Shefali Luthra, Kaiser Health News
The nation’s opioid epidemic has been referred to as right this moment’s version of the 1980s AIDS crisis.
In a speech Monday, President Donald Trump pushed for a harder federal response, emphasizing a tough-on-crime method for drug sellers and extra funding for therapy. And Congress is upping the ante, through a sequence of hearings — together with one scheduled to last Wednesday through Thursday — to check legislation that may sort out the unyielding scourge, which has cost an estimated $1 trillion in untimely deaths, well being care prices and misplaced wages since 2001.
Dr. Leana Wen, an emergency doctor by coaching and the well being commissioner for hard-hit Baltimore, mentioned Capitol Hill has to assist communities prone to changing into overwhelmed.
“We haven’t seen the peak of the epidemic. We are seeing the numbers climb year after year,” she mentioned.
Provisional data from the Centers for Disease Control and Prevention counsel that just about 45,000 Americans died from opioid overdoses within the 12-month interval ending July 2017, up from about 38,000 within the earlier cycle. (Those knowledge are more likely to change, since many dying certificates haven’t but been reported to the CDC.)
“It’s not going to get any better unless we take dramatic action,” Wen mentioned.
And the time for many significant change could possibly be dwindling. Advocates say what they want most is cash, which might most certainly come by the federal government spending invoice that’s due March 23. But they aren’t holding their breath.
Show Me The Money
The federal price range deal, which was signed into legislation in early February, promised $6 billion over two years for initiatives to struggle opioid abuse. Congress remains to be determining the way to divvy up these funds. The blueprint is anticipated to be included within the spending invoice this week.
Last month, a bipartisan group of senators launched a bill that will add one other $1 billion in funding to help expanded therapy and in addition restrict clinicians to prescribing not more than three days’ value of opioids at a time.
That laws is more likely to have vast help within the Senate, however its path by the House is much less sure.
This money infusion remains to be not going to be sufficient, predicted Daniel Raymond, coverage director for the Harm Reduction Coalition, a nationwide group that works on overdose prevention.
“It’s not clear whether there’s a real appetite to go as far as we need to see Congress go,” he mentioned. “To have a fighting chance, we need a long-term commitment of at least $10 billion per year.” Academic specialists mentioned that evaluation sounded on course.
The determine is greater than thrice what’s allotted within the price range and 10 instances what even the brand new Senate invoice would offer, and much past the spending ranges put forth by any earlier packages to struggle the opioid epidemic.
The problem in getting funding — and a key motive why the bipartisan Senate invoice would possibly stall within the House — partly goes to the guts of Republicans’ philosophy about budgeting.
The GOP, which controls each chambers of Congress, has “always been very focused on pay-fors,” mentioned a Republican aide to the House Energy and Commerce Committee, explaining that new funding is usually anticipated to be accompanied by cuts in present expenditures in order that general authorities spending doesn’t rise. And that would restrict how a lot cash lawmakers are in the end keen to decide to struggle opioid abuse.
Some observers fear this notion is pound-foolish.
“We have an enormous set of costs ahead of us if we don’t invest now,” mentioned Dr. Traci Green, an affiliate professor of emergency medication and neighborhood well being science at Boston University, who has extensively researched the epidemic.
Ahead In Congress
Meanwhile, the House might take up its version of a separate Senate-passed proposal designed to, in sure circumstances, make extra outstanding any opioid historical past in a affected person’s medical document. The thought is to forestall medical doctors from prescribing opioids to at-risk sufferers.
In addition, the House’s Energy and Commerce Committee in late February held a listening to centered on “enforcement” — discussing, for instance, giving the federal Drug Enforcement Administration extra energy in drug trafficking, and whether to treat fentanyl, a very potent artificial opioid, as a managed substance. This week’s hearings will sort out a slew of public health-oriented bills, equivalent to ensuring overdose sufferers within the emergency room get acceptable medicine and therapy upon discharge, or increasing entry to buprenorphine, which is used to deal with habit.
And the House Ways and Means Committee, which has jurisdiction over Medicare — the federal insurance coverage plan for seniors and disabled individuals — is working to develop methods that limit access to opioids and make therapy extra out there.
