Opioid Treatment Bill Remains Underfunded as Need Outpaces Capacity

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October 20, 2016; Bend Bulletin

Treatment available to those suffering from opioid addiction has not kept pace with the rise of addiction itself, says a report released last week by the Democratic Staff of the Senate Committee on Finance. The minority report, released by senator Ron Wyden, highlights the “enormous” treatment gaps in states hit hard by the opioid crisis, and criticizes the lack of congressional funding for provisions authorized by the Comprehensive Addiction and Recovery Act.

The CDC has reported that “more people died from drug overdoses in 2014 than in any year on record,” and that nearly half a million people died of opioid overdoses from 2000–2014. It is estimated that 78 people die per day in America from opioid overdoses. Wyden’s report cites a 2015 study from the American Journal of Public Health, which reported widespread under-availability of opioid treatment in nearly every state. There are more addicted people than state and local programs can accommodate, and the capacity gap for medication-assisted treatment is especially high. While medications such as methadone and buprenorphine have been FDA-approved to treat opiate addiction, these medications are prohibitively expensive for most addicted people, and few health plans cover the treatment.

“In every state, across the country, treatment capacity simply does not match the need,” Wyden’s report reads. The Bulletin, a daily newspaper out of Bend, Oregon, recently reported on the finance committee report, adding that using current addiction and treatment surveys, nearly one million opiate-addicted people do not have access to treatment programs.

The Comprehensive Addition and Recovery Act (CARA), passed in July, was intended to allocate funding for state and local programs fighting the rising opioid epidemic. The language in the bill describes a massive, evidence-based grant program funding first responder training, increased availability of naloxone (Narcan) for law enforcement agencies, local treatment programs, pain management research, drug diversion programs, treatment for incarcerated people, and a host of additional programs. Nearly all of the funding is intended for nonprofit, state, and local agencies to address addiction at the community level.

While CARA, the most expansive legislation to ever address addiction support services, was passed nearly unanimously by both the House and Senate, the White House criticized congressional Republicans for blocking built-in funding that Democratic senators had attempted to include in the bill.

Although CARA authorizes $181 million each year in funding for a host of law enforcement and treatment programs, those funds must be appropriated by Congress each year. Even if these funds are appropriated, they fall far short of the $920 million House Democrats hoped to add to CARA before its passage.

Last month, a coalition of 100 nonprofit groups petitioned the Senate for additional addiction services funding. Another letter, signed by several of the same nonprofits, went to the White House, encouraging the president to request the full funding of CARA programs in the next budget or continuing resolution. Republican senators Rob Portman of Ohio, one of CARA’s coauthors, and Kelly Ayotte of New Hampshire also pushed their own party to support CARA funding in advance of Congress’ passage of a continuing resolution to fund the government through December 9th.

The continuing resolution, passed at the end of September, did set aside another $37 million in new funding for CARA programs through the next year. But because that $37 million is to be prorated over one year, only about $7 million has been made available for the duration of the 10-week continuing resolution.

Earlier this week, the New York Times’ editorial board wrote that full funding for CARA could help recover some of the millions of workers missing from the American labor force. But the most impassioned coverage of the bill seems to be showing up in local newspapers like the Toledo Blade or the sites of addiction recovery nonprofits like the Drug Policy Alliance—the places and organizations most likely to be positively impacted by new treatment funding.—Lauren Karch