A public service billboard along Interstate 64 near Charlestown, W.Va., in 2017. (Michael S. Williamson/The Washington Post)

I strongly support Beth Macy’s view on solving the opioid crisis, as outlined in her Sept. 29 op-ed, “A simple way to end the opioid epidemic.” We must make opioid use disorder treatments more accessible. Full stop. However, if we only focus downstream, we will always be fighting a battle, never winning the war. We must include a complementary approach to prevent addiction before it starts.

Between 6 and 20 percent of surgery patients initiate a long-term opioid use habit after a surgery. It’s easy to understand why, as 90 percent of these patients receive opioids to manage their pain. Sometimes in unimaginable quantities.

We can do better. Congress can reduce the risk of patients becoming addicted to opioids if it incentivizes the use of non-opioid pain management approaches. Current Medicare reimbursement policy provides an inadvertent incentive for providers to prescribe opioids, putting non-opioid approaches out of reach for patients and their doctors.

Fortunately, 160 members of Congress agree we should change this dynamic. The Non-Opioids Prevent Addiction in the Nation Act would increase access to and use of non-opioid pain management approaches in managing post-surgical pain. In the process, we can save more individuals from the fatal harms of opioid-related overdose.

I’m sure this is an approach we can all get behind.

Chris Fox, Washington

The writer is executive director of the Voices for Non-Opioid Choices Coalition.

Beth Macy was correct: Expanded access to medications for the treatment of opioid use disorder is critical to ending the opioid epidemic. As we consider expanded access, we can’t forget the population of people for whom diversion from the justice system is not an option.

My life was saved by treatment I received in a Maine drug court 16 years ago. I would not have been eligible for diversion because of the seriousness of my charges. Instead of jail, I was given the opportunity to participate in one of the more than 4,000 treatment courts nationwide and address my opioid use disorder through treatment, counseling and recovery support.

At the time I participated in drug court, medications were not widely available and still viewed with some skepticism. Today, treatment courts are leading the advancement of medication in the justice system. A recent Journal of Substance Abuse Treatment study found that nearly three-quarters of all treatment courts now offer all Food and Drug Administration-approved medications for opioid use disorder, and 90 percent offer buprenorphine and/or methadone.

Medication is crucial to ending the opioid epidemic; we must ensure it continues to be accessible to those involved in the justice system who are not eligible for pretrial diversion or other low-level interventions. Expanding treatment courts will ensure this population receives lifesaving treatment, including medication for opioid use disorder.

Abby Frutchey, Northfield, Maine

The writer is a member of the National Association of Drug Court Professionals Board of Directors.

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