『Inside the White House Drug Policy Office | The Saving Dose Ep. 11 feat. Rob Kent』のカバーアート

Inside the White House Drug Policy Office | The Saving Dose Ep. 11 feat. Rob Kent

Inside the White House Drug Policy Office | The Saving Dose Ep. 11 feat. Rob Kent

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In the eleventh episode of The Saving Dose, Dr. John Hsu and William Pedranti are joined by Rob Kent, former General Counsel at the White House Office of National Drug Control Policy under the Biden administration and a 30-year veteran of New York state government drug policy. He now runs Kent Strategic Advisors, working with treatment providers, advocacy groups, and think tanks to navigate regulators and insurance companies.Rob is one of the few people in this conversation who has been inside the machinery of federal drug policy and is now free to say exactly what he thinks about how it works and where it fails. This episode is the most policy-focused conversation The Saving Dose has had, and it does not pull punches.This episode covers the X-waiver elimination and why removing the barrier did not move prescribing numbers the way anyone hoped, why harm reduction is still the third rail of drug policy, what the Biden administration actually accomplished in its first 18 months before reelection politics took over, why the opioid settlement billions are being misspent in ways Rob believes are worse than the tobacco settlement errors, and what it looks like when an insurance company tells you a person who barricaded themselves in a hotel room and drank the entire minibar did not meet the criteria for inpatient care.00:00 Introduction and Rob Kent's background02:06 Growing up in Syracuse, 30 years in New York state government, White House ONDCP04:00 What the Office of National Drug Control Policy actually does05:32 What the Biden administration focused on: harm reduction, X-waiver, jails and prisons06:49 The biggest challenges: Congress, stigma, and the politics of harm reduction08:33 Why the first 18 months are the window and what happened after10:11 The X-waiver: what it was, why it mattered, and what eliminating it did and did not do12:54 Why removing the barrier was not enough without incentivizing prescribers14:44 John on the X-waiver limiting him to 25 patients and killing the business model16:23 Telehealth and buprenorphine: how COVID blew the door open and what the DEA is doing now18:36 Why too many policymakers still believe addiction is a choice20:03 Proving it works versus winning hearts and minds: Rob's policy approach20:40 OUD as a lifelong condition: why policy needs to treat it like high blood pressure26:00 Medicaid work requirements and what they mean for people in recovery28:47 The opioid settlement billions: why Rob believes the money is being wasted30:16 The death rate dropped 37% after CDC loosened prescribing restrictions in 202231:14 Opioid dependency versus opioid use disorder: two diseases, one stigma33:06 What the Biden CMS guidance on Medicaid in jails actually did34:41 Why guards are the happiest people when MAT is offered in correctional facilities36:33 New York's seven-day acute supply law and what happened when a pain clinic was shut down overnight38:01 How policy swings from one extreme to the other instead of legislating in the middle38:29 John on the 1999 pain as a fifth vital sign movement and what it started42:01 How the Joint Commission and reimbursement incentives built the opioid crisis systemwide43:29 Physicians stopping opioid prescribing entirely out of fear of monitoring44:19 Tylenol and Motrin after a total knee replacement: John on the prescribing overcorrection49:34 Insurance clawbacks: John receives a bill for a patient who died six years after treatment50:17 Rob on insurance companies and where the money in the system actually goes51:04 Kent Strategic Advisors: what Rob does now and who he works with54:05 The insurance company that said a person who barricaded themselves in a hotel room did not need inpatient care55:15 William's experience attending an addiction recovery meeting and why everyone should goAbout the HostsJohn Hsu, MD is the Founder and CEO of iPill and a practicing anesthesiologist with 25 years in pain management and addiction medicine. He has taken multiple products through FDA approval and commercial launch. Connect with John: https://www.linkedin.com/in/john-hsu-md-300a8b2a/William Pedranti is the COO of iPill, a Georgetown Law graduate, and co-founder of PENG Life Science Ventures. He has taken a biotech company from founding through FDA approval, commercial launch, and exit. Connect with William: https://www.linkedin.com/in/williampedranti/Kendra Allen is the CRO of iPill with 20 years in behavioral health revenue strategy, payer contracting, and regulatory navigation. She founded and exited a national healthcare consulting firm. Connect with Kendra: https://www.linkedin.com/in/kendra-allen-cro/About the GuestRob Kent is a former attorney and government official with 30 years of experience in New York state drug policy and addiction recovery. He served as General Counsel at the White House Office of National Drug Control Policy under the Biden administration, where he worked on the X-waiver elimination, harm reduction policy, and expanding...
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