Published June 19, 2019
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.
Rear Admiral Michael Toedt, M.D.
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.