Federal funds to fight opioid crisis don't meet demand

Current federal funding levels to combat the opioid crisis do not meet the alarming demand brought on by the COVID-19 pandemic, according to a new report.

The Bipartisan Policy Center on Wednesday released a report that found federal opioid funding grew only 3.2% in fiscal year 2019, for a total of $7.6 billion.

Three-quarters of that funding went toward treatment, recovery and prevention programs in states, with the rest dedicated to law enforcement. That marks a departure from the "War on Drugs" approach taken by most states for the past 40 years that mostly involved increasing prison sentences for both drug dealers and users.

The analysis also found Medicaid coverage of medication-assisted therapies like buprenorphine and naltrexone and the opioid overdose-reversal medication naloxone grew by 15% to nearly $1.6 billion in 2019.

Despite those gains, the research found the nation's treatment system is woefully inadequate to meet the current demand, estimating only 10% of individuals with substance use disorder issues are receiving appropriate support.

In a panel discussion held Wednesday, Dr. Anand Parekh, chief medical advisor at BPC, said while federal funding remained stable and was allocated to those counties with the highest number of overdose deaths, it was difficult to determine whether it was helping those at highest risk of overdose, like the homeless, the imprisoned and pregnant women.

"Currently, we have no proper mechanism for evaluating the effectiveness of federal investments, and the opioid crisis is getting worse," Parekh said.

The report provided case studies of six states with higher than average overdose death rates in 2018, which included Arizona, Louisiana, New Hampshire, Ohio, Tennessee, and Washington, and found they had shortages in the number of providers able to administer medication-assisted treatment. Vulnerable populations in particular had less access to healthcare professionals who could legally prescribe buprenorphine, federal regulations require clinicians to undergo specialized training to prescribe and then are limited to administering to a maximum of 275 patients after the first year of prescribing.

The report recommended removing the buprenorphine prescribing restrictions and the waiver certification process. It also called for increased coordination between states and federal regulators on harm reduction services like syringe exchange programs, and for Congress to remove its funding ban on syringes. In 2016, lawmakers lifted funding restrictions on needle exchange programs, like administrative costs, but kept a funding ban on the actual syringes.

"America must address the changing complexion—and complexity—of the addiction epidemic," said Regina LaBelle, former chief of staff of the White House Office of National Drug Control Policy and a BPC consultant.

More than 40 states have seen an increase in deaths caused by opioids since the beginning of the pandemic, according to the American Medical Association.

Experts say measures to stem the spread of COVID-19, including social distancing have put those with substance use disorder at higher risk. Many treatment providers have limited access to their facilities and stopped in-person therapy sessions and replaced them with online counseling. Those actions can isolate those with substance use disorder issues, putting them at higher risk of using more and those in recovery of relapsing.