Washington – Democrats drew a line in the sand this week on federal funding to battle opioid addiction and their Republican colleagues blithely walked across it.
Despite protests and high drama over the level of money the federal government will spend fighting heroin addiction and prescription pain pill abuse, Democrats lost their battle this week to increase federal funds by nearly $1 billion to pay for additional treatment for addicts.
The White House estimated the boost in funding would have provided Connecticut with about $9 million over two years to battle opioid addiction in the state.
The partisan standoff came to a head Wednesday when Democrats among the House and Senate negotiators crafting a final opioid addiction bill refused to sign off on it. The rebellious lawmakers included Reps. Elizabeth Esty, D-5th District, and Joe Courtney, D-2nd District, who were both part of the negotiating panel.
“Across the country, men, women, and children are struggling because of this epidemic. It’s a public health emergency, and Congress needs to treat it like one,” Esty said.
Slightly different versions of the Comprehensive Addiction and Recovery Act were approved by the House and Senate in March with overwhelming bipartisan majorities. Since a simple majority was needed to report a final bill out of the negotiating conference – and Republicans had that majority – the Democratic protest was largely symbolic.
On Thursday, House Majority Leader Kevin McCarthy issued a statement that said the opioid-related bills received near unanimous support on the House and Senate floors and accused Democrats of “backpedalling.”
“A funny thing happened on the way to the negotiating table,” McCarthy said. “Democrats in the House and Senate who proudly supported the effort suddenly switched course. Despite the fact that the entire House package … is included in this conference report, many Democrats have threatened to vote against the package and refused to sign the conference report filed yesterday.”
The final bill is expected to be voted on by the House on Friday.
Courtney does not know how he will vote.
“There’s positive things in it, but it hardly measures up to the scope of the problem,” he said.
One provision Courtney supports would lift the cap, now at 100 patients, that limits doctors treating opioid addicts with the medication buprenorphine, which is sold mostly under the brand name Suboxone. Under the bill, doctors would be allowed to treat as many as 275 patients a year with buprenorphine, and the Department of Health and Human Services says that as many as 70,000 more people may have access to the drug as a result.
The bill also would allow nurse practitioners to treat addicts with buprenorphine, an artificial opioid that produces typical opioid effects like euphoria and respiratory depression, but less fully than heroin or pain pills. That allows addicts to wean themselves from the drugs they are addicted to without withdrawal symptoms.
The final opioid bill also would authorize the federal government to provide states with grants to fund training for first responders to treat overdoses, create alternatives to incarceration and investigate ways to combat illegal opioid distribution.
But Courtney said the bill would not help states increase the number of treatment beds needed to combat the growing epidemic, which claimed more than 400 lives in Connecticut last year.
“An addict can’t wait six weeks or eight weeks for a treatment bed, and this bill does nothing for them,” he said.
Courtney has sponsored the Opioid and Heroin Epidemic Emergency Supplemental Appropriations Act, that would provide $600 million immediately to address the issue.
White House takes action
Consumption of heroin and pain killers in the United States has skyrocketed. The Drug Enforcement Agency says that, in 2014 alone, it approved the sale of 14 billion opioid pills. Between 1993 and 2015, oxycodone production jumped from 3.5 tons to 150 tons, the DEA said.
Frustrated by Congress’s inability to pass an opioid bill, President Obama used his executive authority this week to take steps to combat the epidemic.
Like the opioid bill pending in Congress, the president lifted the cap on doctors who treat people with buprenorphine. He also ordered HHS to conduct more than a dozen new scientific studies on opioid abuse and pain treatment.
Another move Obama made was aimed at pressing doctors to lessen their prescription of pain medication.
Currently, the Centers for Medicare and Medicaid Services ties Medicare payments to hospital patients’ responses about pain management on a required questionnaire administered by the Hospital Consumer Assessment of Healthcare Providers and Systems. Obama’s new policy would abolish this connection, which pressures doctors to prescribe opioids so that patient pain ratings are favorable.