The House Energy and Commerce Committee on Thursday advanced 32 bills targeting the opioid crisis to the full House for a vote.
The bills advanced after a marathon markup that lasted seven hours. Another package of 25 bills advanced out of committee earlier this month.
“We have a unique opportunity to save lives, and we can’t lose sight of the real-world impact of our actions throughout this process,” said committee Chairman Greg Walden, R-Ore. “We owe it to the families of the more than 115 Americans who die from opioids every single day to come together and advance legislation that can help stem this tide.”
There were some arguments that played out during the markup as lawmakers offered their amendments. Democrats blasted Republicans for voting against debate on one bill, the Addiction Treatment Access Improvement Act, which would allow clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives to prescribe buprenorphine to patients and to expand the number of patients who can be prescribed the medication by a doctor.
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Republicans voted against having a vote on the bill because officials from the Drug Enforcement Administration said they were concerned buprenorphine would be diverted to people who weren’t prescribed it. Rep. Larry Bucshon, R-Ind., said that if the bill were implemented then the drug would “be at serious risk of fraud and abuse and diversion.”
Buprenorphine, also known as Suboxone, helps stave off the painful symptoms people get from opioid withdrawal. It is an opioid as well, but it helps people function normally and is difficult to overdose. Still, it can be life-threatening when people combine it with a class of drugs known as benzodiapenes, which include Xanax and Valium. There also are reports suggesting that people don’t take it as prescribed.
Still, many addiction experts say the restrictions are too strict and get in the way of people receiving treatment.
Rep. Frank Pallone Jr., the top Democrat on the committee, argued that diversion of the drug wasn’t necessarily a negative outcome, suggesting that people were taking it to be treated without a doctor’s help rather than for recreational purposes.
“They would divert it and use it to save their lives, and that’s a bad thing?” the New Jersey lawmaker asked the committee.
“Increasing the number of providers who would be eligible to treat patients would allow more Americans to access the treatment services they need to survive and move toward recovery,” he continued. “I’d rather they get it [from diversion] than have an overdose.”
Rep. Paul Tonko, D-N.Y., the bill’s author, said that people would die without the ability to access treatment.
“Let’s quit the dynamics that are fake, and let’s go forward with a program that has worked that will keep people from using buprenorphine on the street because they can’t get treatment,” Tonko said.
Republicans and Democrats also sparred over a limit on Medicaid known as the “IMD exclusion,” which prohibits hospitals from receiving government reimbursement for mental health or substance abuse disorder treatment if they have more than 16 beds. The decadesold rule was put into effect to spur the development of more community-based facilities, but they never materialized.
Democrats said that encouraging such centers to be built would be a more effective goal, and they also said that the bills did not adequately address other addictions, including alcohol and cocaine.
“Ignoring other addicts or other addictions is not only a great disservice but great injustice,” Rep. Bobby Rush, D-Ill., said, noting that in the past the crack cocaine epidemic had disproportionately affected African-Americans but was not greeted with similar action as the opioid crisis.
Many other bills advanced, including another by Tonko that would expand treatment for people who entered prisons with addictions to opioids. Another bill would give the Food and Drug Administration more authority to intercept illegal drugs that are trafficked through the mail and would allow the agency to bring more nonaddictive treatments for pain to market. An additional bill would allow the Children’s Health Insurance Program, or CHIP, to cover mental health services at the same level as traditional medical care.
Other legislative packages and standalone bills advanced Wednesday in the House Ways and Means Committee, and House leaders hope to pass a legislative package on the floor ahead of the Memorial Day recess to combat overdose-related deaths and addiction that are tied to opioids such as heroin and prescription painkillers, causing more than 42,000 deaths in 2016.
