August 6, 2025 • 28 mins
When federal funding is slashed for addiction treatment, education, and research, it affects millions of Americans struggling with substance use disorders and those who work with them. Libby Jones discusses the importance of working with and educating those who make policy and funding decisions. Ms. Jones is the Program Director at the Overdose Prevention Initiative (OPI). She has a Bachelor’s of Science degree with an emphasis on government from William & Mary, and a Master’s of Science degree with an emphasis on human rights from the London School of Economics. Libby leads OPI’s work to advance federal policies that reduce opioid overdose deaths through expanding access to treatment, championing harm reduction, and equipping lawmakers with the tools they need to make meaningful change. She continues to be a key voice in pushing for policies that make treatment accessible for all. She and the Overdose Prevention Initiative can be reached at Overdose Prevention Initiative. The State of Wisconsin's Dose of Reality campaign is at Dose of Reality: Opioids in Wisconsin. More information about the federal response to the ongoing opioid crisis can be found at https://www.dea.gov/onepill
The views and opinions of the guests on this podcast are theirs and theirs alone and do not necessarily represent those of the host or Westwords Consulting.
We're always interested in hearing from individuals or organizations who are working in substance use disorder treatment or prevention, mental health care and other spaces that lift up communities. This includes people living those experiences. If you or someone you know has a story to share or an interesting approach to care, contact us today!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:12):
Welcome everybody.
This is Avoiding Addiction Affliction,brought to you by Westwords Consulting,
the Kenosha County Substance Use DisorderCoalition, and by a grant from the state
of Wisconsin's Dose of reality, realtalks that reminds you that opioids are
powerful drugs and that one pill can kill.
I'm Mike McGowan.
How many times have you heardpeople say about our government?
(00:34):
Yeah, but what are you gonna do about it?
Well, while some of us wonder howanything in our government ever gets
done, some people actually work withthe government and get things done.
Libby Jones, my guest today,is one of those people.
Libby is the program director atthe Overdose Prevention Initiative.
She has a Bachelor of Science degree withan emphasis on government from William
(00:56):
and Mary and a Master's of Sciencedegree with an emphasis on human rights
from the London School of Economics.
Her job is to build governmentalsupport for programs that help
people with substance use disorderissues, who have little or no voice.
God bless you, Libby.
Thanks for being with us.
How are you?
Oh, I'm great.
Thanks for having me,this is gonna be fun.
(01:18):
Oh, I am looking forward to this so much.
Well, first I would start out withthe general, tell us about the
Overdose Prevention Initiative.
Yeah, so the Overdose PreventionInitiative, we are a DC based group
that focuses on advancing federalpolicies, kind of in three main areas.
One is expanding access to treatment forAmericans with substance use disorder.
(01:43):
The second is reducing the overalldeath toll from overdose in America.
And the third is really tobreak stigma around substance
use from a policy standpoint.
We are non-partisan.
Every day our team workswith congressional offices
on both sides of the aisle.
(02:03):
We are walking back and forthfrom the house side to the Senate
side pretty much every day.
And we work with federal agenciesthat on both the public health side
of the shop and also law enforcement.
'Cause really we have to haveboth of them at the table for
a lot of these discussions.
But ultimately what our goal is, isto find real policy solutions that
(02:25):
will save lives at the end of the day.
Well, you also focused a loton I was reading your stuff on
people who are incarcerated.
Yes.
And I told this, I talked topeople about this all the time.
People who are in jail areeventually gonna get out, right?
And if they don't addresstheir substance use disorder
issues, they're going back in.
Right?
Right.
So what does effective treatmentlook like in those settings?
(02:49):
Your point about folks getting outis exactly why it's so important.
Incarceration is one of thosekey intervention points, right?
We need to make sure as, as acollective, as a society, that we have
no wrong door to treatment, right?
People are gonna need treatment.
Some will need treatment, you know, cometo ask for treatment in an emergency
(03:12):
room, in an ambulance, but a lot aregoing to have that clarity that they
need treatment during incarceration.
So we do have an obligation to meetpeople where they are and in that moment.
But also, our work isabout overdose prevention.
We are trying to reduce the burden ofdeath in this country from overdose,
and we have a lot of data that showsthat people who are immediately
(03:37):
released from incarceration aresome of the most vulnerable folks
in our society to die from overdose.
There's one study that we citefrequently that says folks with an
untreated substance use disorderare 129 times more likely to die in
the first two weeks after release.
(03:58):
So it's not just a good to have, it'sa must have if we are going to address
that the overdose deaths in this country.
And we are working really closelywith members of Congress to kind
of educate them on this point.
So one of the things that wedid you know, you talk about
giving a voice to the voiceless.
(04:20):
People who are incarceratedcannot effectively lobby
their members of Congress.
So we had to bring membersof Congress to the jail.
So last year we organized a field trip.
We took members of the CongressionalAddiction Treatment and Recovery Caucus.
There were about seven members of Congressand the White House drugs are, we took
(04:42):
them on a field trip to the FairfaxCounty Detention Center in Virginia.
And we kind of arranged it withSheriff Kincaid and Fairfax County so
that these members of Congress couldgo and spend about 90 minutes in the
cell block talking to people in theirjail population who are for the first
time receiving treatment behind bars.
(05:04):
And it's those types of experiences whichare so helpful to getting policy makers to
understand the power and the impact thattreatment during incarceration can have,
and it's treatment during incarcerationhas a direct impact on saving lives.
