In May 2023, CSDAP staff met with Doug Simon, Governor DeSantis’ Director of the Office of Drug Control (a job often referred to as Drug Czar). We asked him to comment on Medication-Assisted Treatment for those addicted to opioids, alcohol or other drugs. Here are his comments, lightly edited for clarity.

Addiction treatment should never be treated with just medication. You need the counselors, you need the support groups. It takes the entire suite. It should never just be medication by itself. That’s a crutch and that can cause other kinds of medical problems, maybe I wouldn’t say that buprenorphine is addictive like all the other drugs but we don’t know the long-term effects if someone is on it for 30 years.

What if you can’t get it, what if you run out, what if you can’t get to their doctor to get the prescription filled. You’ve got to have other coping skills to go about your day. Addiction needs wraparound services. Not only breaking the cycle of addiction, while trying to wraparound from the doctor to the nurse to the social worker to the treatment center. But also wraparound when it comes to treatment and recovery. It requires an all-of-the-above approach.

I think why they stabilize the folks when they come into rehab is to be able to give them some sort of coherence, just get back to feeling a little bit towards normal, not feeling like you’re going to die. So then they can make a clear-headed decision to get the full suite of services. Because if you just kind of stabilize them and shove them out the front door and without the medication, they are definitely going back to their dealer.

It’s easy for people that don’t engage in drug policy very often to use it as a crutch. It’s more than that. It takes a lot more. These folks are coming in with other problems. Not just opioid addiction. 

How do we address the bigger problem of addiction?

The way to make the problem a little bit smaller is we have to prevent drug use from starting. Medication-Assisted Treatment at the end, this is all good and helpful and necessary. But it’s not going to make the problem smaller. It’s almost like the movie Moneyball. You got to think different. What we have to do is reduce the base of customers and we can’t do that if kids start using drugs and they grow into drug addiction.

I advocate for more prevention. Whether it’s school, after school programs. Whether it’s at the home. Whatever it is. It’s that open dialogue with the child. If we can prevent someone from using alcohol or marijuana by the time they’re 21, they have a 90% chance of never falling into addiction. That’s the goal there. 

Some folks are only worried about the treatment after a person becomes addicted. They have to worry about the prevention partners, too. If we don’t prevent drug use before our kids become adults, it makes it so much harder. 

Thank you, Mr. Simon!