Congress moves closer to approving new resources to combat opioid epidemic
The U.S. Senate passed the Opioid Crisis Review Act (OCRA), a package of proposals to address the country’s opioid epidemic. Congressional leadership hopes to quickly merge the Senate proposal with a package that the House passed earlier this year and send to the White House prior to the midterm elections.
Two related issues delayed what many believed would be a quick passage for a bipartisan proposal that was supposed to be finished by the summer. First, some observers claimed that Senate Majority Leader Mitch McConnell was delaying the debate to prevent some senators up for reelection from claiming a victory. However, McConnell announced that the majority caucus had “cleared” the bill to be debated in the Senate. Instead, the minority caucus raised an objection to a provision in the bill that seemed to provide a grant exclusively to the Addiction Policy Forum, a nonprofit associated with the pharmaceutical industry—thus, a second reason for a delay. Senate leadership reached a compromise to include language in the final House-Senate agreement to broaden eligibility for the grant so that other organizations could compete for funding.
A full summary of OCRA is available here. The Senate bill would reauthorize and build on a state-targeted grant program created under the 21st Century Cures Act, which has been used by states to expand methadone treatment, provide medication-assisted treatment in criminal justice settings, connect individuals to community-based treatment, and expand the availability of naloxone. Other provisions address drug packaging and safety, law enforcement, and the reauthorization of funding for drug courts. OCRA would also require the federal government to determine whether federal and state efforts to limit prescription opioids have affected patients, particularly those with chronic pain patients. One key difference between the Senate and House bills is that OCRA does not contain the House-passed language that lifts a Medicaid prohibition preventing states from using federal Medicaid dollars to pay for mental health treatment in an “institution for mental disease,” or a facility with more than 16 inpatient beds.
Recent government reports continue to highlight the need for additional resources for state-based responses to the opioid epidemic. The annual National Survey on Drug Use and Health found 11.4 million Americans misused opioids in 2017, and 2.1 million Americans had opioid disorders. While these figures are down slightly from the previous two years and the number of new heroin users was cut in half, the number of Americans dying from heroin overdoses continues to rise. One researcher noted, “The reason overdose deaths are skyrocketing is not because of a sudden increase in the number of people switching from prescription to heroin, the reason those deaths started going up is because of a sudden increase in the dangerousness. It’s fentanyl, not more people using.” The Centers for Disease Control and Prevention estimates that of the 72,000 overdose-related deaths in 2017, 30,000 were caused by synthetic opioids.