(05:24):
And we also believe that treatmentduring incarceration will lead to
safer communities and healthiercommunities on the outside.
'Cause your point is well taken.
Recidivism will continue if wedon't stop that cycle of addiction.
I'm sure you've heard it.
What do you say to those peoplethat say, well, forced treatment,
forced education just doesn't work.
(05:46):
I mean, we're not talkingabout forced treatment.
What we're talking about ispeople who are incarcerated.
Sometimes this is the first healthcareencounter they're going to have.
This is gonna be a chance to be screenedfor these substance use disorders, and
we need to have it available duringincarceration if people want it.
I don't disagree.
(06:07):
There's evidence that shows thatforced treatment doesn't work.
However, it's a key intervention point.
And if someone who's recently beenarrested or who is being incarcerated,
if they need and they wanttreatment, it needs to be available.
So that's kind of my take on it.
(06:27):
Well, and you never know you right?
You never know when somebody'sgoing to get the aha moment.
Or when I worked in the jail,sometimes you would see people curled
up so the other inmates couldn'tsee them reading the big book or,
or one day at a time, and it's likesomething's clicking there right?
Right, right.
We've gone to tour multiple jails,and when you speak to people who
are incarcerated, who for the firsttime have been offered treatment
(06:51):
during incarceration, it can be verytransformational, you know, and it
changes the trajectory of people's lives.
I agree.
I don't think that forcedtreatment is viable for most folks.
Right.
It just doesn't stick.
We have evidence that shows thatforced treatment is not effective.
(07:14):
But what we do know is that thatintake point, you know, at the time
of arrest during incarceration, isa very critical point for a lot of
people who need treatment, and it'sa tragedy when they, you know, need
that treatment and it's not available.
You know, in 2022, you helped, yourorganization helped Congress pass the
(07:34):
Mainstream Addiction Treatment Act.
For those unfamiliar withit, talk about that a minute.
Oh the MAD Act is what we callit, but this bill will always
be very close to my heart.
The United States has a historyof making it harder than it
needs to be to get treated right?
(laughs)
(laughs) Yup.
(07:54):
You, you know this, right?
And before the passageof the MAD Act in 2022.
Only about, and this is an HHSfigure, only about 7 to 10% of US
physicians had the ability to treata person with opioid use disorder.
And that's because, again, we makeit more difficult than it has to be.
(08:16):
There were outdated federal regulationsthat made it unnecessarily difficult
for doctors to prescribe medicationsto treat opioid use disorder.
So before the MAD Act, these federalregulations required doctors to
seek additional medical trainingoften at their own expense.
File additional paperwork with the DEAto get special registrations and, you
(08:42):
know, welcoming additional oversightover their prescribing records.
I know a lot of doctors.
I'm sure you do too, and I don't knowany doctors who willingly want to have
more paperwork and more oversight.
Right.
And so as a consequence of, youknow, essentially well-meaning
federal regulations, we then have,we've tied our own hands, right?
(09:05):
7 to 10% of physicians couldprescribe just as the overdose
death rate was soaring.
And so what we neededwas all hands on deck.
We couldn't tie our own hands anymore.
So our group worked with a number,hundreds of other organizations across
(09:26):
the country to get this bill passed.
And I think one of the things that wasso overwhelming for me was to see public
health groups, faith-based groups, lawenforcement groups all coming together
to fight for this piece of legislation,which ultimately what it did was it
(09:49):
removed those barriers for medicalproviders to provide this medication.
Because the unintended consequenceis not just we needed a
higher number of prescribers.
I think what's clear, particularly nowthat those federal barriers have been
removed, is how much stigma t hat wascreated by these federal regulations.
(10:14):
Right?
There's this idea that, well, if it'shighly regulated by the feds and we
have to go through all these hoops,then there's something inherently
wrong about this medication.
There's something that isdangerous about this medication or
treating these types of patients.
The bill passed at the end of 2022,but it's going to take years, if
(10:39):
not decades, to combat that stigmathat's associated with this.
And that's a lot of the work that ourteam does, is we recognize that there
are policies that creates stigma,that create unnecessary barriers,
and that's what we've gotta go after.
Well, so that begs the question then.
How do you go, and thisis a big one I know.
(11:00):
How do you go about educatingthose who can enact change?
Because what you're working dailywith people where this is not
their number one area of expertise,it's down the list of ways.
Yep.
No, I mean, you're exactly right.
You know, in my opinion.
Stigma kills.
Mm-hmm.
The impact is of stigma aloneagainst people who use drugs.
(11:24):
There's a stigma against help seeking.
And we need to really workon that on a societal level.
What we try to do isreally humanize addiction.
When we're working with members ofCongress this is one of the issues that,
one of the increasingly rare issueswhere there's true bipartisanship.
(11:44):
And the reason why is becausethere are 535 members of Congress.
Every single one of them has peoplewho have died of overdose, who are
struggling with a substance use disorder.
And so it doesn't matter if you representa rural community or an urban community.
This is in your district.
(12:06):
And I think that helps us when we'reworking with these offices because
every member of Congress wants tofind solutions to this problem.
And we really have to humanize this issue.
There was a survey that came out, Ibelieve, as in 2023 that said that
one in 10 Americans have a lovedone who has died of an overdose.
(12:27):
That's overwhelming.
For me, what I have foundthe most effective tool in
combating stigma is stories.
