Thursday, April 5, 2018

WHY WON'T OUR LEGISLATORS VOTE ON IBOGAINE?

HB1207:  The Ibogaine Treatment Study Bill is stalled in the HGO Committee!  Please call members today and
ASK FOR A VOTE!

Contact info for House Government Operations (HGO) Committee members:

THE PROBLEM

Treatment for opioid dependence, as well as healthcare policy designed to address the epidemic proportions of suffering individuals, have been monopolized by an industry with enough capital to create brilliant marketing and promotion strategies that have created a $1.4 billion opioid addiction treatment industry in the U.S., as of 2014 (Manalo, 2017).

“Interestingly, the pharmaceutical industry's response to this drug addiction crisis is more drugs(Manalo, 2017)

Due to a lack of equally proportional funding for high profile marketing and lobbying strategies, other equally viable or promising alternative treatments, like Ibogaine therapy, have either struggled to gain a foothold in the treatment arena or remain virtually unheard of.  This is simply unconscionable given the degree to which this problem is devastating our families and communities across Maryland, and hemorrhaging our hard-earned tax dollars in a futile attempt to meet the burgeoning capacity needs of our overwhelmed healthcare and justice systems. 

About Ibogaine

Ibogaine is a drug extracted from the root bark of the West African iboga shrub.  It has psychoactive (alterations in perception, mood, consciousness or behavior) and psychedelic (hallucinogenic) properties when ingested.

It’s effectiveness in curing opiate addiction was first discovered in 1962, by Howard Lotsof, a heroin addict living in New York.  Seeking a recreational hallucinogenic experience, he found that after a two day intense hallucinogenic ‘trip’, he no longer felt any cravings for heroin –even more incredibly, he had no withdrawal symptoms.

Since then, studies undertaken by leading research and academic facilities have corroborated Lotsof’s experience, demonstrating that ibogaine is an effective addiction interrupter for most substances including heroin, methadone, methamphetamine, cocaine, alcohol, and nicotine. With just one dose of the hallucinogen and a psychedelic journey that can last days, heroin addicts, alcoholics and cocaine users have reportedly found themselves completely free from their cravings –with none of the usual withdrawal symptoms.

Although how it works in the brain is still not entirely clear, researchers believe that once ingested, ibogaine is converted to a metabolite, called noribogaine. This substance impacts different parts of the brain involved in drug-taking patterns of behavior –neurotransmitter pathways strongly linked to addiction and reward.  Noribogaine ‘rewires’ these areas, basically rebalancing brain chemistry by leveling out dopamine, serotonin, endorphins, adrenaline and other neuro-chemicals –thus allowing the brain to restructure itself to its pre-addicted state. It is like pressing a brain reset button.  Once this process is complete, no further use of ibogaine is necessary.  Long-term relief from withdrawal symptoms probably comes from the fact that ibogaine is stored in fat tissue and slowly released into the bloodstream for up to six months.

In addition to the complete elimination of withdrawal symptoms, users report an experience of clarity and insight into repressed emotional memories, trauma, and subconscious guilt.  Many describe the experience as intensely therapeutic –similar to going through years of therapy in 24 hours, with flashbacks to pivotal life-changing experiences often repressed since childhood.  Afterwards, they are left with critical insights into the root of their addiction process as well as other unhealthy behavior patterns.  Through unlocking past traumatic events or situations, many of which are subconscious, individuals are suddenly able to gain understanding or clarification of the causal factors that have contributed to their compulsion to use substances.

Although medical use of ibogaine is currently not legal in the United States, it is currently used to treat opiate addiction in other countries, including Canada and Mexico.  While 9 of the 28 countries presently in the European Union have similar classifications as the U.S., it is unregulated (neither officially approved nor illegal) in much of the rest of the world.  New Zealand, Brazil, and South Africa have classified ibogaine as a pharmaceutical substance and restrict its use to licensed medical practitioners.  This has led Americans who struggle with addiction to seek out international clinics or underground providers to receive treatment.

