Divided Congress comes together to fight opioid abuse

octors groups are applauding newly-approved national legislation to fight opioid abuse while calling for more funds to implement many of the bill’s programs. The Comprehensive Addiction and Recovery Act of 2016 (CARA) passed both houses of Congress in July after Democrats backed off their demands that higher levels of funding be included in the bill. 

CARA encompasses a variety of programs to deal with opioid abuse, including creation of a task force to examine how doctors can best treat pain and encouraging states to create drug monitoring programs. 

Among its many provisions is one saying that if doctors or patients request only a partial fill of a Schedule II substance, pharmacists are allowed to comply. The bill also calls on Medicare to develop a safe prescribing and dispensing protocol for its beneficiaries.

Other provisions include expanding healthcare provider awareness of the risks associated with the misuse of opioids and increasing the availability of opioid overdose reversal drugs.

The American College of Physicians (ACP) called on Congress to continue its drive to assist with opioid abuse.

“This legislation takes important steps to address this growing crisis and to provide patients with greater access to the care and treatment they need to deal with substance use disorders.  It is critical that Congress now move ahead to ensure funding for these important advancements,” ACP President Nitin S. Damle, MD, MS, said in a statement.

The White House called for $1.1 billion in new funding for addiction-fighting programs, announced after Senate approval that the president would sign it, even though it does not contain the funding levels he wanted. The president signed the bill in late July.

Funding for opioid abuse programs became the sticking point that slowed the legislation. Republicans balked at the funding level the president requested and blocked Democratic attempts to add it to the opioid abuse bills that were simultaneously moving through both houses. 

Consequently, measures passed in each chamber-CARA in the Senate and 18 opioid-related bills in the House-did not include that level of new funding. 

Those differing House and Senate bills needed to be reconciled by a conference committee and then approved by both chambers before a final bill could reach the president’s desk. Conference committee work got off to a sluggish start as reports surfaced that the president was directing Democrats to go slow on the bills in hopes that public pressure would force Republicans to reconsider his funding proposal. The White House also tried to turn up the heat in mid-June by releasing a breakdown of how much money would go to each state under its funding plan.

“Congress has been voting on various pieces of legislation related to the opioid epidemic, but so far has not provided the resources needed to make treatment available to everyone who wants it,” said a June 17 post on the White House blog that included a map showing how much each state would receive in new funding. 

The opioid abuse issue has come up in congressional elections across the country this fall. Democrats likely decided they did not want to be portrayed as the ones blocking government action on the issue, said Kelly Brantley, a director at Avalere Health, a healthcare consulting firm.  

John Frank is a journalist with 38 years of experience. What can physicians do to halt the opioid epidemic? Tell us at medec@ubm.com.