Getting your story out there.
There's no better way ofhumanizing this issue.
And I think it takes a tremendous amountof courage, but I'm always overwhelmed
(12:47):
by the family members or the people whoare in recovery who go to their member
of Congress and tell them their story.
That is really key.
In terms of kind of thetactics that we use.
We are sending all these great storiesand case studies up to Capitol Hill.
But you know, one of the thingsthat we did, which I think has
(13:08):
been helpful is my team organizesa Naloxone training for members of
Congress and their staff every year.
Every September to commemorateNational Recovery Month, we will
bring in usually their med studentswho do a Naloxone training.
And I have witnessed this, I've watchedthis with my own eyes and you know, you
(13:32):
put the Narcan dose in someone's hand,you show them how easy it is to do, and
you talk about how it's effective, youknow, 75 to a hundred percent of the time.
And it's empowering and once you holdit in your hand and you realize how
easy it is, that is a great way ofcombating that stigma that people
(13:55):
have about harm reduction, about,you know, people who use drugs.
So there are certain things, youknow, certain tricks that we up
our sleeve, I guess you couldsay, in telling these stories.
Well, let alone if they ever havethe opportunity, as I'm sure you
have and I have, of watching someonewho's overdosing be administered...
(14:17):
And just see them come back.
It seems like a trick, you know.
I mean, it's called theLazarus drug, right?
Yeah.
It's amazing.
And I think that things like Naloxonetrainings are also empowering, right?
Mm-hmm.
You're like, I can do something, right?
I am armed with this littledevice that I can keep with me.
(14:39):
One member's office contacted us afterone of the Naloxone trainings that
we did, and they reported that one oftheir staffers had revived someone.
Awesome.
It was a bystander here in DC And thatthey had saved somebody's life with the
(15:00):
Naloxone training that we had provided.
I mean, and that just givesyou goosebumps, right?
That you do this to be educationaland you know, just to hear that
almost immediately it was put intopractice is pretty, pretty cool.
Well, you mentioned that themembers of Congress represent all
facets of society from urban torural, to suburban to whatever.
(15:23):
And you know, to ask the hard ones,in the last seven months we've seen
slashing of funding for programs.
We've had people on herewhose programs have been cut.
Yeah.
What do you think about that?
And talk about some ofyour wins at the same time?
(15:43):
I guess.
I mean, it's devastating.
You know, you're talking to folkswhose programs are getting cut.
We have had in the last 12months a lot of progress.
You know, in terms ofdrug overdose deaths.
For the first time in manyyears, we are seeing progress.
(16:05):
For me, it seems counterintuitiveto take your foot off the gas as
soon as you start seeing results.
You know, I understand that there'sa lot of pressure on cutting budgets
and reducing the deficit, but itseems like why would you cut these
programs that are actually working?
Right?
If you're looking to cut programs that areinefficient or ineffective, don't cut the
(16:28):
programs that are literally saving lives.
It just, it doesn't seem tomake a whole lot of sense.
I am personally concerned that thecuts that we're putting into place
now will take years to correct.
Yeah.
My team has heard me say thisbefore, but when the overdose crisis
(16:52):
really took off, right when itreally was reaching crisis levels.
As a nation, we looked to the addictionmedicine community to kind of build
the plane as they were flying.
Right?
In 2018, Congress passed theSupport Act that gave a lot of local
(17:12):
community grant programs right.
To enable communities to literallybuild the plane as they're flying.
They were trying to figureout what's gonna work.
Five years from that, we're seeingthat these programs are working right.
And now those same people that weput in the place of having to build
(17:33):
the plane as they were flying itare now being asked to jump out
of that plane without a parachute.
Right?
(laughs) And, you know, howare we going to make that up?
I don't know.
But all I do know is that weneed to keep the momentum going.
And these programs that we're talkingabout are worth the investment.
(17:54):
You know, we talk aboutreturn on investment.
Every life saved from treatment or harmreduction, every life saved, that's
a person who can go into recovery.
And a person in recovery youknow, those folks are employable.
They pay taxes, they takecare of their families.
(18:14):
I can't think of other programsthat have a more direct impact on
building safer, healthier communities.
There are 23 million Americansthat are in recovery.
Each of those people have loved ones.
They're taking care of theirfamilies and their jobs.
We can't pull the rug out now.
(18:35):
And you also addressed the disparity thatcomes with socioeconomics and there's
a lot of disparity when it comes tosocioeconomic status in our country.
Oh, absolutely.
That's something that weare very, very sensitive to.
You know, we believe that it shouldn'tmatter your race, where you live,
what your income is, or what yourinsurance level is, everyone should
(18:59):
have access to these resources.
We know there are huge disparitiesamongst, for example native
American, Alaska native populations.
They have the highest percapita overdose death rate.
We need to be focusing on that.
Black Americans have a much higheroverdose death rate than white
(19:20):
Americans, but also, whether ornot you're covered by insurance.
That is something if the Congressionalbudget office is predicting
something like 16 million Americanswill lose Medicaid coverage.
Mm-hmm.
That's going to be devastatingfor particularly this field
that you and I are working in.
(19:41):
Medicaid is the largest provider of funderof treatment services in this country.
Well, and talk about rural people.
I mean kids, what is it, 40% of thekids in this country are on Medicaid.
Yes.
So we're talking about you take that away.
Where are they gonnaget access to treatment?
(20:01):
A lot of these folks are working.
