have been lost to the overdose and addiction crisis this country is facing. Action needs to be taken before any more lives are lost. Just because you are addicted to an illicit substance does not mean that you deserve to die — especially when OPCs are proven to save lives.

I passionately plead with our legislatures to pass the Safer Consumption Services Act (Senate Bill S603/ AB A224) to expand the budget and amount of Overdose Prevention Centers throughout our state. This crisis is not going away, we cannot continue to look away and ignore this issue and simply hope it will go away or get better by throwing valuable resources into policing and further criminalizing this dire issue. Lives are at stake, we must act now.

Daniel’s Law

It is my firm belief that involuntary mental health hospitalizations create obstacles to quality, evidence-based mental health care by creating a fear of forced treatment, and fraying a person’s trust in the health care system. Being forcefully hospitalized is one of the most traumatic things an individual can experience.

A family member of mine went through this when they were in college due to being in a mental health crisis, and being confronted by an officer, instead of a mental health professional, did not remedy the situation, but intensified it. This confrontation resulted in them having a severe panic attack as the officer was not equipped to de-escalte the situation, but kept escalating things to a point that my family member did not feel safe.

After the officer called an ambulance, my family member was informed that the first hospital they arrived to did not have proper mental health services. They were then rerouted to a second hospital that had the proper faciltites they required. My family member was terrified, wondering how much this ride would cost them, which is the last thing a person experiencing a mental health crisis should be worrying about.

Instead of finding relief during their hospitalization, for the first twenty-four hours they sat on a stretcher in the hallway waiting for an open room getting little to no sleep. When they got into a room and were admitted into the behavioral health unit, they were lumped in with patients of varying mental illnesses. There was chaos in the halls, screaming rang throughout the quarters, with medication shoved down their throat.

This created a resistance to treatment for months afterwards, and shut my family member down from talking about the experience until after years of intensive therapy. While my family member did not have a co-occurring disorder - which further exasterbates this issue - and is not an unhoused individual, they were not given the qualitative treatment they needed. I am lucky that they are still here with us and that they are in recovery.

People who struggle with behavioral health issues are marginalized and face stigma that can lead to severe consequences. Chairperson Lee and members of these esteemed committees, you must realize that this policy perpetuates the belief that many people hold that individuals with mental health issues are dangerous. But in reality, they are more likely to be victims of crime and excessive use of force by the police than to cause harm.

I urge this committee to put an end to this policy, in the words of my esteemed colleague, Matt Kudish, the CEO of the New York chapter of NAMI, “The City has the power to provide onsite treatment, as well as treatment in homeless shelters or supported housing, but has chosen not to.”

The time to make these changes and to address the mental health crisis within our city is now. But causing generational trauma in the process and resistance to behavioral health care is not the way to go about it.

In the News

Break Free Foundation’s Position Statements

Buprenorphine Prescribing Waiver

Medications for Opioid Use Disorder (MOUD)

Recovery Training for Healthcare Professionals

Safer Consumption Services Act

Daniel’s Law

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