Opioid Bills Pass, Discrepancies Persist

In what was dubbed “Opioid Week,” the House passed several bills Thursday aimed at battling the nation’s opioid addiction epidemic. The 18 bills, including three passed earlier in the week, have now been bundled into one.

“Additional funding is crucial but must be invested in evidence-based treatment.”

The bills offer substance abuse education, treatment, and law enforcement provisions, which may all sound like a step in the right direction — yet how to pay for this remains the big question. Legislators are feeling the heat to get something done quickly as the epidemic of overdose deaths reaches deeper into the heart of so many communities across the country.

One House bill authorizes $103 million in grants from fiscal 2017 to 2021, redirecting existing funding within the Justice Department and other agencies. That passed in a 413-5 vote, but doesn’t attach new funding.

Combined, the House bills would be similar to what the Senate has done with the Comprehensive Addiction and Recovery Act. The Senate bill would authorize $62 million a year from fiscal 2016 through 2020 for grants, but an amendment for $600 million in emergency funding was shot down.

Currently both bills work from existing funding — they do not authorize additional funding. Democrats want to push for emergency funding to add more money to the bill and make it available more quickly, while Republicans want to go through traditional methods to release existing funds. Emergency funds don’t have to be paid for with tax increases or cuts in other spending.

In February, the White House asked Congress for $1.1 billion in new funding to fight opioid addiction.

Dr. Thomas Kosten, director of the Division of Alcohol and Addiction Psychiatry at the Baylor College of Medicine, is concerned about funding to go along with the bills, which he said is required to support the programs.

But he believes the new legislation, once is passes, will help to ease the epidemic.

Kosten specified that substance abuse treatment and prevention programs that show efficacy — such as those that incorporate methadone, buprenorphine, and injectable naltrexone — are the ones that need to be funded. He also wants to see insurance companies mandated to pay for care.

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Additional funding is crucial, but it must be invested in evidence-based treatment and programs that give high-quality care, said Dr. Arthur Robin Williams, a psychiatrist with the NYU Langone Medical Center in New York.

“Many treatment programs do not actually offer evidence-based treatment with medications such as methadone, buprenorphine, or extended-release naltrexone,” Williams said.

He added, “Many sober houses and residential facilities don’t accept patients on these medications, even though they are the gold standard treatment for patients with opioid addiction.”

The next step is for the House and Senate to come together to work out kinks in the bills so they can go before the president, who has said they won’t mean much without funding. Streamlining the bills likely won’t happen without more back and forth about how much money is required — and when it can be released — to fund the initiatives.