Yes.
We're not talking about, youknow, folks who are unemployed.
We're talking about millionsof Americans who are working
and who are receiving Medicaid.
75%.
Yeah.
Yeah.
Exactly.
And so that will be devastating.
And I don't know how we make up for that.
(20:24):
Going back to your earlier point aboutfederal funding there are a number of
these grants programs, for example,that are administered by SAMSA.
A lot of those grant programs makeup the gaps for supporting services
that aren't covered by Medicaid.
So here we are, we're gonna takeMedicaid away, and then we're gonna
(20:45):
put extra strain on these grants thatare also being cut or eliminated.
And you can kind of see you'rein the tunnel and you see
the freight train coming.
And we are gonna have to see howwe deal with the approaching train.
Well, so let's go back thento if you had in a room every
(21:08):
legislator or local representative.
What do you wish they understood?
I mean, I wish they understoodthe gravity of Medicaid cuts.
I will say that personally.
Personally, I think that, you know,we know Medicaid is the largest
funder of Medicaid supported,or of treatment services.
(21:31):
And the cuts to Medicaidwill be disastrous.
I want them to understand that forpeople who are in pain and they're not
physical pain or mental pain, it's notillogical to seek relief from that pain.
And if you can't go to a doctor or anemergency room and get treatment and help,
(21:58):
it's not illogical to go to the streets.
And that's what unfortunatelyis what's going to happen.
It's not a moral failing.
It is, you know, partof the human condition.
And
I've been very impressed with anumber of members of Congress who
(22:20):
have stepped forward and talked abouttheir own family's struggles and kind
of made this a very personal issue.
And just appealing tothe humanity of everyone.
Everyone has stories, everyone hasloved ones who've been impacted
in some way by this epidemic.
(22:42):
And kind of appealing tothat sense of humanity.
Every time there's an economic downturn orsomething, we see the usage levels go up.
I mean, recent history, just look at,I know it's a different issue, but
when COVID hit, alcohol usage wentthrough the roof and it's still is high
in many, in many communities right?
(23:03):
Absolutely.
Yep.
Absolutely.
And so we can predict, I think right,as you have less access to treatment
and resources and an economic downturnthat you might end up seeing a
rise in some of the substance use.
It's not speculations, this isn'tLibby Jones telling you like
what I see in my crystal ball.
We know, we've seen this before.
(23:26):
Yes, we have.
To your point about COVID.
Exactly.
We saw this in the early two thousands.
As pain medication prescribingwent up and then the federal
government, the state governmentsput the hammer down on prescribing.
Yep.
Then what happened?
It forced people to street drugs,and people were forced to do that
because treatment wasn't available.
(23:48):
There are so many examples in recenthistory where this has happened.
This isn't speculation.
We know what's going to happen.
And this is not the time againto, to take your foot off the gas.
No.
It's a straight linefrom Vicodin to fentanyl.
Exactly.
Yeah.
So what gives you hope?
Because clearly you can't do this dayto day without thinking We got a shot.
(24:13):
Yes, let me just say this.
I feel like I'm extremely luckythat every day I get to go to work
and I get to fight for somethingthat I'm really passionate about.
Right.
At the end of the day am a girl fromWest Virginia who has kind of made
(24:33):
it my life's mission to give back tomy community, and I realize that that
is a privileged position to be in.
What gives me hope ismeeting people in recovery.
What gives me hope is going to thejail and talking to people who are
incarcerated about, you know, now thatthey have access to treatment, that
(24:58):
they're hopeful for their futures.
The more time you spend talking to peoplein recovery, talking to folks who've
overcome their substance use disorder.
There's no way that you can't be hopeful.
And that you wanna goout and keep fighting.
Last week I was, I told my team this, wewere, we had a series of hill meetings one
(25:24):
day last week, and we were going from thehouse to the Senate, to the house, to the
Senate, and it is hot, and it is humid.
It is just almostunlivable in DC right now.
And when I got home from being, youknow, all these hill meetings, both of
my feet were literally bleeding, right.
Just, it was, it was a, a rough day right.
(25:45):
To be walking back and forth.
But you know what, I would do thatevery day if, you know, because we were,
we were there with people who we wereaccompanying a, a police chief from Ohio
and his team that were talking aboutthe work that they're doing with people
who experience non-fatal overdoses.
(26:05):
And, you know, the amount of I,there was no shortage of amazing
stories that this crew shared withus, and that is, is reason for hope.
Awesome.
Because the more, again, you can'tdeny that these stories have power.
(26:27):
And that's what keeps me going.
Awesome.
Libby, I'm so glad you could join us.
I coincidentally, last night, I hearda young woman, I think her name was
Kyla Scanlon she wrote a book calledIn This Economy and she was on the
Comedy Central with John Stewart.
Yeah.
And he asked her a question about howis it that the Defense Department and
(26:48):
other departments see a raise in whatthey get, even though they've never
had an auditor can pass an audit.
And then we're cuttingsome of the other programs.
And she said they have advocates.
And people on Medicaid don't.
Well, I'm so glad that they do,and that you're one of them.
We are out there and we'refighting the good fight.
I mean, literally tillour feet are bleeding.
(27:10):
There's a whole contingency here inDC that are fighting for Medicaid
and for access to healthcare.
I mean, you read in my bio and atthe start of the podcast, I'm not
an addiction medicine specialist.
I actually have no medical background.
