Brian Mosley had finished a long day at work when he sat down and wrote a letter to someone he hoped could help.
Mosley, a licensed psychotherapist, has a private practice office in Alum Creek that offers Suboxone treatment to opioid addicts. Because of federal guidelines limiting the number of medication-assisted treatment caseloads that physicians can take on, Mosley routinely got calls from addicts he couldn't help.
That particular March day had been busier because a local substance abuse treatment physician had passed away. Patients inundated Mosley's clinic with calls as they sought help with their problem.
After 1 a.m., Mosley sat down and typed an email to President Barack Obama, asking him to loosen the federal limits on the number of patients that doctors are allowed to treat each year.
Mosley got word last week that the president had not only read his email, but he also wrote him a response.
"I was more like venting, and I actually got a response," Mosley said Thursday.
When he wrote his letter, federal guidelines said physicians could treat only 30 medication-assisted patients the first year and 100 each year after that.
"One of our physicians is at his 100 limit and the other is at her 30 limit," Mosley wrote, in part. "I provide the therapy to these patients and arrange intake for new patients. I receive calls every day asking for an appointment, some of these people even live in other states, many tell me they have called dozens of physicians and clinics, the desperation and sadness of these people is overwhelming. Several times patients waiting for a spot in our clinic have overdosed and died."
Obama wrote back to tell Mosley that the federal Department of Health and Human Services issued a final rule increasing the limit from 100 to 275.
"My administration has been doing everything we can to increase access to treatment, but it won't be enough without more resources from Congress" the president wrote. "That's why I have called on Congress to provide $1.1 billion in new funding to help ensure that all Americans who want treatment for an opioid use disorder can get the help they need. Unfortunately, Congress has repeatedly failed to provide these resources. Congress needs to act quickly because lives are at stake."
A White House representative - after convincing Mosley that she wasn't a prank caller - explained to him that the president takes 10 letters from the public each night to read in the residence.
Mosley said he's impressed that Obama took the time to read his letter, but even though the caseload limits have been extended, that isn't likely to help his patients. The two physicians who work at Mosley's clinic are family physicians and he thinks the extended case limits apply only to board-certified addiction specialists, he said.
He said he's still exploring options for expanding the doctors' case loads.
Mosley, 51, is originally from Logan County. He was trained at Marshall University and has worked at hospitals in Logan and Boone counties. In his 26 years as a therapist in the area, he's seen the opioid epidemic worsen over time, he said.
Mosley said his clinic and others like it face a big stigma. Before he opened the Alum Creek clinic, Mosley counseled patients getting Suboxone treatment in Boone County. The town of Madison asked them to leave or else officials would pass an ordinance outlawing the treatment within town limits, he said.
He's had people ask his patients to use the back door. Others have accused him of running a pill mill. But Mosley understands. The clients he sees are often rough around the edges, he said.
Mosley said before the president's letter, he was beginning to think the government didn't care.
"City government in one town runs you out, and then the president writes you back," he said.
Reach Lori Kersey at lori.kersey@wvgazettemail.com, 304-348-1240 or follow @LoriKerseyWV on Twitter.