Senate Considers Opioid Crisis Bill, But Critics Say It Isn’t Enough

By Kelly Burch 09/05/18

“A little drama for little substance,” said one addiction advocate familiar with the bill. 

hydrocodone in the spotlight

The U.S. Senate is preparing to pass a bill to address the opioid epidemic, but critics say that the legislation skirts around the most important—and contentious—issues that could help change the way that opioid addiction is handled. 

“A little drama for little substance,” one addiction advocate familiar with the bill told STAT News

The bill addresses treatment and prevention, according to a copy reviewed by STAT. There are provisions that will better equip law enforcement to detect fentanyl being shipped in the mail system and that will help develop a have a better disposal system for unused opioids.

In addition, there are provisions to expand treatment by easing access to medication-assisted treatment with buprenorphine, training doctors to screen for substance use disorder and increasing access to treatment via telemedicine. 

However, treatment advocates say that the bill will do little to affect how treatment is delivered because it does not take enough bold steps to change the status quo. 

“Overdose rates continue to rise, and our response is still falling short given the mammoth size of the problem,” said Andrew Kessler, the founder of Slingshot Solutions, a behavioral health consulting group. “We are in the early phases of our response to this epidemic, and I can only hope that this bill is the first of many we can pass.”

One big change that has a chance of passing is repealing the IMD exclusion, which prevents treatment centers with more than 16 beds from receiving Medicaid payments.

An opioid response bill passed in June repealed the exclusion, but only for the treatment for opioid and cocaine addiction.

Despite the fact that the current Senate bill doesn’t mention the exclusion, Ohio Senator Rob Portman said that he is hopeful that a repeal will be included in the final bill. He said that leadership has agreed on the repeal, but could not gather enough votes. 

“We’ve worked out an agreement that I think most leadership on both sides agree with, but we weren’t able to get the sign-off from everybody,” Portman said.

The Senate bill also includes a call for the development of best practices in disclosing a patient’s history with substance abuse. The House bill would allow a history of addiction treatment to be disclosed without a patient’s expressed permission, but Senate lawmakers are concerned that this could lead to breaches of privacy and stigma. 

With the coming November election, many lawmakers are hesitant to vote on anything controversial, meaning that the bill may stall for now. However, some Senators are pushing to make sure it gets a vote this month. 

“As soon as both parties agree, we can have a roll call vote next week. When we do that, it’ll get virtually unanimous support, and then we’ll work with the House and put the bills together,” said Senator Lamar Alexander, who spearheaded the bill. 

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.