New Opioid Funding is a Welcome Start, But More Will Be Needed

New Opioid Funding is a Welcome Start, But More Will Be Needed

A $6 billion boost to fight the opioid epidemic - $3 billion in 2018 and $3 billion in 2019 - was a highlight of the 2-year, $400 billion federal budget passed last week by Congress.

The injection of new funding will go toward state grants, public prevention programs and law enforcement, to combat the catastrophic loss of lives, disruption of families and impact on society at large of the opioid epidemic.

Senate Majority Leader Mitch McConnell (R-Ky) said the spending bill will "bolster our ongoing national struggle against opioid addiction and substance abuse. It will fund new grants, prevention programs and law enforcement efforts in vulnerable communities all across our country."

It's only a beginning

According to many experts, however, the $3 billion a year is only a fraction of what it's going to take to really make a difference.

A recent financial analysis by the White House's own Council of Economic Advisers found that the opioid epidemic cost the economy $504 billion in 2015 - six times more than earlier studies have indicated. And since then the problem has been getting worse, not better.

The colossal blow of the opioid epidemic to the nation's economy equals nearly 3 percent of the gross domestic product (GDP) - equal to the investment in commercial real estate across the entire nation, and roughly three-quarters of the annual defense budget.

In late 2016, after years of dickering, Congress finally approved $1 billion in state grants for the opioid epidemic, through the 21st Century Cures Act. Some earlier funding had been made available through the Comprehensive Addiction and Recovery Act (CARA).

Meanwhile, the White House sent it's $4.4 trillion budget proposal for fiscal year 2019 to Congress on Monday, February 12, just three days after Congress approved it's 2018 / 2019 spending bill. It contains big increases in military spending, infrastructure, the border wall, and additional funding to combat the opioid epidemic.

President Trump's proposed budget adds more than $7 trillion in new debt by the end of the decade, while it proposes spending $57 billion less than what Congress just authorized.

However, for fiscal year 2019, it does propose nearly $17 billion to fight the opioid epidemic, with a total of $30 billion for all drug control efforts.

Public health emergency

In late 2017, President Trump declared the opioid epidemic a "public health emergency." But after months of waiting with no announcements of additional funding, many suspected the current administration had little intention to address the problem.

In November, the Centers for Medicare and Medicaid Services made a policy change allowing states to apply for waivers to use Medicaid to pay for residential drug treatment at facilities that have more than 16 beds. Some states are already taking advantage, according to news reports.

In early January, President Trump signed the bipartisan Interdict Act giving federal agents more tools to curtail opioid trafficking. When the funding is made available, this might help stem the tide of fentanyl products arriving via the US mails and otherwise from China and elsewhere.

Less than a minute

In his 80-minute State of the Union address two weeks ago, Trump spent less than a minute talking about the opioid epidemic.

"We must get much tougher on drug dealers and pushers if we are going to succeed in stopping this scourge," the President said. "My administration is committed to fighting the drug epidemic and helping get treatment for those in need, for those who have been so terribly hurt. The struggle will be long and it will be difficult but, as Americans always do, in the end, we will succeed, we will prevail."

And most recently, Trump told a mixed bag of pro- and con-Trump workers in Cincinnati that the opioid epidemic "has never been worse. People form blue ribbon committees. They do everything they can. And frankly, I have a different take on it. My take is you have to get really, really tough, really mean with the drug pushers and the drug dealers."

The dig at blue ribbon committees suggesting they have been ineffective refer to one he convened himself last year, that was chaired by former New Jersey Governor Chris Christie. Called the President's Commission on Combating Drug Addiction and the Opioid Crisis, it issued more than 50 recommendations, which the Trump administration so far has largely ignored.

DEA stepping in

A change in DEA regulations in January allows mid-level Nurse Practitioners and Physician Assistants to register and prescribe buprenorphine. And the new spending bill expands the role of physician assistants to "attending physician" for hospice patients.

Meanwhile, Attorney General Jeff Sessions announced in January that a DEA program called the Opioid Fraud and Abuse Detection Unit, that he introduced last August, has begun its nationwide investigation using patient medical data to identify pharmacies and drug prescribers issuing unusual or disproportionate or suspicious amounts of opioids.

At Novus, we closely follow the political and economic ramifications of the opioid epidemic. But day to day, we are fully focused on providing the most effective medical detox available. Our intention is always to help patients achieve their first step on the way to a sustainable sobriety.

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