These are some promising concepts, Raymond mentioned, nevertheless it’s nonetheless “playing catch-up. … The big gap is the money, and the broader vision.”
This flurry of exercise comes after Congress in 2016 handed two legal guidelines instantly coping with habit and substance abuse issues, the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act. CARA promised $181 million — though it didn’t acceptable these dollars — whereas the Cures Act supplied $1 billion over two years.
It’s taking part in out in opposition to the backdrop of regular coverage tensions.
The Trump administration, which in October declared the opioid epidemic a public well being disaster, has repeatedly pushed a extra punitive method, equivalent to harsher sentences for drug trafficking, together with the dying penalty and establishing necessary minimal sentences. That emphasis, specialists mentioned, detracts from different elements of the plan that may spotlight, say, habit therapy.
Instead, these specialists emphasised therapy and prevention in addition to “harm reduction” concepts equivalent to offering extra overdose-antidote medicine and funding applications like syringe exchanges.
They say specializing in punishment has been ineffective previously and neglects the guts of the difficulty.
Certainly, curbing the movement of unlawful medicine is essential, Wen mentioned. But it’s inadequate by itself. And the scale of the issue means lawmakers want to supply faster, extra direct support — not simply proposals that tinker “around the edges.”
“We would never refuse any funding, because we need it desperately,” she mentioned. “But ask us what we need.”
The nation’s opioid epidemic has been referred to as right this moment’s version of the 1980s AIDS crisis.
In a speech Monday, President Donald Trump pushed for a harder federal response, emphasizing a tough-on-crime method for drug sellers and extra funding for therapy. And Congress is upping the ante, through a sequence of hearings — together with one scheduled to last Wednesday through Thursday — to check legislation that may sort out the unyielding scourge, which has cost an estimated $1 trillion in untimely deaths, well being care prices and misplaced wages since 2001.
Dr. Leana Wen, an emergency doctor by coaching and the well being commissioner for hard-hit Baltimore, mentioned Capitol Hill has to assist communities prone to changing into overwhelmed.
“We haven’t seen the peak of the epidemic. We are seeing the numbers climb year after year,” she mentioned.
Provisional data from the Centers for Disease Control and Prevention counsel that just about 45,000 Americans died from opioid overdoses within the 12-month interval ending July 2017, up from about 38,000 within the earlier cycle. (Those knowledge are more likely to change, since many dying certificates haven’t but been reported to the CDC.)
“It’s not going to get any better unless we take dramatic action,” Wen mentioned.
And the time for many significant change could possibly be dwindling. Advocates say what they want most is cash, which might most certainly come by the federal government spending invoice that’s due March 23. But they aren’t holding their breath.
Show Me The Money
The federal price range deal, which was signed into legislation in early February, promised $6 billion over two years for initiatives to struggle opioid abuse. Congress remains to be determining the way to divvy up these funds. The blueprint is anticipated to be included within the spending invoice this week.
Last month, a bipartisan group of senators launched a bill that will add one other $1 billion in funding to help expanded therapy and in addition restrict clinicians to prescribing not more than three days’ value of opioids at a time.
That laws is more likely to have vast help within the Senate, however its path by the House is much less sure.
This money infusion remains to be not going to be sufficient, predicted Daniel Raymond, coverage director for the Harm Reduction Coalition, a nationwide group that works on overdose prevention.
“It’s not clear whether there’s a real appetite to go as far as we need to see Congress go,” he mentioned. “To have a fighting chance, we need a long-term commitment of at least $10 billion per year.” Academic specialists mentioned that evaluation sounded on course.
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The nation’s opioid epidemic has been referred to as right this moment’s version of the 1980s AIDS crisis.
In a speech Monday, President Donald Trump pushed for a harder federal response, emphasizing a tough-on-crime method for drug sellers and extra funding for therapy. And Congress is upping the ante, through a sequence of hearings — together with one scheduled to last Wednesday through Thursday — to check legislation that may sort out the unyielding scourge, which has cost an estimated $1 trillion in untimely deaths, well being care prices and misplaced wages since 2001.
