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House lawmakers to introduce 2 dozen opioid-related bills this week

Expert says one bill could be a game-changer

CNN  — 

Fresh on the heels of President Donald Trump’s plan to tackle the opioid crisis, House lawmakers this week plan to introduce more than two dozen bills aimed at ending the epidemic, ranging from better access to treatment programs to exploring opioid alternatives for pain.

The bills will be the focus of two days of hearings on Wednesday and Thursday before the House Energy and Commerce Committee with the focus on public health and prevention initiatives.

Chairman Greg Walden, a Republican from Oregon, has made combating the opioid epidemic the committee’s top priority, saying lawmakers are “crafting legislative solutions to help stem the tide and investigating some of the root causes of this scourge.”

“We’re really digging in so we can deliver relief for those devastated by this crisis,” he told CNN in a written statement.

The opioid epidemic claimed nearly 64,000 lives in drug overdoses in 2016 and has killed more than 500,000 people since 2000, according to the US Centers for Disease Control and Prevention. Trump has declared the epidemic a public health emergency and has vowed to fix the crisis.

One of the bills, called the Preventing Overdoses While in Emergency Rooms act, or POWER act, is a bipartisan measure that seeks to provide patients who have overdosed better access to treatment when they get discharged from emergency rooms.

The bill would set up protocols for emergency rooms around the nation on how best to discharge overdose patients, making sure they have the opioid overdose antidote naloxone and access to other medication-assisted treatment, as well as being linked up with peer-support specialists and other treatment programs that best fit the patient.

“Often, people who survive an overdose end up doing it again because they’re unable to access the necessary treatment,” said Rep. David B. McKinley, a Republican from West Virginia, who has sponsored the bill with Rep. Michael Doyle, a Democrat from Pennsylvania. “This bill would ensure these patients receive the treatment they need in the emergency room and are then placed in the care of a substance abuse treatment provider to receive continued care, giving them a better shot at recovery.”

Dr. Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness, reviewed the various pieces of legislation and said that bill excites him the most.

“All too often, during the past two decades, patients have been discharged from emergency rooms without any linkage to downstream care,” Alexander told CNN. “There is compelling scientific evidence and data to support better linking patients who experience overdose with follow-up care. If this bill that can fulfill that promise, it will be the gift that keeps on giving.”

If patients being discharged from emergency rooms had access to say a seven-day supply of a medication-assisted treatment like buprenorphine, he said, “I mean that’s the type of thing that really could move mountains here.”

A recent CDC report found that emergency department visits due to suspected opioid overdoses continued to climb – about 30% – from July 2016 to September 2017 across the country.

The bills range from efforts to explore non-addictive alternatives for pain to easier ways to dispose of extra opioid pills to better data sharing of a patient’s medical records with health care providers.

Several bills seek to give the US Food and Drug Administration more authority and new methods to streamline its efficiency and effectiveness. One measure seeks to accelerate bringing a breakthrough treatment for pain to the market. The proposals also want to study the long-term efficacy of opioids and allow for the FDA to consider the potential for drug abuse before bringing a new drug to the market.

CNN spoke with multiple health policy experts about the legislative initiative. While they lauded the efforts being put forward, every one of them said Congress and President Trump need to back any such plan with tens of billions of dollars in new funding.

Congress has allocated $6 billion over the next two years for opioid-related spending. The White House last year estimated the cost of the opioid epidemic at a whopping $500 billion – a figure that was more than six times higher than the previous estimate of $78.5 billion.

“$6 billion is a drop in the bucket,” Alexander said. “It’s going to take tens of billions of dollars.”

So far, there has been no indication from congressional leaders or the White House of a willingness to put up that type of money for a long-term sustained approach. Chairman Walden has said in the past that he wants “to get the policy right first, and let the policy dictate the resources.”

“I would argue that we on the front lines already know what is working,” said Dr. Leana Wen, Baltimore City Health Commissioner. “There needs to be far more funding, and that funding needs to come directly to local jurisdictions like ours that are the hardest hit and have already done a lot when it comes to our overdose prevention treatment work.”

She said most of the bills being proposed are already things Baltimore is doing at the local level, it’s just that “what we need is a commitment to sustain ongoing resources to treat the disease of addiction.”

Residents of Baltimore, she said, have saved more than 1,600 lives due to a policy that helped provide naloxone to every resident in the city. But the city is now having to ration a limited supply of the life-saving drug. “Every day, I have to decide: Who are the people in our city who have access to this medication,” she said. “I hope that Congress and the federal government will hear our pleas for help and provide us with the resources we need.”

Dr. Andrew Kolodny, co-director of the Opioid Policy Research Collaborative at Brandeis University, said the nation has to reduce the number of new people becoming addicted to opioids every year and that treatment needs to be more easily available for people who are already addicted.

“We need to make treatment much easier to get than pain killers, heroin or fentanyl,” he said. “You want somebody who is opioid-addicted to be able to walk into a treatment center and be able to start treatment that same day.”

He said he hopes the nation’s leaders will focus on building out a long-term treatment program, designating $60 billion over 10 years. “If we get there, we’ll start to see overdose deaths come down,” Kolodny said.

President Trump, on Monday, rolled out a three-part plan to tackle the opioid epidemic, saying his administration would focus on reducing demand through education, cut off the flow of illicit drugs and save lives by expanding opportunities for evidence-based addiction treatment.

He also said he would seek the death penalty for drug traffickers. “This isn’t about being nice anymore,” Trump said at an event in New Hampshire. “These are terrible people, and we have to get tough on those people. We can have all the blue-ribbon committees we want. But if we don’t get tough on the drug dealers, we’re wasting our time.”

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    The White House has indicated it would be willing to allocate more money for treatment programs, but has consistently refused to put a dollar figure behind what it believes is needed.

    Patrick Kennedy, the former Democratic representative who was one of six members of Trump’s opioid commission, told CNN in January that Congress had turned the panel’s work into a “sham” and “charade” by not putting more serious money forward to fight the epidemic.

    “Everyone is willing to tolerate the intolerable – and not do anything about it,” Kennedy said. “I’m as cynical as I’ve ever been about this stuff.”