IBOGAINE

BENEFITS
·         Eliminates craving and withdrawal symptoms associated with opiate use disorder (Alper, 1999; Alper et al., 2012; Cloutier-Gill et al., 2016; Franciotti, 2013; Glick, 1991, 1999; Heink, 2017; Lotsof and Alexander, 2001; Mačiulaitis et al., 2008; Mash et al., 1995, 2000, 2001; Noller, 2016; Sheppard, 1994)

·         Clinical trials have reported rates of abstinence at twelve month follow-up of between 20% (Brown & Alper, 2017), 24% (Bastiaans, 2004), 40% - 50% (Mash, 2016), and 57% (Noller, 2016).  Other studies report that participants were either abstinent from all drug use, or had stopped use of primary and secondary drugs of choice (primary opiates) (Bastiaans, 2004)

·         Ibogaine is not addictive (Koenig and Hilber, 2015; Ross, 2012)

·         Perceived improvement in overall health by 58% of respondents (Bastiaans, 2004)

·         Significant reductions in reported depression (Mash, 2012; Noller, 2016) by 100% of respondents (Bastiaans, 2004)

·         Triggers recovery patterns for other psychological issues including anxiety disorders and post-traumatic stress disorder (Anderson, 1998; Bastiaans, 2004)

·         Reduced criminal behavior (Bastiaans, 2004)

·         Reported improvements in family relationships and social connectivity (Brown and Alper, 2017; Noller, 2016) in 88% of respondents (Bastiaans, 2004)

·         Limited potential for abuse due to nausea and vomiting (Alper et al, 2012), and its propensity for facilitating emotionally unsettling and uncomfortable memories during therapy (Donnelly, 2011)
RISKS

·         If not dosed or administered correctly, it may cause cardiac arrest or seizures  (Alper et al., 2012; Breuer et al, 2015; Hoelen, 2009; Jacobson, 2017; Maas, 2006; Noller, 2016;) –A total of 27 deaths have been reported globally since Ibogaine’s use as an anti-addictive medication (Litjens, 2016)

·         ‘Waking dreams’ that may be unpleasant or emotionally uncomfortable (Taylor, 2017)

·         Hampers muscle coordination during therapy (Taylor, 2017)

·         May induce periods of nausea and vomiting during therapy (Breuer et al, 2015; Taylor, 2017)



Monday, April 2, 2018

ACTION ALERT: One More Call!


‘ONE MORE WEEK LEFT’ STATUS
The Maryland General Assembly ends in one more week --on April 9th.  Please call your legislators and ask them to VOTE IMPORTANT BILLS OUT OF COMMITTEE!  Most SUD bills are in limbo with the Committees reluctant to vote on them one way or another.  If there is no vote --they "die in Committee".  Nothing is moving.

If you care about any of the following bills, NOW is the time to call COMMITTEE MEMBERS (links below) and ask for A VOTE ON BILL #...  Call every day, all week long, and send an email.  Pass this along to your friends, colleagues, neighbors, and strangers on the street corners and ask them to call as well. 
Here is a list of some really good bills STUCK in Committee:

STUCK in House Government Operations Committee (HGO):
For HGO Committee member contacts go to: http://mgaleg.maryland.gov/webmga/frmMain.aspx?pid=cmtepage&stab=04&id=hgo&tab=subject7&ys=2018RS

1)      HB326: Safe and Supervised Consumption Site Pilot Program: Provides a safe place for users to bring drugs.  This is NOT enabling.  This is a place where these individuals (someone’s child) can get medical assistance (in case of O.D.), access to treatment, or at least use a phone to call their family, etc.  80+ such sites around the world have a zero overdose rate, and a high rate of getting these folks into treatment. 

2)      HB1207: Ibogaine Treatment Study Program: Provides funding for Maryland to study the efficacy of Ibogaine to treat opiate dependence.  It is currently used to treat opiate addiction in other countries, including Canada, Mexico, New Zealand, Brazil, South Africa, and many European countries, and has a success rate of between 40% - 57%.  The entrenched Pharma / medical lobby opposes this solution because it is natural, and would compete with pharmaceutical solutions.  Currently, many families send their loved ones to Mexico and Canada to access treatment. 

STUCK in House Appropriations Committee:
For Appropriations Committee member contacts go to: http://mgaleg.maryland.gov/webmga/frmMain.aspx?pid=cmtepage&stab=04&id=app&tab=subject7&ys=2018RS

3)      HB1577: Funding for Family Navigation Services: Allocates $1,665,915 to the state annual budget for family ‘navigators’ to assist parents of children (including young adults) with behavioral health needs (including addiction).  Navigators assist parents / caregivers in 1) understanding and addressing their child’s behavioral health needs; 2) identifying community resources; and 3) obtaining needed services.  Many organizations in our grassroots community-based network already provide these services without any reimbursement. 

