Congressional Roundtable Addresses Increasing Threat Within Opioid Epidemic
On Tuesday, the Bipartisan Opioid Task Force held a roundtable discussion on an increasing threat within the opioid epidemic: fentanyl and other synthetic opioids. Synthetic opioids are the leading cause of overdose deaths in the United States, causing over 28,000 deaths in 2017. The roundtable meeting focused on expanding the behavioral health workforce, new criminal justice interventions, innovative pharmacological treatments, and recently proposed legislation.
The Task Force, led by founding co-chair Rep. Annie Kuster (D-NH), was joined by Dr. Elinore McCance-Katz, Assistant Secretary, Substance Abuse and Mental Health Services Administration (SAMHSA), Kemp Chester, Office of National Drug Control Policy (ONDCP) and James Walsh, State Department, as well as Dr. Margaret Jarvis, American Society of Addiction Medicine (ASAM). Task Force members Representatives Bill Johnson (R-OH), Conor Lamb (D-PA), David Trone (D-MD), Donald Norcross (D-NJ), John Rutherford (R-FL), and Lisa Blunt Rochester (D-DE) were also at the table.
EXPANDING THE BEHAVIORAL HEALTH WORKFORCE
74% of counties in the U.S. are lacking sufficient providers to fully meet their behavioral health needs, according to the Health Resources and Services Administration (HRSA). Without intervention, the Task Force feared this number will only grow. HRSA reports indicate that an additional 250,000 practitioners are needed to meet projected demand by 2025.
As Dr. McCance-Katz and Dr. Jarvis noted, Congress has taken several steps to address this issue in recent legislation, including:
- The SUPPORT for Patients and Communities Act of 2018 (H.R 6): With advocacy efforts from its members, the National Council championed this 2018 law and was instrumental in including several important measures, such as loan repayment for addiction professionals, removing barriers to medication-assisted treatment (MAT), and increased access to electronic health records.
- The 21st Century CURES Act of 2016, which required a training demonstration program on mental and substance use disorders. This provision, passed into law in 2016, has not yet received appropriated funding from Congress.
- The Opioid Workforce Act of 2019 (H.R. 2439) would increase the number of residents in behavioral health-related residency programs. This bill is currently under review by the House Ways and Means and Energy and Commerce committees.
Rep. Kuster noted two new bipartisan bills her office is working on to address the opioid crisis within justice-involved populations. The Community Re-Entry through Addiction Treatment to Enhance (CREATE) Opportunities Act (H.R. 3496) would bring MAT to correctional facilities. The bill would create a new grant program within the Department of Justice for MAT and would require grantees develop a plan for continued treatment upon release. Representatives Blunt Rochester, Jackie Walorski (R-IN), and Michael Turner (R-OH) are co-sponsors of this bill.
The second bill is still being drafted for introduction this Congress and would ensure that individuals who enter jails or prisons do not lose their Medicaid coverage while incarcerated. This would enable people to access Medicaid services as soon as they are released from incarceration, rather than waiting the current five to six-month period to have their coverage reinstated. A similar bill, the Humane Correctional Health Care Act (H.R. 6764), was introduced last Congress by Rep. Kuster.
Roundtable participants noted that innovative steps are needed to curb the opioid crisis. Some proposed solutions included the following:
- The Comprehensive Addiction Resources Emergency (CARE) Act (S. 1365/H.R. 2569). The National Council supports this effort, which would authorize $100 billion over ten years to support researching and implementing evidence-based addiction treatment.
- SAMHSA mentioned it is providing technical assistance on the opioid crisis to any community that requests it, with specialized programs available to support Latino and Native American populations. It is also putting a focus on re-implementing the Drug Abuse Warning Network to help identify substance use crises in hospitals.
- ASAM noted its support for behavioral health parity, 42 CFR Part 2, and addiction treatment for justice-involved populations. It also endorsed the Mainstreaming Addiction Treatment Act of 2019 (H.R. 2482), which would eliminate the need for a Drug Enforcement Administration (DEA) waiver to treat addiction with buprenorphine.
The Task Force noted it will continue to work together to find bipartisan methods of addressing the opioid crisis. However, in looking to the future, many in attendance voiced the concern that current legislative and policy efforts are too narrowly focused on opioids and should be moving toward preventing and treating addiction on the whole.