Democratic senators Tuesday continued to push for more comprehensive legislative action to combat opioid misuse, including emergency funding.
Ranking member Sen. Ron Wyden (D-Ore.) said at a hearing of the Senate Finance Committee that the opioid abuse epidemic is a complex problem that needs a multifaceted solution, including improvement for prevention, treatment and enforcement.
“Real success is going to require attention to all three,” he said.
Wyden said pharmaceutical companies should practice more responsible marketing, and that doctors should be advised by independent experts and not pharmaceutical representatives when learning about available medications.
Lawmakers praised the Comprehensive Addiction and Recovery Act, which was passed out of the Senate Judiciary Committee this month and would fund more state-level programs for addiction treatment and prescription monitoring programs.
Sen. Chuck Schumer (D-N.Y.) said it wasn't enough, however, and said a proposal of $600 million in emergency funding for the issue should be included in legislation.
Sen. Robert Menendez (D-N.J.) said he was troubled that no witnesses at the hearing were asked to speak about medication-assisted treatment for addiction, which was highlighted in President Barack Obama's fiscal 2017 budget request for the HHS.
Obama, speaking to the National Governors Association on Monday, focused on improving access to mental health treatment, particularly in rural areas, but also said doctors should consider alternative therapies for pain patients.
At the hearing Tuesday, senators also expressed bipartisan support for a bill that would allow Medicare to implement patient review and restriction programs that require some opioid patients to always receive their prescriptions through the same doctor and pharmacy.
Alan Coukell, senior director of health programs for the Pew Charitable Trusts, said he supports these “lock-in” provisions.
“This is not a new idea,” he said. “Programs like this are already in widespread use in the commercial market and Medicaid.”
Also discussed was the draft Families First Act, which would encourage mental health treatment that works to keep families together instead of placing children in foster care. The law would use federal foster-care funding to help opioid-addicted parents raise their children.
Dr. Nancy Young, director of the California-based Children and Family Futures, said data shows these programs are successful at providing better care but need to be more broadly implemented.
“It's time that we moved from pilots and demonstrations to actual change that allows kids to stay home,” she said.
David Hart, assistant attorney in charge with the Oregon Justice Department, joined Coukell and Young in supporting recent efforts by the Centers for Disease Control and Prevention to create guidelines for providers who prescribe opioids.
The guidelines have received a lot of feedback, including concerns that they could keep patients with legitimate needs to manage pain from getting medication.
Hart said the guidelines should “help get the balance right” between overprescribing of opioids and cuts to patients who need them. Most of those prescribing are primary-care providers, not specialists, including many midlevel providers, he said.