On the final day of testimony before Texas lawmakers on the opioid crisis, Rodolfo Morales, a doctor from San Antonio, described the moment seven years ago when he found his 21-year-old son dead from a drug overdose in his bedroom.
A Boy Scout and musician, Morales’ son — unlike many — had access to health insurance and good treatment options. But it was not enough to save his life.
Morales said those with fewer resources are even more at risk. As a physician who has spent his career working at community health centers, he said he often had little to offer his patients who struggled with substance abuse but a patchwork array of services that were meager at best.
“Many times the best that I could do was pray with them,” he said.
It was a sentiment echoed at the Texas House hearing Wednesday by criminal justice professionals, medical experts and people in long-term recovery working in the addiction treatment field. They all said they are unable to meet the growing needs of their clients.
They called on lawmakers to expand Medicaid coverage and reduce the number of uninsured people in the state, who often suffer the worst consequences of the opioid crisis. Ninety-four percent of them have no access to treatment, experts said.
“This is an untenable and unsustainable solution,” said Laura Guerra-Cardus, deputy director for the Children’s Defense Fund. “Coverage is a necessary tool for helping treat substance use disorders.”
Texas in 2016 saw a 7.4 percent increase in fatal opioid overdoses, which is considerably lower than in other states like Pennsylvania, which saw a 44.1 percent increase, U.S. Centers for Disease Control and Prevention data show.
However, experts in Texas have repeatedly testified that the numbers could be higher. Data might be skewed due to incomplete death investigations and reporting, they’ve said.
Doctors and health professionals Wednesday said effective tools exist to treat the problem, but many options are not covered by insurance, and, according to chiropractor Craig Benton, “Medicaid is extremely limited in what it will pay for.”
Benton said doctors for years have relied on opioids to treat chronic pain but other options like physical therapy and acupuncture are often equally beneficial. He said it is crucial that Medicaid cover these options so health care professionals have other things to offer chronic pain patients, many of whom say they have been unfairly targeted by new opioid prescribing regulations.
Recovery community organizations also have been a vital resource for many recovering addicts, according to Robin Peyson, executive director of Communities for Recovery in Austin. They do outreach, connect people to peer support coaches and provide support beyond a rehab center’s usual 30-day treatment. But they aren’t allowed to bill Medicaid for their services, something Peyson urged legislators to reconsider.
“We are the leaders in the state for delivering these services, but we are excluded,” she said.
Others advocated for more money for adolescent treatment centers, substance abuse prevention education, recovery housing and rehabilitation centers that keep mothers and their children together, of which Texas only has 10.
The National Alliance on Mental Health recommended offering mental health and substance abuse treatment services in tandem, since up to 30 percent of individuals with drug problems also report having a mental health disorder.
Others pushed for more prescription drug take-back programs, which help keep medications out of addicts’ hands.
Wednesday’s public hearing was the last meeting of the 13-member Select Committee on Opioid and Substance Use, which over the last several months has heard expert testimony on drug use among pregnant women, veterans, homeless people and those with mental illness, as well as how law enforcement and first responders’ jobs are changing in the face of the opioid crisis.
The House members will write a report due Nov. 1, which could help craft bills for the legislative session in January.
“It is hard to legislate what to do for the hundreds of thousands of Texans who are suffering from addiction,” the committee’s chair, Four Price, R-Amarillo, said Wednesday. “All of the information we have received has been very helpful to us.”