I have a graduate degree in humanrights, which my parents still can't
(27:33):
understand how I could be employed.
Right.
That's what this is.
It's a human rights struggle.
And you know, that's somethingthat I think about often.
It's about just basic human rights.
And that's why we're out here fighting.
And decency.
As always, for those of you who areinterested, there's links to the resources
(27:54):
for the Overdose Prevention Initiativeand Ms. Jones attached the podcast.
Libby, thanks so much.
Let's do this again as we seethe effects down the line.
Yeah, let's do this.
Yeah.
Thank you for listening, watching.
We hope you find, help,support wherever you are.
As always, thank you for listening.
Be safe.
Never give up and keep walkingeven when your feet are bleeding.
Welcome everybody.
This is Avoiding Addiction Affliction,brought to you by Westwords Consulting,
the Kenosha County Substance Use DisorderCoalition, and by a grant from the state
of Wisconsin's Dose of reality, realtalks that reminds you that opioids are
powerful drugs and that one pill can kill.
I'm Mike McGowan.
How many times have you heardpeople say about our government?
(00:34):
Yeah, but what are you gonna do about it?
Well, while some of us wonder howanything in our government ever gets
done, some people actually work withthe government and get things done.
Libby Jones, my guest today,is one of those people.
Libby is the program director atthe Overdose Prevention Initiative.
She has a Bachelor of Science degree withan emphasis on government from William
(00:56):
and Mary and a Master's of Sciencedegree with an emphasis on human rights
from the London School of Economics.
Her job is to build governmentalsupport for programs that help
people with substance use disorderissues, who have little or no voice.
God bless you, Libby.
Thanks for being with us.
How are you?
Oh, I'm great.
Thanks for having me,this is gonna be fun.
(01:18):
Oh, I am looking forward to this so much.
Well, first I would start out withthe general, tell us about the
Overdose Prevention Initiative.
Yeah, so the Overdose PreventionInitiative, we are a DC based group
that focuses on advancing federalpolicies, kind of in three main areas.
One is expanding access to treatment forAmericans with substance use disorder.
(01:43):
The second is reducing the overalldeath toll from overdose in America.
And the third is really tobreak stigma around substance
use from a policy standpoint.
We are non-partisan.
Every day our team workswith congressional offices
on both sides of the aisle.
(02:03):
We are walking back and forthfrom the house side to the Senate
side pretty much every day.
And we work with federal agenciesthat on both the public health side
of the shop and also law enforcement.
'Cause really we have to haveboth of them at the table for
a lot of these discussions.
But ultimately what our goal is, isto find real policy solutions that
(02:25):
will save lives at the end of the day.
Well, you also focused a loton I was reading your stuff on
people who are incarcerated.
Yes.
And I told this, I talked topeople about this all the time.
People who are in jail areeventually gonna get out, right?
And if they don't addresstheir substance use disorder
issues, they're going back in.
Right?
Right.
So what does effective treatmentlook like in those settings?
(02:49):
Your point about folks getting outis exactly why it's so important.
Incarceration is one of thosekey intervention points, right?
We need to make sure as, as acollective, as a society, that we have
no wrong door to treatment, right?
People are gonna need treatment.
Some will need treatment, you know, cometo ask for treatment in an emergency
(03:12):
room, in an ambulance, but a lot aregoing to have that clarity that they
need treatment during incarceration.
So we do have an obligation to meetpeople where they are and in that moment.
But also, our work isabout overdose prevention.
We are trying to reduce the burden ofdeath in this country from overdose,
and we have a lot of data that showsthat people who are immediately
(03:37):
released from incarceration aresome of the most vulnerable folks
in our society to die from overdose.
There's one study that we citefrequently that says folks with an
untreated substance use disorderare 129 times more likely to die in
the first two weeks after release.
(03:58):
So it's not just a good to have, it'sa must have if we are going to address
that the overdose deaths in this country.
And we are working really closelywith members of Congress to kind
of educate them on this point.
So one of the things that wedid you know, you talk about
giving a voice to the voiceless.
(04:20):
People who are incarceratedcannot effectively lobby
their members of Congress.
So we had to bring membersof Congress to the jail.
So last year we organized a field trip.
We took members of the CongressionalAddiction Treatment and Recovery Caucus.
There were about seven members of Congressand the White House drugs are, we took
(04:42):
them on a field trip to the FairfaxCounty Detention Center in Virginia.
And we kind of arranged it withSheriff Kincaid and Fairfax County so
that these members of Congress couldgo and spend about 90 minutes in the
cell block talking to people in theirjail population who are for the first
time receiving treatment behind bars.
(05:04):
And it's those types of experiences whichare so helpful to getting policy makers to
understand the power and the impact thattreatment during incarceration can have,
and it's treatment during incarcerationhas a direct impact on saving lives.
(05:24):
And we also believe that treatmentduring incarceration will lead to
safer communities and healthiercommunities on the outside.
'Cause your point is well taken.
Recidivism will continue if wedon't stop that cycle of addiction.
I'm sure you've heard it.
What do you say to those peoplethat say, well, forced treatment,
forced education just doesn't work.
(05:46):
I mean, we're not talkingabout forced treatment.
What we're talking about ispeople who are incarcerated.
Sometimes this is the first healthcareencounter they're going to have.
This is gonna be a chance to be screenedfor these substance use disorders, and
we need to have it available duringincarceration if people want it.
I don't disagree.
