Philly methadone clinic doctor: Medicaid cuts will kill people

Drug paraphernalia is so commonplace on the streets of Kensington, jars of needles collected there were used in a display at Philadelphia City Hall to raise awareness of the opioid crisis on June 22.

Jon is a patient of mine who was a veteran of the Iraq War, and was injured while working as a contractor after he left the service. The injury led to an oxycodone prescription that lasted too long.

Soon, a familiar story unfolded: Oxycodone in the clinic led to oxycodone on the street, which led to heroin. Family ties fell apart. Friends left him. Homeless, he landed on the streets in Kensington, home to Philadelphia’s most notorious drug district.

Manik Chhabra: “Our society’s response to this epidemic will be our legacy.”

I’m a primary-care doctor who sees patients in a methadone clinic. All of my patients are fighting opioid dependency by getting life-saving treatment.

I also live in Kensington, where I see the evidence of the epidemic every day.

In November, 50 people overdosed in a single day close to my home. In December, 35 died from overdoses in a five-day period. Last year more than 4,000 people died of overdose in Pennsylvania, nearly a quarter of them in Philadelphia.

Our society’s response to this epidemic will be our legacy. Opiates already are killing more of our neighbors than died at the height of the HIV epidemic in the ’90s.

But unlike that terrifying era, today we have effective treatment for this latest epidemic. Every day, buprenorphine and methadone help save the lives of thousands.

Medicaid is the lifeblood of treatment in this country, especially to those who are the most vulnerable. Medicaid and CHIP (the state Children’s Health Insurance Program) provide life-stabilizing medications to 30 percent of all Americans in treatment and 124,000 here in Pennsylvania.

In the coming days, the Senate is expected to vote on the Better Care Reconciliation Act, a GOP effort to repeal the Affordable Care Act that largely mirrors the House Republicans’ American Health Care Act. Both GOP plans make significant cuts to Medicaid. While the BCRA provides a single year’s worth of funding to combat the opioid crisis, the $2 billion allocation is many billions less than what state governors say they need. Worse, there’s no guarantee it will continue beyond 2018.

By cutting Medicaid and making essential health benefits — including treatment for mental health and substance use disorder — optional, the BCRA and AHCA would keep hundreds of thousands of Americans from life-saving treatment. This means more needless emergency room visits, more hospitalizations, more babies born addicted to the opiates their mothers used during pregnancy.

People who are receiving treatment are our friends and neighbors.

Jon, through treatment with methadone, found his anchor. He has rebuilt relationships with family and friends, rents an apartment, works part time, and is back in school studying physical therapy.

Medicaid cuts will kick out the stool on which so many people such as Jon are precariously perched. If they become law, more Americans will die of overdose. Full stop.

Don’t let this be our legacy.  

Manik Chhabra, M.D., is a primary-care physician in Philadelphia. Follow him on Twitter: @manikchhabra