The Senate this week passed sweeping legislation aimed at easing the nation’s opioid epidemic, but advocates worry that it doesn’t go far enough.
Washington state officials praised the Opioid Crisis Response Act, which would increase regulation of opioid manufacturers and expand addiction treatment options.
But they stressed that it’s just one step in addressing the epidemic, which has caused more than 7,500 deaths in Washington between 2006 and 2016, according to the state’s Department of Health.
“It is an incremental change. It is not a massive change,” said Jason McGill, Gov. Jay Inslee’s senior health policy advisor. “Let’s face it. With what Congress is right now, getting anything passed is probably a good thing.”
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Among the concerns is the exclusion of policies, endorsed by the American Society of Addiction Medicine and the National Governors Association, that would streamline the process of caring for addicted patients. The House passed its version of the bill earlier this year; negotiators from the two chambers will now craft a compromise plan, and the House and Senate will vote on it, probably later this year.
McGill also saw plenty to like in the bill approved overwhelmingly this week by the Senate, especially initiatives that complement or expand programs Washington is already employing to fight the opioid crisis.
The legislation includes a telemedicine grant to teach the best practices for dealing with opioid addiction to doctors who work at community opioid recovery centers, McGill said.
That would create a network for physicians similar to the Hub and Spoke model used in Washington, which he said has seen “some real success.” Statistics from the state’s Department of Social and Health Services show Washington’s model is outperforming its goals, with more than 3,200 people in treatment as of July, nearly twice its target number.
The bill also has a $46 million grant program, proposed by Sen. Maria Cantwell, D-Washington, to train emergency responders for dealing with the aftermath of a drug overdose, and link them with clinicians and peer recovery people. McGill said Washington has a related pilot program underway “that we’d like to scale up” using a federal grant.
Casey Katims, Washington’s director of federal and inter-state affairs, liked a bill provision that allows doctors to continue caring for 275 addicted patients with medication-assisted treatment, a technique that combines medication and therapy.
A crucial part of the legislation, Katims said, is a funding for Opioid State Targeted Response grants, which “we’ve been able to deploy ... in really important ways to help people who are struggling with addiction.”
But the bill, approved Monday night by a 99-1 vote, has flaws.
It does not include a change to the Medicaid Institutions for Mental Diseases exclusion, which limits the funding that residential treatment facilities with more than 16 beds can receive from Medicaid — a joint federal-state program that provides free or discounted health care for low-income Americans.
President Donald Trump has been granting waivers to Washington and other states so their facilities can receive the Medicaid funding, Katims said, but Inslee would like to see a change in the law.
Monday’s opioid bill does not modify a patient privacy rights law that hampers doctors’ ability to access information about patients’ substance use disorders, another change that Inslee has endorsed. He declared a “public health crisis” in Washington, where prescription-related deaths are decreasing but heroin and fentanyl overdoses have risen over the last few years.
Sen. Patty Murray, D-Washington, the top Democrat on the Senate Health Committee, cheered the bill’s passage but acknowledged the legislation does not go far enough in combating the epidemic.
“I know this is far from case-closed,” she said. “We have a whole lot more work ahead of us in the coming months and years to truly respond to this crisis.”
Another of Cantwell’s initiatives in the bill would increase civil and criminal penalties on opioid manufacturers that fail to control “negligent distribution” of painkillers, which her office said could strengthen lawsuits Washington cities and the state have filed against manufacturers.
Last year, Washington Attorney General Bob Ferguson sued Purdue Pharma, the maker of the pain reliever OxyContin, accusing the company of “fueling the opioid epidemic in Washington state, embarking on a massive deceptive marketing campaign and convincing doctors and the public that their drugs are effective for treating chronic pain and have a low risk of addiction, contrary to overwhelming evidence.”
If successful, the lawsuit, filed in King County Superior Court, would force the company to forfeit the money it made in Washington as a result of its “illegal conduct,” and put it toward countering the state’s epidemic.
“We vigorously deny the state’s allegations,” said Bob Josephson, a Purdue spokesman. “The state claims Purdue acted improperly by communicating with prescribers about scientific and medical information that (the Food and Drug Administration) has expressly considered and continues to approve. We believe it is inappropriate for the state to substitute its judgment for the judgment of the regulatory, scientific and medical experts at FDA.”