(06:07):
There's evidence that shows thatforced treatment doesn't work.
However, it's a key intervention point.
And if someone who's recently beenarrested or who is being incarcerated,
if they need and they wanttreatment, it needs to be available.
So that's kind of my take on it.
(06:27):
Well, and you never know you right?
You never know when somebody'sgoing to get the aha moment.
Or when I worked in the jail,sometimes you would see people curled
up so the other inmates couldn'tsee them reading the big book or,
or one day at a time, and it's likesomething's clicking there right?
Right, right.
We've gone to tour multiple jails,and when you speak to people who
are incarcerated, who for the firsttime have been offered treatment
(06:51):
during incarceration, it can be verytransformational, you know, and it
changes the trajectory of people's lives.
I agree.
I don't think that forcedtreatment is viable for most folks.
Right.
It just doesn't stick.
We have evidence that shows thatforced treatment is not effective.
(07:14):
But what we do know is that thatintake point, you know, at the time
of arrest during incarceration, isa very critical point for a lot of
people who need treatment, and it'sa tragedy when they, you know, need
that treatment and it's not available.
You know, in 2022, you helped, yourorganization helped Congress pass the
(07:34):
Mainstream Addiction Treatment Act.
For those unfamiliar withit, talk about that a minute.
Oh the MAD Act is what we callit, but this bill will always
be very close to my heart.
The United States has a historyof making it harder than it
needs to be to get treated right?
(laughs)
(laughs) Yup.
(07:54):
You, you know this, right?
And before the passageof the MAD Act in 2022.
Only about, and this is an HHSfigure, only about 7 to 10% of US
physicians had the ability to treata person with opioid use disorder.
And that's because, again, we makeit more difficult than it has to be.
(08:16):
There were outdated federal regulationsthat made it unnecessarily difficult
for doctors to prescribe medicationsto treat opioid use disorder.
So before the MAD Act, these federalregulations required doctors to
seek additional medical trainingoften at their own expense.
File additional paperwork with the DEAto get special registrations and, you
(08:42):
know, welcoming additional oversightover their prescribing records.
I know a lot of doctors.
I'm sure you do too, and I don't knowany doctors who willingly want to have
more paperwork and more oversight.
Right.
And so as a consequence of, youknow, essentially well-meaning
federal regulations, we then have,we've tied our own hands, right?
(09:05):
7 to 10% of physicians couldprescribe just as the overdose
death rate was soaring.
And so what we neededwas all hands on deck.
We couldn't tie our own hands anymore.
So our group worked with a number,hundreds of other organizations across
(09:26):
the country to get this bill passed.
And I think one of the things that wasso overwhelming for me was to see public
health groups, faith-based groups, lawenforcement groups all coming together
to fight for this piece of legislation,which ultimately what it did was it
(09:49):
removed those barriers for medicalproviders to provide this medication.
Because the unintended consequenceis not just we needed a
higher number of prescribers.
I think what's clear, particularly nowthat those federal barriers have been
removed, is how much stigma t hat wascreated by these federal regulations.
(10:14):
Right?
There's this idea that, well, if it'shighly regulated by the feds and we
have to go through all these hoops,then there's something inherently
wrong about this medication.
There's something that isdangerous about this medication or
treating these types of patients.
The bill passed at the end of 2022,but it's going to take years, if
(10:39):
not decades, to combat that stigmathat's associated with this.
And that's a lot of the work that ourteam does, is we recognize that there
are policies that creates stigma,that create unnecessary barriers,
and that's what we've gotta go after.
Well, so that begs the question then.
How do you go, and thisis a big one I know.
(11:00):
How do you go about educatingthose who can enact change?
Because what you're working dailywith people where this is not
their number one area of expertise,it's down the list of ways.
Yep.
No, I mean, you're exactly right.
You know, in my opinion.
Stigma kills.
Mm-hmm.
The impact is of stigma aloneagainst people who use drugs.
(11:24):
There's a stigma against help seeking.
And we need to really workon that on a societal level.
What we try to do isreally humanize addiction.
When we're working with members ofCongress this is one of the issues that,
one of the increasingly rare issueswhere there's true bipartisanship.
(11:44):
And the reason why is becausethere are 535 members of Congress.
Every single one of them has peoplewho have died of overdose, who are
struggling with a substance use disorder.
And so it doesn't matter if you representa rural community or an urban community.
This is in your district.
(12:06):
And I think that helps us when we'reworking with these offices because
every member of Congress wants tofind solutions to this problem.
And we really have to humanize this issue.
There was a survey that came out, Ibelieve, as in 2023 that said that
one in 10 Americans have a lovedone who has died of an overdose.
(12:27):
That's overwhelming.
For me, what I have foundthe most effective tool in
combating stigma is stories.
Getting your story out there.
There's no better way ofhumanizing this issue.
And I think it takes a tremendous amountof courage, but I'm always overwhelmed
(12:47):
by the family members or the people whoare in recovery who go to their member
of Congress and tell them their story.
That is really key.
In terms of kind of thetactics that we use.
We are sending all these great storiesand case studies up to Capitol Hill.
But you know, one of the thingsthat we did, which I think has
(13:08):
been helpful is my team organizesa Naloxone training for members of
Congress and their staff every year.
Every September to commemorateNational Recovery Month, we will
bring in usually their med studentswho do a Naloxone training.