STUCK in Senate Finance Committee:
For Finance Committee member contacts go to:
http://mgaleg.maryland.gov/webmga/frmMain.aspx?pid=cmtepage&stab=04&id=fin&tab=subject7&ys=2018RS

4)      SB975: Task Force to Study the Impact of Drug Addiction on our State: Creates a Task Force to study the impact of addiction in Maryland: the number of emergency room visits and deaths related to drug addiction; economic and health care costs related to drug addiction; the number of families negatively impacted by drug addiction; the portion of the unemployment rate attributable to the unemployment of individuals with criminal records involving drug–related crimes; recidivism rates related to drug addiction; physical and mental health issues caused by drug addiction; homelessness due to drug addiction; deep–seated physiological problems due to drug addiction; the lack of health insurance coverage for addiction treatment; the exacerbation and remission status of chronic diseases similar to drug addiction such as diabetes, cancer, and cardiovascular disease;  ways to promote early detection of diseases, such as hepatitis C, related to drug addiction; and the number of an individual’s failed treatment attempts.  The Task Force will then make recommendations.   This costs no money. Our state seems reluctant to act to address the ADDICTION EPIDEMIC.  The information gathered in this Task Force will prove just how costly INACTION can be. 

5)      SB702: Requires Insurance Companies to Pay for Assessments for Opioid Use Disorder: Currently, many people seeking treatment for a chronic opioid dependence must first be ‘assessed’ in order to receive treatment.  Depending on their insurance, many are paying hundreds of dollars for this assessment out-of-pocket.  Pain management doctors encounter problems when referring patients for an assessment because the insurance provider may not pay for them.  Or insurance companies are taking their sweet time in making pre-authorizations for these assessments.  This bill ensures that insurance companies fast-track and approve these authorizations. 

STUCK in the Senate:
For Senate Committee member contacts go to:
http://mgaleg.maryland.gov/webmga/frmmain.aspx?pid=legisrpage&tab=subject6

6)      HB922: Establishes Provisions for a ‘Pill Mill’ Tip-Line, and Procedures for Investigating Overdose Death: This bill mandates the state to devise a means for citizens to anonymously report “pill mills” and doctors “prescribing for profit” to authorities for investigation. 

THESE  BILLS  DESERVE  A  VOTE!


Tuesday, March 6, 2018

REIMBURSEMENT FOR PEER RECOVERY SERVICES


SB765 / HB772:  Maryland Medical Assistance Program –Services Provided by Certified Peer Recovery Specialists

THE PROBLEM

Currently, there are upwards of fifteen incorporated non-profit organizations throughout Maryland that were founded and are currently operated by individuals with lived experience in providing solutions to the ‘opioid epidemic’.  Among the services they currently provide are ‘peer recovery services’.  These Peer Recovery Specialists are either individuals who have survived and recovered from a substance use disorder themselves, or parents (caregivers) who have supported an adolescent or young adult child struggling to recover from their disorder. 

They provide services to those desperate for solutions –to those caught in the grips of their own disorder, or their parent caregivers who are assisting them with accessing help.  The services they provide include: 1) educating those who are impacted about aspects of addiction based on scientifically valid information; 2) assisting individuals seeking treatment and recovery services in accessing these services; 3) facilitating family peer support and bereavement groups; 4) providing one-to-one peer coaching; 5) serving as diversion advocates in the courtroom –assisting judges and legal counsel in creating treatment plans as an alternative to incarceration; 6) providing impacted individuals and their family members with Naloxone; 7) linking individuals without funding for treatment and recovery services with private scholarships and public grant funding; and 8) providing evidence-based training and mentoring to other peer specialists.  These organizations are often providing higher deliverables at a lower cost than other service providers or government programs. 

Some of these incorporated Maryland business owners have been operating for more than a decade on the efforts of volunteers often working the equivalent of a full-time job, or with very limited funding derived from small grants and private donations, despite the fact that they are a valuable and very visible resource within their community.  In order to sustain and maintain the life-saving services they provide to those struggling with an often fatal disorder, their services must be fairly compensated. 

THE SOLUTION –INCLUDES BILL AMENDMENTS

Peer Recovery Specialists providing vital and often life-saving services to individuals with a substance use disorder and their families, should be able to be reimbursed through the Maryland Medical Assistance Program.  However, the current legislation fails to address several important issues: 
1)      The services which would be reimbursable are not specified, and we suggest that these should minimally include educating the individual and/or family caregiver, assisting the individual in accessing treatment and recovery services, providing individual coaching, justice system diversion and/or courtroom advocacy, and Naloxone training. 

2)   Currently, most business owners solely providing Peer Recovery Services are not certified under any certifying entity, nor does a certification path even exist whereby they are able to become certified.  Most of these registered Maryland businesses are owned and operated by parent caregivers.  Also, there are organizations which have historically provided peer support in the mental health arena, and train their own specialists.  We are concerned that a single entity or organization seeking to ‘corner the market’ on peer certification, and subsequently peer training and peer credentialing, would emerge as a result of this bill.  This may have the effect of excluding already existing businesses that have been effectively providing these services.  While we are not opposed to a certification process –provided that it is developed by stakeholders, and the process is inclusive of those currently in the business of providing these services, this does not yet exist.  Therefore, the “certification” stipulation should either be dropped until a future time when this component can be addressed in a fair and comprehensive way, or addressed within this bill so as not to unfairly exclude business owners who have been providing services well before any Maryland certifying entity even existed.   

