The Senate health care committee will consider a sweeping bill next week meant to combat the opioid epidemic, according to four lobbyists and a congressional aide familiar with the legislation.
The proposal would reauthorize a number of programs first created by the SUPPORT Act, an addiction-focused bill that Congress first passed in 2018. Many of those programs’ authorizations expired earlier this year, however, leading addiction treatment advocates to fret that lawmakers — and specifically the committee’s chairman, Sen. Bernie Sanders (I-Vt.) — no longer view the issue as a priority.
If passed, the legislation would mark Capitol Hill’s first major action this year on the addiction crisis. Current data shows that roughly 110,000 Americans are dying of drug overdoses each year. Roughly 85,000 of those overdoses involve opioids.
Still, Congress in recent years has done little to address the crisis. In one notable exception late last year, lawmakers did pass a bill that allowed doctors, nurse practitioners, and physician assistants to prescribe buprenorphine, a common medication used to treat opioid use disorder, directly to patients without undergoing special training. The new law, however, doesn’t appear to have driven a meaningful increase in the number of prescribers.
The refreshed SUPPORT Act would reauthorize programs that provide funding to community-based organizations working to address the addiction crisis, make permanent certain provisions that expanded access to addiction medications, and expand access to treatment for pregnant women and, separately, incarcerated people.
The legislation is a catch-all proposal that is likely to wrap in a number of addiction bills that have already been introduced, but haven’t yet gained traction in the House or Senate. While it is likely to include a number of priorities that the American Society of Addiction Medicine outlined in a recent open letter to Congress, it’s unclear whether it will include others.
One bill, the TREATS Act, would create a permanent exemption from certain laws governing controlled substances, allowing health providers to continue prescribing buprenorphine via telemedicine and without conducting an in-person examination. Prescribers have been allowed to do so since regulators enacted emergency Covid-19 flexibilities in 2020, but recently, the Drug Enforcement Administration has moved to restore a requirement that providers conduct a physical exam before distributing buprenorphine. The proposal has sparked vocal pushback from advocates, addiction doctors, and Democratic members of Congress. But the legislation, which has bipartisan support from Sens. Tim Kaine (D-Va.), Mark Warner (D-Va.), and Thom Tillis (R-N.C.), would effectively preempt the DEA and leave the new flexibilities in place permanently.
The legislation is likely to exclude another major piece of legislation that the American Society of Addiction Medicine is aggressively pushing, according to lobbyists: the Modernizing Opioid Treatment Access Act.
MOTAA, as the proposal from Sens. Ed Markey (D-Mass.) and Rand Paul (R-Ky.) is known, would allow addiction doctors to prescribe methadone directly to patients. Studies show that methadone is highly effective at preventing opioid overdose and death, and it is widely accessible in much of the Western world, including in Australia and a number of European countries. In the U.S., however, patients can receive it only by attending a specialized clinic that usually requires them to appear in person every morning to receive a dose.
Even if the bill passes the HELP Committee and the full Senate, its fate remains unclear. Earlier this year, two House committees passed a similar version of a SUPPORT Act reauthorization bill, though the full chamber hasn’t yet approved the legislation, and it’s unclear where the addiction crisis ranks on the priority list of House Speaker Mike Johnson (R-La.), who took power in October.
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