Congress Takes Steps to Curb Opioid Epidemic

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ACP applauds bipartisan effort, but urges more funding for researching treatment options

Oct. 5, 2018 (ACP) – Though Congress may be divided on many issues, the House and Senate came together in recent weeks in a bipartisan bid to devote more federal resources to halting the opioid epidemic.

The American College of Physicians, which has advocated for the legislation, is pleased but believes more action is needed.

“In general, ACP is supportive of the legislation,” said Brian Buckley, senior associate for legislative affairs. “We believe this bill makes important strides in combating the opioid epidemic through increased access to treatment programs for patients who abuse these substances, increasing education opportunities for physicians who prescribe opioids and removing barriers to ensure that our patients receive access to medications such as buprenorphine and naloxone to treat their addiction.”

Still, more funding for research is needed, Buckley said, and Congress needs to make it easier to treat patients who are struggling with addiction.

Opioid overdoses kill an average of 115 Americans every day, he said.

The House and Senate both approved opioid bills in September and then sent them to a conference committee to work out differences between the two versions. The House and Senate each overwhelmingly passed the revised version.

“If this legislation can save one life, bring help to one person, that is what matters,” said House Speaker Paul Ryan, a Republican from Wisconsin, according to a report in The Hill. “It's going to do far more than that.”

The Opioid Crisis Response Act of 2018, which follows up on the Comprehensive Addiction and Recovery Act in 2016, “contains a mix of law enforcement and public health measures, including one that aims to block deadly fentanyl from being imported through the mail and one that will allow more nurses to prescribe medication for opioid addiction,” The New York Times reported. “Another provision could make it easier for Medicaid recipients to get inpatient care for substance abuse over the next five years.”

In addition, Buckley said, the bill “provides tools for the Food and Drug Administration to address challenges to developing non-addictive medical products to treat pain or addiction through the application of novel clinical trials to test the efficacy of these products.”

“It also supports the use of patient experience data from individuals who use alternatives to opioids,” he said. And, “it includes policies to reduce administrative burdens associated with the use of prescription drug monitoring programs as well as other efforts to improve physician clinical workflow when using these data systems.”

According to The Times, the cost of the legislation wasn't immediately clear, although one estimate put it at $8 billion over five years. Critics say that's not nearly enough. However, a bill to allocate $100 billion over 10 years has not gained significant support, according to The Times.

Though ACP supports the legislation, the College is concerned about the prospect of mandatory requirements that physicians only partially fill opioid prescriptions.

Dr. Ana María López, ACP's president, said that “ACP is concerned that establishing mandatory partial-fill limits without an exception process or opportunity to re-evaluate whether a patient needs additional medication could place a serious burden on patients and physicians alike.”

Buckley said that the legislation authorizes a study by the Secretary of Health and Human Services into the impact of prescribing limits on the incidence and prevalence of opioid overdoses and opioid use disorders. It also would explore whether the impact of prescription limits would increase burdens on physicians.

“ACP would support a careful study and report on federal and state laws and regulations that limit the limit, length, quantity, or dosage of opioid prescriptions so that the effect on the policy on patients is better understood,” Buckley said.

Moving forward, he said, ACP believes that Congress “needs to continue to provide additional funding for research on the most effective non-pharmacologic and non-opioid treatment intervention to use to manage a patients pain.” Additional policies also are needed to remove administrative burdens linked to treating patients with opioid use disorders, Buckley said.

More Information

ACP's letters on opioid legislation, sent to Senate and House leaders, are available on the College's website.

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