Dr. Leana Wen, an emergency doctor by coaching and the well being commissioner for hard-hit Baltimore, mentioned Capitol Hill has to assist communities prone to changing into overwhelmed.
“We haven’t seen the peak of the epidemic. We are seeing the numbers climb year after year,” she mentioned.
Provisional data from the Centers for Disease Control and Prevention counsel that just about 45,000 Americans died from opioid overdoses within the 12-month interval ending July 2017, up from about 38,000 within the earlier cycle. (Those knowledge are more likely to change, since many dying certificates haven’t but been reported to the CDC.)
“It’s not going to get any better unless we take dramatic action,” Wen mentioned.
And the time for many significant change could possibly be dwindling. Advocates say what they want most is cash, which might most certainly come by the federal government spending invoice that’s due March 23. But they aren’t holding their breath.
Show Me The Money
The federal price range deal, which was signed into legislation in early February, promised $6 billion over two years for initiatives to struggle opioid abuse. Congress remains to be determining the way to divvy up these funds. The blueprint is anticipated to be included within the spending invoice this week.
Last month, a bipartisan group of senators launched a bill that will add one other $1 billion in funding to help expanded therapy and in addition restrict clinicians to prescribing not more than three days’ value of opioids at a time.
That laws is more likely to have vast help within the Senate, however its path by the House is much less sure.
This money infusion remains to be not going to be sufficient, predicted Daniel Raymond, coverage director for the Harm Reduction Coalition, a nationwide group that works on overdose prevention.
“It’s not clear whether there’s a real appetite to go as far as we need to see Congress go,” he mentioned. “To have a fighting chance, we need a long-term commitment of at least $10 billion per year.” Academic specialists mentioned that evaluation sounded on course.
The determine is greater than thrice what’s allotted within the price range and 10 instances what even the brand new Senate invoice would offer, and much past the spending ranges put forth by any earlier packages to struggle the opioid epidemic.
The problem in getting funding — and a key motive why the bipartisan Senate invoice would possibly stall within the House — partly goes to the guts of Republicans’ philosophy about budgeting.
The GOP, which controls each chambers of Congress, has “always been very focused on pay-fors,” mentioned a Republican aide to the House Energy and Commerce Committee, explaining that new funding is usually anticipated to be accompanied by cuts in present expenditures in order that general authorities spending doesn’t rise. And that would restrict how a lot cash lawmakers are in the end keen to decide to struggle opioid abuse.
Some observers fear this notion is pound-foolish.
“We have an enormous set of costs ahead of us if we don’t invest now,” mentioned Dr. Traci Green, an affiliate professor of emergency medication and neighborhood well being science at Boston University, who has extensively researched the epidemic.
Ahead In Congress
Meanwhile, the House might take up its version of a separate Senate-passed proposal designed to, in sure circumstances, make extra outstanding any opioid historical past in a affected person’s medical document. The thought is to forestall medical doctors from prescribing opioids to at-risk sufferers.
In addition, the House’s Energy and Commerce Committee in late February held a listening to centered on “enforcement” — discussing, for instance, giving the federal Drug Enforcement Administration extra energy in drug trafficking, and whether to treat fentanyl, a very potent artificial opioid, as a managed substance. This week’s hearings will sort out a slew of public health-oriented bills, equivalent to ensuring overdose sufferers within the emergency room get acceptable medicine and therapy upon discharge, or increasing entry to buprenorphine, which is used to deal with habit.
And the House Ways and Means Committee, which has jurisdiction over Medicare — the federal insurance coverage plan for seniors and disabled individuals — is working to develop methods that limit access to opioids and make therapy extra out there.
These are some promising concepts, Raymond mentioned, nevertheless it’s nonetheless “playing catch-up. … The big gap is the money, and the broader vision.”
This flurry of exercise comes after Congress in 2016 handed two legal guidelines instantly coping with habit and substance abuse issues, the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act. CARA promised $181 million — though it didn’t acceptable these dollars — whereas the Cures Act supplied $1 billion over two years.
It’s taking part in out in opposition to the backdrop of regular coverage tensions.
