Pubdate: Tue, 12 Jul 2016
Source: New York Times (NY)
Copyright: 2016 The New York Times Company
Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html
Website: http://www.nytimes.com/
Details: http://www.mapinc.org/media/298

AN INADEQUATE OPIOID BILL IN CONGRESS

Congress is about to pass a bill meant to deal with the nation's 
opioid epidemic. It contains some good ideas. It will also be far 
less effective at saving lives than it should be.

The Senate is expected to vote soon on the measure, approved by the 
House on Friday by an overwhelming 407-to-5 majority. It would 
authorize addiction treatment and prevention programs to stem what 
has become a scourge and a disgrace - more than 28,600 overdose 
deaths in 2014. But it contains not a penny to support those initiatives.

The bill would allow the federal government to award grants to states 
to treat people who are hooked on prescription painkillers and 
illicit drugs like heroin. In Congress, however, getting a program 
authorized is only half the battle. Republican leaders say they will 
allocate funding when lawmakers return to Washington after a 
seven-week break that begins at the end of the week and ends after 
Labor Day. Yet there is no good reason for Congress to put off a vote 
on funding, given the urgency of the problem.

Almost two million people abused or were dependent on prescription 
opioids in 2014. Many of them became addicted when they were 
prescribed painkillers. Some of those people have gone on to use 
heroin and fentanyl, a very potent drug that is often sold as heroin 
or mixed with it. The musician Prince died of a fentanyl overdose in April.

Many people who need treatment for addiction are going without 
because the health system does not have the capacity to respond to 
the epidemic. In addition, some people cannot afford to pay for 
treatment because their insurance policies do not cover it.

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Grants that allow states to make more treatment options available - 
helping people pay to see addictions specialists, for instance - are 
plainly needed. The Obama administration has asked for $1.1 billion 
in new money, most of which would be used by states on medicine and 
the cost of treating people. House Republicans say they will 
appropriate $581 million when Congress returns in September. That's 
too stingy given the scope of the problems and will in any case be 
vulnerable to the usual haggling over federal spending that occurs in 
the days leading up to the end of the government's fiscal year, on Sept. 30.

Another problem with this bill is that it would not require states to 
create prescription drug monitoring programs that doctors have to use 
when prescribing opioids. Such programs can help reduce the drug 
abuse that can result from overprescribing, experts say. At least 26 
states and Guam require physicians to use monitoring programs, 
according to the National Conference of State Legislatures.

The bill does include an important provision that should make it 
easier for people to get help even without more funding. It would 
allow physician assistants and nurse practitioners to prescribe 
buprenorphine, an opioid that can help wean people off stronger drugs 
like heroin while greatly reducing the risk of overdoses. Under 
current law, only doctors can prescribe buprenorphine and only for 
100 patients at a time. Separately, the Department of Health and 
Human Services said last week that it would increase that to 275 patients.

Many lawmakers, especially those who are up for re-election, clearly 
want to show voters that they are doing something about opioids. This 
bill amounts to progress, but it will not change the trajectory of 
this epidemic.
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MAP posted-by: Jay Bergstrom