And I have witnessed this, I've watchedthis with my own eyes and you know, you
(13:32):
put the Narcan dose in someone's hand,you show them how easy it is to do, and
you talk about how it's effective, youknow, 75 to a hundred percent of the time.
And it's empowering and once you holdit in your hand and you realize how
easy it is, that is a great way ofcombating that stigma that people
(13:55):
have about harm reduction, about,you know, people who use drugs.
So there are certain things, youknow, certain tricks that we up
our sleeve, I guess you couldsay, in telling these stories.
Well, let alone if they ever havethe opportunity, as I'm sure you
have and I have, of watching someonewho's overdosing be administered...
(14:17):
And just see them come back.
It seems like a trick, you know.
I mean, it's called theLazarus drug, right?
Yeah.
It's amazing.
And I think that things like Naloxonetrainings are also empowering, right?
Mm-hmm.
You're like, I can do something, right?
I am armed with this littledevice that I can keep with me.
(14:39):
One member's office contacted us afterone of the Naloxone trainings that
we did, and they reported that one oftheir staffers had revived someone.
Awesome.
It was a bystander here in DC And thatthey had saved somebody's life with the
(15:00):
Naloxone training that we had provided.
I mean, and that just givesyou goosebumps, right?
That you do this to be educationaland you know, just to hear that
almost immediately it was put intopractice is pretty, pretty cool.
Well, you mentioned that themembers of Congress represent all
facets of society from urban torural, to suburban to whatever.
(15:23):
And you know, to ask the hard ones,in the last seven months we've seen
slashing of funding for programs.
We've had people on herewhose programs have been cut.
Yeah.
What do you think about that?
And talk about some ofyour wins at the same time?
(15:43):
I guess.
I mean, it's devastating.
You know, you're talking to folkswhose programs are getting cut.
We have had in the last 12months a lot of progress.
You know, in terms ofdrug overdose deaths.
For the first time in manyyears, we are seeing progress.
(16:05):
For me, it seems counterintuitiveto take your foot off the gas as
soon as you start seeing results.
You know, I understand that there'sa lot of pressure on cutting budgets
and reducing the deficit, but itseems like why would you cut these
programs that are actually working?
Right?
If you're looking to cut programs that areinefficient or ineffective, don't cut the
(16:28):
programs that are literally saving lives.
It just, it doesn't seem tomake a whole lot of sense.
I am personally concerned that thecuts that we're putting into place
now will take years to correct.
Yeah.
My team has heard me say thisbefore, but when the overdose crisis
(16:52):
really took off, right when itreally was reaching crisis levels.
As a nation, we looked to the addictionmedicine community to kind of build
the plane as they were flying.
Right?
In 2018, Congress passed theSupport Act that gave a lot of local
(17:12):
community grant programs right.
To enable communities to literallybuild the plane as they're flying.
They were trying to figureout what's gonna work.
Five years from that, we're seeingthat these programs are working right.
And now those same people that weput in the place of having to build
(17:33):
the plane as they were flying itare now being asked to jump out
of that plane without a parachute.
Right?
(laughs) And, you know, howare we going to make that up?
I don't know.
But all I do know is that weneed to keep the momentum going.
And these programs that we're talkingabout are worth the investment.
(17:54):
You know, we talk aboutreturn on investment.
Every life saved from treatment or harmreduction, every life saved, that's
a person who can go into recovery.
And a person in recovery youknow, those folks are employable.
They pay taxes, they takecare of their families.
(18:14):
I can't think of other programsthat have a more direct impact on
building safer, healthier communities.
There are 23 million Americansthat are in recovery.
Each of those people have loved ones.
They're taking care of theirfamilies and their jobs.
We can't pull the rug out now.
(18:35):
And you also addressed the disparity thatcomes with socioeconomics and there's
a lot of disparity when it comes tosocioeconomic status in our country.
Oh, absolutely.
That's something that weare very, very sensitive to.
You know, we believe that it shouldn'tmatter your race, where you live,
what your income is, or what yourinsurance level is, everyone should
(18:59):
have access to these resources.
We know there are huge disparitiesamongst, for example native
American, Alaska native populations.
They have the highest percapita overdose death rate.
We need to be focusing on that.
Black Americans have a much higheroverdose death rate than white
(19:20):
Americans, but also, whether ornot you're covered by insurance.
That is something if the Congressionalbudget office is predicting
something like 16 million Americanswill lose Medicaid coverage.
Mm-hmm.
That's going to be devastatingfor particularly this field
that you and I are working in.
(19:41):
Medicaid is the largest provider of funderof treatment services in this country.
Well, and talk about rural people.
I mean kids, what is it, 40% of thekids in this country are on Medicaid.
Yes.
So we're talking about you take that away.
Where are they gonnaget access to treatment?
(20:01):
A lot of these folks are working.
Yes.
We're not talking about, youknow, folks who are unemployed.
We're talking about millionsof Americans who are working
and who are receiving Medicaid.
75%.
Yeah.
Yeah.
Exactly.
And so that will be devastating.
And I don't know how we make up for that.
(20:24):
Going back to your earlier point aboutfederal funding there are a number of
these grants programs, for example,that are administered by SAMSA.
A lot of those grant programs makeup the gaps for supporting services
that aren't covered by Medicaid.
So here we are, we're gonna takeMedicaid away, and then we're gonna
(20:45):
put extra strain on these grants thatare also being cut or eliminated.
And you can kind of see you'rein the tunnel and you see
the freight train coming.
