Some substance abuse treatment advocates and experts charge that lawmakers must add long-term funding to the massive opioid package currently working its way through Congress in order to fully tackle the epidemic.
The Opioid Response Act, passed by the Senate on Monday, includes a slew of proposals to combat the crisis but only minimal funding, with Republicans instead counting on future annual appropriations bills for additional funds.
The Senate and House, which passed its own slate of bills in June, are poised to work out a compromise between the versions of their bills, both of which would expand treatment options, spur development of nonaddictive painkillers, and crack down on the tide of illicit fentanyl flooding into the U.S.
However, advocates say that the legislation should not head to President Trump’s desk without more long-term funding dedicated to expanding treatment for addiction.
“That is crucial if you want to see opioid deaths come down in a significant way,” said Andrew Kolodny, co-director of opioid policy research at Brandeis University.
Kolodny called for new funding of $6 billion a year over the next 10 years. His proposal resembles the CARE Act sponsored by Rep. Elijah Cummings, D-Md., and Sen. Elizabeth Warren, D-Mass., that would give $100 billion over 10 years to states to fight the crisis, which federal data shows killed more than 42,000 Americans in 2016.
The National Council for Behavioral Health also criticized the lack of sustained funding in the package.
“To truly address the root causes of the opioid crisis, we need to invest in the full continuum of behavioral health services,” said Linda Rosenberg, president of the group that represents mental health and addiction treatment providers, in a statement earlier this week. “We need a comprehensive solution. This package of bills does not achieve that.”
Republicans have responded to the criticism of a lack of funding in the package by promising to cobble together funding from other sources. For example, a separate House-Senate conference committee approved an appropriations bill last week that includes $6.7 billion in funding to fight the crisis.
Also, a spending bill in March included $3 billion in opioid funding.
But Kolodny said that one-shot funding isn’t enough.
“It is meaningless without a commitment for long-term funding and without the creation of new funding streams,” he said.
He said that consistent and predictable funding is needed to help establish opioid recovery centers.
Other advocates believe that the final version could include a greater expansion of access to medication addiction treatment. For instance, both the Senate and House versions codify an increase in patients that qualified physicians can treat with the addiction treatment buprenorphine from 100 to 275.
However, the House version allows more people like nurse specialists and nurse anesthetists to deliver the treatment. The Senate version does not include this expansion, something that could be considered in conference.
“You need more providers that are able to provide this treatment,” said Kevin Roy, chief public policy officer for the advocacy group Shatterproof. “Certainly expanding that access to primary care setting as well as other practitioners is one way.”
Kolodny said that both the House and Senate legislation are too favorable to the pharmaceutical industry.
He argued that public-private partnerships work for spurring development of vaccines or rare diseases, which drug companies often neglect because they do not yield sufficient profits. Chronic pain drugs, on the other hand, do not suffer the same problem and shouldn’t be given extra subsidies, in Kolodny’s opinion.
“They don’t need incentives on this, so to me this is a handout to the industry that got us into this mess,” he said.
Sen. Lamar Alexander, R-Tenn., lead sponsor of the Senate bill, said Monday the plan is to meet with House lawmakers to hammer out a final version by Friday. The House would then vote on it next week and the Senate the week after.
However, a formal conference still requires procedural steps that include votes by both chambers, a House aide told the Washington Examiner. Both the Senate and House are out for the rest of this week.
