I echo everybody on the panel who has said that it is critical that we respond with a wide variety of different opioid agonist medications and options for people. We need to dramatically expand access to those medications as first-line treatments for opioid use disorder.
We also know there are some patients for whom those medications are either not an option or something they've tried and that has not been successful for them. I don't think it's okay to just say, “well, I'm sorry, but that's all we have for you.” I think it is reasonable to prescribe people prescription opioid medications in an attempt to stabilize them, support them and reduce their extreme risk of overdose death from consuming fentanyl and other toxic street drugs.
I don't think these are opposing things. I think we absolutely need on-demand, high-quality evidence-based treatment, using the full range of modalities—including injectable opioid agonist treatment, which really has not been expanded at all in our country.
That being said, there will be people for whom, for whatever reason, those medications are not an option or have not worked. We can't abandon that population. We really need to support everybody possible staying alive. It's just not acceptable to have this level of death in our country from something that is ultimately preventable.