- The Washington Times - Tuesday, February 27, 2018

A bipartisan crop of senators on Tuesday unveiled a sequel to landmark 2016 legislation that targeted the opioids crisis, saying Congress should make sure a brand-new batch of federal dollars are directed toward programs that work.

The bill, dubbed the Comprehensive Addiction and Recovery Act 2.0, would instill new reforms, too, after President Trump urged the government to treat opioids addiction as a public health emergency.

Most notably, the bill would impose a three-day limit on initial fills of opioid pills for acute pain, with exceptions for people with chronic pain and lengthy illnesses.

It would also let states waive a cap on the number of patients each doctor can treat with buprenorphine — an effective way to wean patients off their addiction to opioid painkillers or heroin.

The bill’s lead sponsors, Sen. Rob Portman of Ohio and Sen. Sheldon Whitehouse of Rhode Island, said Congress couldn’t afford to rest easy after they authored the initial “CARA” bill two years ago.



“Passage of CARA was a historic moment, the first time in decades that Congress passed comprehensive addiction legislation, and the first time Congress has ever supported long-term addiction recovery,” Mr. Portman, a Republican, said. “Now we have the opportunity to build on this effort, increasing funding levels for programs we know work and implementing additional policy reforms that will make a real difference in combating this epidemic.”

Opioid-related overdoses killed 42,000 people in the U.S. in 2016, and estimates suggest the problem worsened last year, due to the flood of synthetic fentanyl into the heroin supply.

Congress recently approved a two-year budget deal that allocates an extra $6 billion to the opioids fight in 2018 and 2019.

CARA 2.0 would direct $1 billion of that money toward programs that have proven to be effective, senators said — including $600 million to expand access to medication-assisted treatment, such as buprenorphine, and an overdose-reversing drug known as naloxone.

Another $200 million would be used to help people transition from opioids treatment to long-term recovery, and $100 million would be spent on treatment for pregnant women and those who recently gave birth — up from about $18 million in 2016.

And it authorizes $10 million for a national education campaign about the dangerous of abusing prescription opioids, heroin or fentanyl — a dangerous synthetic opioid.

The rest would divvied up among programs that assist newborns exposed to opioids and help young people and military veterans recover from addiction.

The bill kicks off a busy week for federal policymakers looking to put muscle behind Mr. Trump’s emergency declaration.

The House’s tax-writing panel solicited help Tuesday from insurers and doctors Tuesday in combating opioids abuse under Medicare, the federal insurance program for seniors.

A bipartisan letter from Ways and Means Committee Chairman Kevin Brady, Texas Republican and ranking member Rep. Richard Neal, Massachusetts Democrat, cited an inspector general report that said one third of enrollees in Medicare’s drug-benefit program received an opioid prescription in 2016, translating to nearly 80 million prescriptions that cost $4.1 billion.

“These numbers are unacceptable, and we look forward to partnering with stakeholders such as yourself as well as the administration in this fight against the crisis within the Medicare program,” the committee leaders wrote.

The panel wants feedback by March 15 on a series of ideas, such as limits on fills of painkillers, ways to reduce the use of opioids in emergency rooms and whether its possible to expand the use of medication-assisted treatment under the program, among other things.

The House Energy and Commerce Committee on Wednesday will begin vetting bills that allow the Drug Enforcement Administration to classify more than a dozen forms of fentanyl, which is driving opioid-related deaths but can be chemically manipulated to skirt legal restrictions.

The panel will also take up legislation giving hospice-care workers legal authority to dispose of opioid medications after a patient dies, so the pills don’t end up in the wrong hands.

On Thursday, the U.S. Chamber of Commerce will explore ways to combat the epidemic in a daylong summit at its D.C. headquarters.

Speakers will include Energy and Commerce Committee Chairman Greg Walden, Food and Drug Administration Commissioner Scott Gottlieb, U.S. Surgeon General Jerome Adams and Anne Schuchat, the acting director of the Centers for Disease Control and Prevention.

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