Title X and America’s Substance Use Crisis

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To Fight the Opioid Epidemic and Protect Women’s Health, We Need All Tools in the Toolkit, and that Includes a Strong Title X Program

This Woman’s History Month, we want to highlight a public health program that throughout its history has played a key role in giving women a critically important entry point into the health care system: The Title X Program. Title X funds the nation’s program for affordable birth control and reproductive health care at Planned Parenthood health centers, community health centers, and more (if you’ve ever received a pap test for free, you’ve probably got Title X to thank for it).

Despite a decades-long track record of providing vital care to millions, the Title X program is currently threatened by rules proposed by the Administration that would censor health care providers that participate in the program from having open, honest and complete conversations with their patients. The proposed rule on Title X could cut access to care for over four million patients that rely on the program, as well as the efforts to combat the opioid epidemic.

Here are three reasons the Title X gag rule threatens the fight against the opioid crisis:

  1. Title X health centers screen patients for substance use and refer them to appropriate secondary care services, like addiction treatment. These centers help fill the gap of an already under-resourced problem. Since the vast majority of women who receive services through Title X-funded health centers report it as either their sole source or primary source of care, these centers are absolutely vital in early identification and treatment of behavioral health conditions, an essential component of addressing the opioid epidemic.
  2. Women with low-incomes, like those disproportionately struggling with substance use disorders, are more likely to report that Title X health centers are their main or only source of health care. What’s more, the use of illicit substances is connected with increased rates of sexually transmitted infections (STIs) and other infectious conditions. All of these factors point to the critical role that the Title X program plays in America’s fight against the opioid epidemic.
  3. Women with substance use disorder need to have complete information from their doctors about preventing pregnancy, continuing a pregnancy, parenting, adoption and abortion. As Dr. Mishka Terplan, an ob-gyn and addiction-medicine specialist has explained, “most pregnancies among women with opioid use disorder are unplanned. …This disparity in unplanned pregnancies between women with and without a substance use disorder is directly related to the availability of family planning services — as a large percentage of women with substance abuse disorder report no contraceptive use and very few utilize highly effective methods such as implants or IUDs.”

Look, the simple fact is every day in America, 42 women die from opioid overdoses. The opioid crisis is severely underfunded as it is, making the preservation of access to programs that currently help combat the opioid epidemic essential. Title X is one of those critical programs.

But it’s not just women with substance use disorder who are at risk from this rule. All women, no matter who they are, where they live, or how much money they make, must be able to trust that their health care providers are giving truthful and complete health information. Because this gag rule destroys the patient-provider relationship and intrudes in a provider’s practice, the American Nurses Association, the National Association of Community Health Centers, the American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists (ACOG), and others have stepped forward to oppose the gag rule on Title X.

What better time than Women’s History Month to rededicate yourself to fighting for effective policies that are proven to help address the opioid epidemic, while increasing access to vital health care services for those most in need?


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