Few public health challenges have been more daunting and persistent than the opioid crisis, which started because of egregious conduct by opioid manufacturers and now is driven by an influx of fentanyl. In my home state of New Hampshire — which has been at the forefront of this heartbreaking epidemic for more than a decade — too many promising futures have been snatched away. As we look to the next stage of bipartisan efforts to take on this challenge, we must quickly reauthorize and expand the SUPPORT Act, which expired Sept. 30. It laid a new foundation for our response to this epidemic — and now it can be used to increase access to the gold standard of treatment for addiction.
In 2018, we came together across party lines to pass the SUPPORT Act, which established vital infrastructure for communities in New Hampshire and across the country to treat addiction, help people recover, and prevent substance misuse in the first place.
While there are dozens of vital measures in this legislation, one of the most critical provisions helped expand access to medication-assisted treatment, the gold standard of addiction care. Access to this lifesaving medication, buprenorphine, has historically been limited by law and clinician reluctance, fueled by harmful stigmas surrounding addiction treatment.
But the evidence, including from the National Institutes of Health, shows that medication-assisted treatment works better than any other treatment, because it helps cut the craving to use opioids like fentanyl. This evidence led the drafters of the original SUPPORT Act to require that every state provide Medicaid coverage for medication-assisted treatment. But now that the SUPPORT Act has expired, this requirement ends in 2025, jeopardizing access to medication-assisted treatment, as many states could choose not to cover it under Medicaid anymore. The looming expiration of this key provision is one of the many reasons that we must reauthorize the SUPPORT Act as quickly as possible.
There are also, sadly, new threats to address since we first passed the SUPPORT Act in 2018. For instance, there has been a recent surge of overdose cases caused by drugs laced with xylazine, a powerful animal tranquilizer. In response, the reauthorized and expanded SUPPORT Act, which I have worked to develop and move forward in Congress, would help make test strips for xylazine readily available to protect people in our communities from overdose — just one of many provisions that would equip community members and first responders with the tools that they need to save lives as we face new challenges from this ongoing crisis.
But we cannot stop with reauthorizing the SUPPORT Act. We must continue to take additional steps to increase access to medication-assisted treatment and recovery supports. Last year, Sen. Lisa Murkowski, a Republican from Alaska, and I worked to pass into law the Mainstreaming Addiction Treatment (MAT) Act, which removed a burdensome requirement, known as the X-waiver, that prevented doctors and nurses from prescribing medication-assisted treatment, even when Medicaid or private insurance covered it. While this was an important step, we need to keep up the effort to educate and support more health care professionals — from primary care physicians to ER doctors and nurses — on medication-assisted treatment so that they actually prescribe it to their patients, and help them stay in recovery. For instance, health care providers should be trained to recognize the signs of opioid use disorder and understand the benefits of medication-assisted treatment so that they offer it to their patients.
And outdated stigmas still significantly block access to methadone, another type of medication for opioid use disorder, which sometimes is the most appropriate for patients with severe opioid addiction. Currently, methadone for opioid use disorder is only available at certified Opioid Treatment Programs. However, in rural states like New Hampshire, the nearest methadone clinic can be a two-hour drive away — and patients have to go every day for treatment. That’s why I’ll keep pushing to pass the Modernizing Opioid Treatment Act, which would allow physicians to prescribe methadone to their patients so that they do not need to go to a methadone clinic. This could help save lives and get more patients dealing with addiction on the road to recovery.
With a challenge as ever-changing as the fentanyl crisis, we cannot afford complacency, nor can we become paralyzed by despair. We must keep working on a bipartisan basis to save more lives and dismantle dangerous stigmas surrounding addiction, so that more Americans struggling with addiction can get the care that they need, wherever they are, and when they need it most.
Sen. Maggie Hassan, a Democrat from New Hampshire, is in her second term and previously served as Governor of New Hampshire. In the Senate, she serves on the Finance Committee and the Health, Education, Labor, and Pensions Committee, both of which have jurisdiction over legislation related to the fentanyl crisis, including the SUPPORT Act.