The Trump administration, which in October declared the opioid epidemic a public well being disaster, has repeatedly pushed a extra punitive method, equivalent to harsher sentences for drug trafficking, together with the dying penalty and establishing necessary minimal sentences. That emphasis, specialists mentioned, detracts from different elements of the plan that may spotlight, say, habit therapy.
Instead, these specialists emphasised therapy and prevention in addition to “harm reduction” concepts equivalent to offering extra overdose-antidote medicine and funding applications like syringe exchanges.
They say specializing in punishment has been ineffective previously and neglects the guts of the difficulty.
Certainly, curbing the movement of unlawful medicine is essential, Wen mentioned. But it’s inadequate by itself. And the scale of the issue means lawmakers want to supply faster, extra direct support — not simply proposals that tinker “around the edges.”
“We would never refuse any funding, because we need it desperately,” she mentioned. “But ask us what we need.”
The determine is greater than thrice what’s allotted within the price range and 10 instances what even the brand new Senate invoice would offer, and much past the spending ranges put forth by any earlier packages to struggle the opioid epidemic.
The problem in getting funding — and a key motive why the bipartisan Senate invoice would possibly stall within the House — partly goes to the guts of Republicans’ philosophy about budgeting.
The GOP, which controls each chambers of Congress, has “always been very focused on pay-fors,” mentioned a Republican aide to the House Energy and Commerce Committee, explaining that new funding is usually anticipated to be accompanied by cuts in present expenditures in order that general authorities spending doesn’t rise. And that would restrict how a lot cash lawmakers are in the end keen to decide to struggle opioid abuse.
Some observers fear this notion is pound-foolish.
“We have an enormous set of costs ahead of us if we don’t invest now,” mentioned Dr. Traci Green, an affiliate professor of emergency medication and neighborhood well being science at Boston University, who has extensively researched the epidemic.
Ahead In Congress
Meanwhile, the House might take up its version of a separate Senate-passed proposal designed to, in sure circumstances, make extra outstanding any opioid historical past in a affected person’s medical document. The thought is to forestall medical doctors from prescribing opioids to at-risk sufferers.
In addition, the House’s Energy and Commerce Committee in late February held a listening to centered on “enforcement” — discussing, for instance, giving the federal Drug Enforcement Administration extra energy in drug trafficking, and whether to treat fentanyl, a very potent artificial opioid, as a managed substance. This week’s hearings will sort out a slew of public health-oriented bills, equivalent to ensuring overdose sufferers within the emergency room get acceptable medicine and therapy upon discharge, or increasing entry to buprenorphine, which is used to deal with habit.
And the House Ways and Means Committee, which has jurisdiction over Medicare — the federal insurance coverage plan for seniors and disabled individuals — is working to develop methods that limit access to opioids and make therapy extra out there.
These are some promising concepts, Raymond mentioned, nevertheless it’s nonetheless “playing catch-up. … The big gap is the money, and the broader vision.”
This flurry of exercise comes after Congress in 2016 handed two legal guidelines instantly coping with habit and substance abuse issues, the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act. CARA promised $181 million — though it didn’t acceptable these dollars — whereas the Cures Act supplied $1 billion over two years.
It’s taking part in out in opposition to the backdrop of regular coverage tensions.
The Trump administration, which in October declared the opioid epidemic a public well being disaster, has repeatedly pushed a extra punitive method, equivalent to harsher sentences for drug trafficking, together with the dying penalty and establishing necessary minimal sentences. That emphasis, specialists mentioned, detracts from different elements of the plan that may spotlight, say, habit therapy.
Instead, these specialists emphasised therapy and prevention in addition to “harm reduction” concepts equivalent to offering extra overdose-antidote medicine and funding applications like syringe exchanges.
They say specializing in punishment has been ineffective previously and neglects the guts of the difficulty.
Certainly, curbing the movement of unlawful medicine is essential, Wen mentioned. But it’s inadequate by itself. And the scale of the issue means lawmakers want to supply faster, extra direct support — not simply proposals that tinker “around the edges.”
“We would never refuse any funding, because we need it desperately,” she mentioned. “But ask us what we need.”