Despite tough talk from the White House on the country’s opioid crisis, response to the crisis has been slow. However, the federal response to the opioid crisis is gaining strength. In the past few months, various government agencies and law enforcement increased their efforts to influence drug policy. These efforts seek to reduce opioid addiction and provide substantial support for those struggling with opioid dependence.
What Has Been the Recent Federal Response to the Opioid Crisis?
The federal response to the opioid crisis is occurring on multiple fronts. As stated earlier, administrative, legislative and law enforcement agencies stepped up pressure to change policy. Ultimately, these actions by the federal government hope to spur drug companies and healthcare providers into action. By offering new treatment and therapy options such as MAT, people struggling with opioid addiction can get the help they desperately need.
The following are some of the measures being taken by federal agencies:
New Guidance on Designing Medication-Assisted Therapy Programs
Last week, the FDA release the first of two documents outlining ways drug companies can improve MAT program options. The first document outlines the FDA’s position on the research and development of a sustained-released form of buprenorphine. Additionally, the document focuses on ways future versions of the drug can be approved through the Federal Food, Drug and Cosmetic Act. Soon to be released, the second document from the FDA provides guidance for development of treatment approaches and products that address addict’s needs.
Increased Federal Funding for Treatment
The recent federal response to the opioid crisis is also seen in increased funding. Last month, Congress earmarked $30 million dollars funding for Prescription Drug Monitoring Programs (PDMPs). Additionally, the House Appropriations Committee set forth direction on ways to improve performance of PDMP’s.
The “Stop Opioid Abuse and Reduce Drug Supply and Demand” Initiative
Last month, President Trump introduce a new initiative during a speech in Manchester, New Hampshire. This initiative includes three main components:
- Increased focus on educating Americans about the danger of opioid drugs an the over-prescription of opioids. To achieve this goal, the initiative would create a nationwide evidence-based campaign to raise public awareness, supporting research and development efforts for innovative technologies, and create new therapies that help opioid addicts get and stay clean. Additionally, the initiative would include the creation of a “Safe Prescribing Plan” that includes creating a national interoperable PDMP.
- Increased law enforcement, including measures to prevent opioids entering the United States. The initiative would create various enforcement task forces and teams, and increase criminal penalties for opioid dealers.
- Increased focus on helping addicts by using evidence-based treatment and recovery support services. This includes the use of naloxone to reduce overdoses, improving overdose tracking systems at the state and local level, and treating criminal offenders struggling with opioid addiction.
Encouraging the Expansion of Naloxone Use
Another promising sign of the increasing federal response to the opioid crisis is the expansion of naloxone use. In an advisory issued earlier this month, Surgeon General Jerome Adams encouraged health providers to increase the use of “overdose reversal” drug. Additionally, the advisory calls on prescribers, treatment providers, and pharmacists to better evaluate the identify the following:
- Identify those who are at high risk for opioid overdose
- Find whether individual states allow pharmacists to prescribe naloxone independently or are able to dispense the drug under a standing order or collaborative practice agreement
- prescribe or dispense naloxone to those at elevated risk for opioid overdose.
- utilize their states’ PDMPs to identify high-risk populations.
Pending Legislation to Combat the Opioid Crisis
The federal response to the opioid crisis is also seen in pending legislation. According to an article published on the C&M Health Law website, the following are legislative proposals being debated in Congress:
- Authored by Virginia Republican Morgan Griffith (R-VA), there is pending legislation intended to enhance and improve state-run PDMPs. This legislation is intended to improve current federal support for PDMPs by requiring a coordinated effort between the CDC, SAMHSA, and the Office of the National Coordinator for Health Information Technology. This will improve surveillance, data collection, and integration of PDMP data into physician clinical workflow. The goal is for timely, complete and accurate information to be delivered to providers and dispensers, allowing them to make the best clinical decisions for their patients at the point of care.
- H.R. 3331, authored by Kansas Republican , is intended to promote the testing of incentive payments for behavioral health providers to adopt and use certified electronic health record technology.
- The Opioid Response Act of 2018, S. 2680 encourages the coordination of agencies such as the FDA, CDC, SAMHSA, and the NIH to address the opioid epidemic.
- Special Registration for Telemedicine Clarification Act of 2018, H.R. 5483 This bill, authored by Reps. Buddy Carter (R-GA) and Rep. Cheri Bustos (D-IL), will clarify telemedicine waivers. Federal law permits the Attorney General to issue a special registration to health care providers to prescribe controlled substances via telemedicine in legitimate emergency situations, such as a lack of access to an in-person specialist.
Current Federal Response to the Opioid Crisis is an Encouraging Sign
The flood of legislative actions of the past couple of months signals a sea change in the fight against opioid addiction. While encouraging, federal legislative bodies need to continue to be aggressive in battling opioid addiction. In a recent article published in The Guardian, opioid overdoses increased by roughly 30% across the US in just 14 months between 2016 and 2017. The article also contains CDC statistics which state that illicit and prescription drug overdoses killed 64,000 people and 142,000 overdoses were reported in US hospital emergency departments between July 2016 and September 2017.
If the current push in legislation is ineffective, America can face a grim future. According to projections featured in an article on the STAT website:
Opioids could kill nearly half a million people across America over the next decade as the crisis of addiction and overdose accelerates…There are now nearly 100 deaths a day from opioids, a swath of destruction that runs from tony New England suburbs to the farm country of California, from the beach towns of Florida to the Appalachian foothills…
In the worst-case scenario put forth by STAT’s expert panel, that toll could spike to 250 deaths a day, if potent synthetic opioids like fentanyl and carfentanil continue to spread rapidly and the waits for treatment continue to stretch weeks in hard-hit states like West Virginia and New Hampshire…If that prediction proves accurate, the death toll over the next decade could top 650,000. That’s almost as many Americans as will die from breast cancer and prostate cancer during that time period. Put another way, opioids could kill nearly as many Americans in a decade as HIV/AIDS has killed since that epidemic began in the early 1980s.
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