And we are gonna have to see howwe deal with the approaching train.
Well, so let's go back thento if you had in a room every
(21:08):
legislator or local representative.
What do you wish they understood?
I mean, I wish they understoodthe gravity of Medicaid cuts.
I will say that personally.
Personally, I think that, you know,we know Medicaid is the largest
funder of Medicaid supported,or of treatment services.
(21:31):
And the cuts to Medicaidwill be disastrous.
I want them to understand that forpeople who are in pain and they're not
physical pain or mental pain, it's notillogical to seek relief from that pain.
And if you can't go to a doctor or anemergency room and get treatment and help,
(21:58):
it's not illogical to go to the streets.
And that's what unfortunatelyis what's going to happen.
It's not a moral failing.
It is, you know, partof the human condition.
And
I've been very impressed with anumber of members of Congress who
(22:20):
have stepped forward and talked abouttheir own family's struggles and kind
of made this a very personal issue.
And just appealing tothe humanity of everyone.
Everyone has stories, everyone hasloved ones who've been impacted
in some way by this epidemic.
(22:42):
And kind of appealing tothat sense of humanity.
Every time there's an economic downturn orsomething, we see the usage levels go up.
I mean, recent history, just look at,I know it's a different issue, but
when COVID hit, alcohol usage wentthrough the roof and it's still is high
in many, in many communities right?
(23:03):
Absolutely.
Yep.
Absolutely.
And so we can predict, I think right,as you have less access to treatment
and resources and an economic downturnthat you might end up seeing a
rise in some of the substance use.
It's not speculations, this isn'tLibby Jones telling you like
what I see in my crystal ball.
We know, we've seen this before.
(23:26):
Yes, we have.
To your point about COVID.
Exactly.
We saw this in the early two thousands.
As pain medication prescribingwent up and then the federal
government, the state governmentsput the hammer down on prescribing.
Yep.
Then what happened?
It forced people to street drugs,and people were forced to do that
because treatment wasn't available.
(23:48):
There are so many examples in recenthistory where this has happened.
This isn't speculation.
We know what's going to happen.
And this is not the time againto, to take your foot off the gas.
No.
It's a straight linefrom Vicodin to fentanyl.
Exactly.
Yeah.
So what gives you hope?
Because clearly you can't do this dayto day without thinking We got a shot.
(24:13):
Yes, let me just say this.
I feel like I'm extremely luckythat every day I get to go to work
and I get to fight for somethingthat I'm really passionate about.
Right.
At the end of the day am a girl fromWest Virginia who has kind of made
(24:33):
it my life's mission to give back tomy community, and I realize that that
is a privileged position to be in.
What gives me hope ismeeting people in recovery.
What gives me hope is going to thejail and talking to people who are
incarcerated about, you know, now thatthey have access to treatment, that
(24:58):
they're hopeful for their futures.
The more time you spend talking to peoplein recovery, talking to folks who've
overcome their substance use disorder.
There's no way that you can't be hopeful.
And that you wanna goout and keep fighting.
Last week I was, I told my team this, wewere, we had a series of hill meetings one
(25:24):
day last week, and we were going from thehouse to the Senate, to the house, to the
Senate, and it is hot, and it is humid.
It is just almostunlivable in DC right now.
And when I got home from being, youknow, all these hill meetings, both of
my feet were literally bleeding, right.
Just, it was, it was a, a rough day right.
(25:45):
To be walking back and forth.
But you know what, I would do thatevery day if, you know, because we were,
we were there with people who we wereaccompanying a, a police chief from Ohio
and his team that were talking aboutthe work that they're doing with people
who experience non-fatal overdoses.
(26:05):
And, you know, the amount of I,there was no shortage of amazing
stories that this crew shared withus, and that is, is reason for hope.
Awesome.
Because the more, again, you can'tdeny that these stories have power.
(26:27):
And that's what keeps me going.
Awesome.
Libby, I'm so glad you could join us.
I coincidentally, last night, I hearda young woman, I think her name was
Kyla Scanlon she wrote a book calledIn This Economy and she was on the
Comedy Central with John Stewart.
Yeah.
And he asked her a question about howis it that the Defense Department and
(26:48):
other departments see a raise in whatthey get, even though they've never
had an auditor can pass an audit.
And then we're cuttingsome of the other programs.
And she said they have advocates.
And people on Medicaid don't.
Well, I'm so glad that they do,and that you're one of them.
We are out there and we'refighting the good fight.
I mean, literally tillour feet are bleeding.
(27:10):
There's a whole contingency here inDC that are fighting for Medicaid
and for access to healthcare.
I mean, you read in my bio and atthe start of the podcast, I'm not
an addiction medicine specialist.
I actually have no medical background.
I have a graduate degree in humanrights, which my parents still can't
(27:33):
understand how I could be employed.
Right.
That's what this is.
It's a human rights struggle.
And you know, that's somethingthat I think about often.
It's about just basic human rights.
And that's why we're out here fighting.
And decency.
As always, for those of you who areinterested, there's links to the resources
(27:54):
for the Overdose Prevention Initiativeand Ms. Jones attached the podcast.
Libby, thanks so much.
Let's do this again as we seethe effects down the line.
Yeah, let's do this.
Yeah.
Thank you for listening, watching.
We hope you find, help,support wherever you are.
As always, thank you for listening.
Be safe.
Never give up and keep walkingeven when your feet are bleeding.
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