3)      In order to ensure that these two provisions are adequately addressed, this bill should make provision for a work group to be convened, which includes all current Maryland business owners who have legitimate incorporated businesses that currently provide peer support services.  

THE SPONSORS: Senator James Mathias / Delegate Antonio Hayes

FOR FURTHER INFORMATION: EMAIL info@faceaddictionmd.org / CALL 301-525-6183

Wednesday, February 28, 2018

STOP KICKING PATIENTS OUT OF TREATMENT TO THEIR DEATH!


HEARING IN SENATE FINANCE ON THURSDAY, 2/29
Call / Write members of the Senate Finance Committee (below)
SB921 / HB1531:  Task Force on the Premature Discharge of Patients with Substance Use Disorders

THE PROBLEM

Patients diagnosed with an often fatal co-occurring disorder and admitted to an inpatient treatment facility are routinely kicked out of treatment –often for extremely trivial infractions.  Patients who are assessed as needing inpatient treatment in order to recover, and who fail to receive it, are at high risk of death as a result –a death that could have been prevented.  Patients have been kicked out of treatment for sneaking a cigarette; walking into another person’s room; talking to, holding hands with, or kissing another patient; leaving treatment for a couple hours after notifying staff in order to say goodbye to a dying parent in a hospital; cursing at a staff member; making an inappropriate gesture to another patient; using a cell phone; and other behaviors that would not merit discharging a suicidal patient, or a cancer patient, or a kidney dialysis patient from necessary treatment.  These actions would not even warrant expelling an adolescent from high school regardless of the fact that many of these infractions are disallowed in Maryland’s high schools.  Regardless of students’ rule-breaking behavior, society still believes that these students are better off with a high school education than expulsion for “breaking the rules”.

Patients are discharged before their planned discharge date, often with very little notice (sometimes mere minutes), despite the fact that they have been diagnosed with an acute, chronic, often fatal disorder; and have been admitted to a healthcare facility or program on the basis that this level of care is necessary in order for them to recover from it.  The sudden and unexpected dismissal –often to immediate homelessness, triggers feelings of extreme distress, crisis, depression, failure and hopelessness –the very feelings that caused or exacerbated their substance use in the first place.  With a lowered tolerance to opiates, due to the time they have spent in detox, they are at extremely high risk of overdose.  If they are prematurely discharged from an outpatient Suboxone provider –often because they were late for, or unable to make an appointment due to transportation issues or work conflicts, the onset of withdrawal is imminent.  All gains that have been made while in treatment quickly unravel. 

THE SOLUTION

This bill establishes a Task Force to collect and analyze treatment data regarding the frequency and circumstances of premature discharge from treatment.  It requires the Task Force to suggest steps which would mitigate the dangers of premature patient discharge.  It is unconscionable that providers continue to place patients’ lives in jeopardy by premature discharge –often for committing the very behaviors that they have been diagnosed as needing professional assistance to overcome. 
TO CONTACT THE SPONSOR:
Senator Steve Hershey / Delegate Seth Howard                                                     

FOR FURTHER INFORMATION:
EMAIL info@faceaddictionmd.org / CALL 301-525-6183


SENATE FINANCE COMMITTEE

Thomas Middleton:  

John Astle: 

Joanne Benson:  

Brian Feldman: 


Stephen Hershey:  
Phone: 410-841-3639 | 301-858-3639 | Toll-free in MD: 1-800-492-7122 ext. 3639

J.B. Jennings:  
Phone: 410-841-3706 | 301-858-3706 | Toll-free in MD: 1-800-492-7122 ext. 3706

Katherine Klausmeier:  
Phone: 410-841-3620 | 301-858-3620 | Toll-free in MD: 1-800-492-7122 ext. 3620

James Mathias:  
Phone: 410-841-3645 | 301-858-3645 | Toll-free in MD: 1-800-492-7122 ext. 3645

Nathaniel Oaks:  
Phone: 410-841-3697 | 410-301-3697 | Toll-free in MD: 1-800-492-7122 ext. 3697

Edward Reilly:  
Phone: 410-841-3568 | 301-858-3568 | Toll-free in MD: 1-800-492-7122 ext. 3568

Jim Rosapepe:  
Phone: 410-841-3141 | 301-858-3141 | Toll-free in MD: 1-800-492-7122 ext. 3141