‘You Guys Are Talking My Language’: Cortez Masto Commends Experts On Substance Abuse Care

5 months ago

Earlier this month, Sen. Catherine Cortez Masto (D-NV) questioned experts on building substance abuse disorder care improvements during a Senate Finance Committee hearing.

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00:00 Thank you. And for the benefit of the committee, the adopting an integrated care model is so

00:07 important and that's why Senator Cornyn and I, because of our work here together on this

00:12 committee, have introduced the Complete Care Act. I welcome you to join us on that and

00:17 what it does is expand access to behavioral health services delivered in the primary care

00:23 setting by helping those providers with the upfront cost of adopting that integrated care

00:28 model. That's a first step. That's for behavioral health. I suspect and hope that the same integrated

00:35 model would work for substance abuse disorder. And you guys are all talking my language because

00:40 this is the conversation I have in my state. The lack of continuum of care, the challenges

00:45 we have with the workforce, the stigma associated with behavioral health and substance abuse

00:49 issues and this idea that in the United States what should be happening is that if you have

00:57 a physical issue or a mental health issue or substance abuse disorder, you should be

01:02 able to go to a doctor, access that care no matter what it is, be able to afford it, have

01:07 quality care and get that support without the stigma, without the silos of how am I

01:15 going to pay for it. That is our challenge in this country and the work that you are

01:20 all doing and the advocacy is going to help us at least at the federal level start filling

01:26 in the gaps in that continuum of care and hopefully overcome this stigma for so many

01:30 reasons. And so that's why I appreciate the committee and the work that everybody is doing.

01:36 The other thing I have learned from at least the folks in Nevada that peer support specialists

01:41 are key. And I have met so many of them, right? And this makes the difference as well. And

01:48 so Senator Cassidy and I introduced the Peers in Medicare Act. And again, it's legislation

01:54 that would expand coverage of peer support services so that people with Medicare can

01:59 access the care they need. So I guess for all of you, maybe Dr. Christine, let me start

02:07 with you. Talk a little bit about why this is crucial, why we have peer support specialists,

02:16 why is it important to integrate this into part of this services for individuals?

02:23 Thank you, Senator, for that question. Peer support specialists are crucial to our treatment.

02:32 These individuals are often the single person on our team that can connect with patients

02:39 that are especially hard to reach and patients that may have experienced the most stigma

02:44 in our medical settings to begin with. And so as somebody with lived experience who's

02:48 been in their shoes, that is really inviting the patient in to treatment in a way that

02:55 simply those of us without that lived experience can't always do.

02:59 And that's true for adults and our youth, correct?

03:03 Yeah, I think it's true for youth as well. I think you have to be thoughtful about creating

03:09 systems where youth who are doing that work as peers are supported because they're younger

03:14 and so it would look differently. But that credibility and that, I think about the way

03:21 that patients sigh and relax when they are able to talk to someone who sort of understands

03:25 what is going on. And that's like a human thing. And so it just sort of seems like rational

03:31 then that we would have people as part of our teams who would be able to offer that

03:35 as like a component of the treatment, the care that we are actually offering to people.

03:41 One final thing, and we haven't touched on and would like any of you just to weigh in

03:46 on this. It's maternal health care. Many pregnant postpartum women with substance use

03:51 disorders face barriers that may affect their treatment to services. So I would ask any

03:58 of you to weigh in. Are there services or treatment strategies that we should be talking

04:02 about as it pertains to maternal care as well? Is there a uniqueness around that that we're

04:07 not aware of that we're lacking in our continuum of care here?

04:12 And Dr. Sulliner?

04:14 I'd be happy to offer some comments. I'm sure the other panelists have some as well. I think

04:19 it's important to emphasize, first of all, that for pregnant people, medications for

04:25 opioid use disorder are effective. And there has historically been a lot of stigma about

04:30 starting people in pregnancy on medications. And I think a lot of it has to do with this

04:36 unfortunate narrative that we can have babies that are born with addiction. That's just

04:40 absolutely not correct medically or scientifically. There is a syndrome called neonatal abstinence

04:45 syndrome. It's very easy to manage. I don't know if it's very easy, but it's manageable

04:51 clinically and it puts mom and baby on the right track. So I think making sure that the

04:56 same interventions that we're recommending for everyone else are offered to pregnant

05:00 people is really one critical piece of the puzzle around pregnancy.

05:05 And is there a barrier to affordability through Medicare or Medicaid?

05:11 I would say that Medicaid has been a terrific system for pregnant people. I think that it's

05:16 important that we recognize that Medicaid expansion is catching more people during pregnancy

05:22 and taking steps to ensure that people maintain their Medicaid coverage during that incredibly

05:27 vulnerable period of time. So I would just say that Medicaid is a major part of that solution.

05:34 And it is in Nevada, believe me, we've just extended it. So thank you. Thank you, Mr.

05:37 Chairman.

05:38 Senator Stabenow.

‘You Guys Are Talking My Language’: Cortez Masto Commends Experts On Substance Abuse Care

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