Addiction experts are up in arms following remarks from Health and Human Services Secretary Tom Price, in which he referred to medication-assisted treatment for addiction as “substituting one opioid for another.”

Nearly 700 researchers and practitioners – including 17 North Carolinians (see below) – sent a letter Monday communicating their criticisms to Price and urging him to “set the record straight.”

The medicines Price referred to are methadone and buprenorphine, both of which are opioids. The letter notes that there is a “substantial body of research” showing the drugs’ effectiveness, and that they have been the standard of care for addiction treatment for years. The drugs tamp down cravings and prevent withdrawals, helping people suffering from addiction to stop misusing prescription or illicit opioids and get back to living productive lives. Experts say Price’s remarks, made last week to the Charleston Gazette-Mail, ignore the primary benefits of such medications and go against scientific evidence.

“I was just totally gobsmacked,” says Brendan Saloner, an addiction researcher and assistant professor at the Johns Hopkins Bloomberg School of Public Health.

Saloner says that Price’s own Department of Health and Human Services (HHS) displays information online that contradicts his comments.

“I couldn’t believe we were having to reopen this conversation. It totally flies in the face of all the evidence,” he says. “These drugs are highly effective in restoring a sense of normalcy in people’s lives.”

Price instead touted treatment with a third addiction medicine, Vivitrol, a brand name formulation of naltrexone, which is an opioid blocker. All three drugs — methadone, buprenorphine and naltrexone — have been shown to help reduce relapse and keep people in treatment.

 “Instead of talking about getting the right medication to the right patient at the right time, [Price] actually maligned the use of buprenorphine and methadone,” says Dr. Corey Waller, an addiction psychiatrist who heads legislative advocacy at the American Society of Addiction Medicine.

Addiction experts say that Price’s remarks are consistent with widespread, but inaccurate, views on the use of buprenorphine and methadone, also known as opioid maintenance therapy. They worry that the secretary’s comments perpetuate those views. “It’s not replacing one drug for another because we define addiction based on behavior, not on the absence or presence of a drug,” says Waller.

An HHS spokesperson, Alleigh Marre, wrote in an email that Price’s remarks did not signal a shift in the department’s policies regarding the drugs. “One of the five pillars of the secretary’s strategy to combat the opioid epidemic is expanding access to treatment and recovery services, including medication-assisted treatment,” she wrote.

North Carolina researchers who signed the letter:

Adaora A. Adimora MD, MPH
Professor of Medicine and Epidemiology University of North Carolina at Chapel Hill

Apostolos A. Alexandridis,
MPH Epidemiologist
Injury Prevention Research Center, University of North Carolina at Chapel Hill

Nabarun Dasgupta, MPH, PhD
Injury Prevention Research Center, University of North Carolina at Chapel Hill

Corey Davis, JD, MSPH
Teaching Professor
Brody School of Medicine, East Carolina University

Stacie Dusetzina, PhD
Assistant Professor
University of North Carolina at Chapel Hill

Linda Dykstra, PhD
Professor Emeritus
University of North Carolina at Chapel Hill

Cynthia E. Kuhn, PhD
Professor of Pharmacology, Professor of Psychiatry
Duke University Medical Center

Christina S. Meade, PhD
Associate Professor of Psychiatry and Behavioral Sciences
Duke University School of Medicine

John T. Mitchell, PhD
Assistant Professor
Duke University School of Medicine

A. John Rush, MD
Adjunct Professor, Professor Emeritus
Duke Medical School, USA; Duke- NUS

Catherine P. Sanford, MSPH
Retired Injury Epidemiologist
Adjunct Professor, Maternal and Child Health
NC Division of Public Health; NC Harm Reduction Coalition

Nicole Schramm-Sapyta, PhD
Chief Operating Officer
Assistant Professor of the Practice, Duke Institute for Brain Sciences

Alex Gertner
MD/PhD student
University of North Carolina at Chapel Hill

Aaron Mitchell, MD
Hematology-Oncology Fellow, Postdoctoral Research Fellow
University of North Carolina, Chapel Hill

Louise Vincent, MPH
Executive Director of Urban Survivors Union (National Drug User Union)
Founder of NC Chapter of Urban Survivors Union

Fred Wells Brason II
President and CEO Project Lazarus

Stephen A. Wyatt, DO
Medical Director, Addiction Medicine, Carolinas Healthcare System
University of North Carolina at Chapel Hill

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