Exploring The New Opioids Package: What Does The Legislation Cover?

By Paul Gaita 10/12/18

The wide-ranging bipartisan legislation addresses overprescribing, overdose prevention, medication-assisted treatment and more.

doctor writing a prescription

New legislation intended to aid in the fight against the opioid epidemic was approved by both the House and Senate, and is currently headed for signature by President Donald Trump.

The bill, known as the Substance Use Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act (or SUPPORT), is a rare bipartisan effort, authored primarily by Senators Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), and offers $8 billion in wide-ranging programs that intend to boost access to substance treatment, as well as methods of intervention to reduce the availability of opioids.

Policymakers have expressed their support for the bill, though treatment advocates have voiced reservation about the scope and effectiveness of the legislation. Here's what is proposed by the SUPPORT Act:

- Expansion of provisions for Medicaid programs, including expanded access to opioid addiction treatment, including secured flexibility for alternative services not permitted under a state Medicaid plan, improved data sharing between state databases, and increased screening for opioid dependency during doctor's visits.

- Increased Medicaid coverage for opioid treatment programs that prescribe medication-assisted treatment (MAT), which is currently not recognized by Medicaid, and an increase in the number of health care specialists that are allowed to prescribe and dispense such treatment.

- A provision to expand a grant program that allows first responders to administer naloxone for opioid overdoses.

- Creation of a grant program from the Substance Abuse and Mental Health Services Administration (SAMHSA) to establish comprehensive opioid recovery centers, which will provide dependency and recovery programs for communities.

- A provision to allow the National Institutes of Health (NIH) to establish "high impact, cutting-edge research" for combating the opioid epidemic and development of non-addictive pain management medication, which will be funded through reauthorization of the Common Fund from the 21st Century Cures Act.

- Authorization for the Drug Enforcement Administration (DEA) to reduce manufacturing quotas for controlled substances, including prescription opioids, when the agency suspects diversion. 

- Authorization for the Department of Health and Human Services to allow doctors to remotely prescribe medication-assistant treatments to assist needy individuals in remote or rural areas.

- The STOP Act, which will assist the U.S. Postal System in preventing the import of fentanyl through international mail by improved digital tracking. 

- Improved coordination between the Food and Drug Administration and U.S. Customs and Border Protection to allow greater means of detecting and halting the import of drugs at borders.

- Increased penalties for manufacturers and distributors in regard to overprescription of opioid medication.

Response from the health care field was mixed. Some, like Kelly J. Clark, president of the American Society of Addiction Medicine, called it "an important step in ensuring that individuals with substance use disorder are able to get the help they need."

But Keith Humphreys, a drug policy expert at Stanford University who worked with White House staff on the bill, viewed the scope of the bill as limited.

"This reflects a fundamental disagreement between the parties over whether the government should appropriate the large sums a massive response would require. Lacking that, Congress did the next best thing—which is to find agreement on all the second-tier issues as they could."

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, Amazon.com and The Los Angeles Beat, among many other publications and websites.