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From Health Law Daily, March 14, 2016

HHS and Senate act to address the growing opioid epidemic

By Harold Bishop, J.D.

One day after the Senate passed a bipartisan bill to address the ongoing opioid epidemic, HHS Secretary Burwell announced $94 million in funding to 271 health centers in 45 states, the District of Columbia, and Puerto Rico to improve and expand the delivery of substance abuse services in health centers. The funding specifically focuses on treatment of opioid use disorders in underserved populations. The $94 million investment is expected to help awardees hire approximately 800 providers to treat nearly 124,000 new patients.

According to HHS, approximately 4.5 million people in the United States were users of non-medical prescription pain reliever in 2013, and an estimated 289,000 were current heroin users. HHS estimates the number of unintentional overdose deaths from prescription pain medications has nearly quadrupled from 1999 to 2013, and deaths related to heroin increased 39 percent between 2012 and 2013.

Health center funding. The funding will be administered by the Health Resources and Services Administration (HRSA). The funding will increase the number of patients screened for substance use disorders and connected to treatment, increase the number of patients with access to medication assisted treatment (MAT) for opioid use and other substance use disorder treatment, and provide training and educational resources to help health professionals make informed prescribing decisions.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA)-HRSA Center for Integrated Health Solutions, MAT is the use of pharmacological medications, in combination with counseling and behavioral therapies, to provide a “whole patient” approach to the treatment of substance use disorders. Research indicates that a combination of medication and behavioral therapies can successfully treat substance use disorders, and for some people struggling with addiction, MAT can help sustain recovery.

Senate bill. The Comprehensive Addiction and Recovery Act of 2016 (CARA) (S. 524) was first introduced by Senators Sheldon Whitehouse (D-RI) and Sen. Rob Portman (R-Ohio) in February 2015. During the drafting of the bill, Senators Whitehouse, Portman, Amy Klobuchar (D-Minn), and Kelly Ayotte (R-NH) held five congressional briefings with stakeholders from public health, law enforcement, criminal justice, and other fields looking at ways to better support prevention efforts, addiction treatment, and recovery. The bill passed the Senate on March 10 by a vote of 94 to 1.

CARA would:

  • expand prevention and educational efforts—particularly aimed at teens, parents and other caretakers—to prevent the abuse of opioids and heroin and to promote treatment and recovery;
  • make naloxone more widely available to law enforcement agencies and other first responders to help in the reversal of overdoses to save lives;
  • provide resources to promptly identify and more effectively treat incarcerated individuals suffering from addiction disorders;
  • increase the number of disposal sites for unwanted prescription medications to keep them out of the hands of our children and adolescents;
  • launch an evidence-based opioid and heroin treatment and interventions program and promote treatment best practices throughout the country; and
  • strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.

The Hill reported that attempts by Democrats to add an amendment for $600 million in emergency funding to the bill were rejected in the Senate. Republicans who opposed the funding said there was $400 million included in last year’s omnibus spending bill that could be used to fund the bill. The bill now goes to the House where favorable action is expected.

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