House Surprises Everyone by Passing a Bipartisan Package of 18 Bills to Battle America's Opioid Epidemic

House Surprises Everyone by Passing a Bipartisan Package of 18 Bills to Battle America's Opioid Epidemic

Just weeks after the Senate passed the historic Comprehensive Addiction and Recovery Act (CARA) by an overwhelming bipartisan vote of 94-to-1, Congress has again demonstrated broad bipartisan support for the battle against America's opioid epidemic. And then just a few weeks ago, House lawmakers sent an astounding new bipartisan package of no less than 18 bills to the Senate, all of them aimed directly at battling substance use and addiction.

Who of us 5 years ago, or even one year ago, would have dreamed that the House of Representatives would get together in such a rare spirit of bipartisanship? Such a display has been surprising given the past eight years of constant wrangling across the aisles. It's especially heartening for those of us who toil in the field of treatment and recovery. It means our voices are being heard in Washington. And it holds promise for better things to come and, hopefully, better days ahead for millions of Americans seeking recovery. Of course, these bills must still be passed by the Senate. But even at this stage, it's one of the most optimistic signs in troubled times that, when the chips are down, our lawmakers can still come together and try to do what's needed for the good of all.

More Money and Another Crucial Bill Needed

Unless Congress comes up with at least $1 billion, says the White House, what's called for in the new bills cannot be accomplished. Although the House authorized $103 million for the new programs, that's seen as a mere pittance compared to estimates of implementing them. Even more worrisome, Congress failed to say where it expects any of the money to come from. The CARA bill authorized nearly $80 million for drug abuse treatment and prevention programs within the Department of Health and Human Services and the Department of Justice. A month earlier, President Obama had requested $1.1 billion to fight the opioid epidemic. There's been no sign of from where, or even if, Congress will find those funds either. Democrats introduced an amendment to CARA asking for $600 million more in immediate emergency funding. After that move was blocked by the Republicans, and after a lot of arguing, the bill moved forward and was passed without the emergency funding.

TREAT Bill Will Expand Allowable Total Patients

While more money for the 18 new House bills remains fairly critical, another bill needs to be passed by the Senate before the new House legislation can have any effect, says Corey Waller, MD, chair of the legislative advocacy committee for the American Society of Addiction Medicine (ASAM). Waller, a physician and addiction specialist, told MedPage Today that without the provisions in the still-unpassed Recovery Enhancement for Addiction Treatment Act (TREAT), up to 80 percent of the provisions presented in the myriad House bills "could die without reaching committee." The TREAT bill allows qualifying physicians to increase the number of allowed opioid addiction treatment patients. After one year and 24 hours of specialized training, physicians could be approved for "an unlimited number of patients," up from the current 30 to 100 patients.

TREAT also expands the definition of "qualifying practitioner" to include nurse practitioners and physicians assistants licensed to prescribe pain meds in their states. Waller said the provisions of CARA and the TREAT bills taken together "mirror" those included in the 18 new House bills. But the new House legislation "just did it in a bunch of smaller bills." He said that everything in the new House bills has to match the proposed legislation on the Senate side "but that accord isn't currently in place because only the CARA bill has passed." TREAT is still awaiting a vote in the Senate.

Although We Work Hard and Appreciate New Legislation, However…

According to the Centers for Disease Control and Prevention, 44 people die from an overdose of prescription painkillers every day. Drug overdose is the leading cause of accidental death in the U.S. - 28,000 in 2014 - and it has quadrupled since 1999. Obviously, this is a dangerous situation that needs a lot of attention, and we're glad that lawmakers at various levels are taking a stronger interest. But...with all the attention on boosting treatment and recovery resources, sometimes in our enthusiasm some details can get overlooked. Much of the funding being called for by the White House is aimed at supporting medication-assisted treatment (MAT) with little or no funding for traditional abstinence treatment.

The National Institute on Drug Abuse (NIDA), an agency of the National Institutes of Health, points out in its essential 13-point list of the Principles of Effective Treatment that "no single treatment is appropriate for everyone." NIDA says that MAT can help patients "...when combined with counseling and other behavioral therapies" and "...can be an effective component of treatment when part of a comprehensive behavioral treatment program." But just throwing a lot of government money at MAT and throwing MAT at people seeking recovery is a poor approach to treatment and recovery when it excludes intense counseling and a definite timetable to get off MAT and get drug-free.

Here at Novus, we've learned how badly people want their drug-free lives back. We welcome helpful new legislation, but we urge lawmakers to expand their vision to ensure that proper and complete treatment is part of the package.

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