972BC3C458F1ED198725846D006DEE77 Hearing Summary

Julie Reiskin, Colorado Cross-Disability Coalition (CCDC), presented on the barriers persons with disabilities experience when trying to access treatment for SUD.  Ms. Reiskin referred to a PowerPoint during her presentation (https://leg.colorado.gov/sites/default/files/images/committees/2017/sud_treatment_barriers_legislative.fin__0.pdf ).

Kate Nicolson, CCDC, spoke about her professional experience with the Americans With Disabilities Act (ADA).

Ms. Reiskin explained that in order to address the needs of persons with disabilities, SUD treatment providers must provide effective communication including American Sign Language; provide or allow personal assistance; and modify policies, practices, or procedures unless it causes a fundamental alteration to the policy, practice, or procedure. She explained that many of the services needed do not cost money but require awareness, cultural competency, and training.

Ms. Nicolson discussed ways to change attitudes around treating persons with disabilities.  Ms. Reiskin suggested that treatment providers could allow a patient's caregiver to provided services in the treatment facility at no cost to the facility.

Ms. Nicholson told the committee that individuals with disabilities are facing extreme barriers to receiving SUD treatment.  She suggested that some barriers are related to the demonization of opioids, conflating addiction and dependence, and treating all use as misuse.

Ms. Nicholson discussed the difference between addiction and dependency. She stated that persons who depend on opioids for pain control cannot find a caregiver who is willing to provide care.

Ms. Reiskin discussed stigmatizing specific populations when they seek care and the lack of attention to their real needs.

Ms. Nicolson explained that some state policies limit care to individuals with disabilities, including prescribing limits and policies that negatively impact access to medication. She also told the committee that people with disabilities who have pain, a substance use disorder, or are in recovery are being abandoned in care. She also stated that some providers refuse to treat this population.  She discussed the negative impact of tapering policies on chronic pain patients. 

Ms. Nicolson discussed issues related to doctors and pharmacists flagging of patients and non-transparent use of medical information She stated that the appropriate response, even to identified drug-seeking behavior, is never dismissal from care.

The committee discussed the problems related to stigma related to substance use.

Ms. Reiskin discussed solutions for addressing the stigma persons with disabilities encounter when seeking care, including: assure state oversight is not making things worse; protect providers that treat complex patients especially those who responsibly prescribe opioids and medication-assisted treatment; provide disability cultural competency training for SUD providers and medical providers; check with disability advocates when advancing any policies related to SUD to assure no inadvertent harm; and require Medicaid and state regulated insurance to have exceptions to morphine milligram equivalents limits.

Committee discussion followed.  Committee members made closing comments.