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In a public teleconference of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, the Commission’s draft Interim Report was unveiled. Chair of the Commission, Governor Chris Christie, highlighted the recommendations of report, which will be sent to the President.
The Commission recommends action on the following:
• Rapidly increase treatment capacity. Grant waiver approvals for all 50 states to quickly eliminate barriers to treatment resulting from the federal Institutes for Mental Diseases (IMD) exclusion within the Medicaid program. This will immediately open treatment to thousands of Americans in existing facilities in all 50 states.
• Mandate prescriber education initiatives with the assistance of medical and dental schools across the country to enhance prevention efforts. Mandate medical education training in opioid prescribing and risks of developing an SUD by amending the Controlled Substance Act to require all Drug Enforcement Administration (DEA) registrants to take a course in proper treatment of pain. HHS should work with partners to ensure additional training opportunities, including continuing education courses for professionals.
• Immediately establish and fund a federal incentive to enhance access to Medication Assisted Treatment (MAT). Require that all modes of MAT are offered at every licensed MAT facility and that those decisions are based on what is best for the patient. Partner with the National Institutes of Health (NIH) and the industry to facilitate testing and development of new MAT treatments.
• Provide model legislation for states to allow naloxone dispensing via standing orders, as well as requiring the prescribing of naloxone with high-risk opioid prescriptions; we must equip all law enforcement in the United States with naloxone to save lives.
• Prioritize funding and manpower to the Department of Homeland Security’s (DHS) Customs and Border Protection, the DOJ Federal Bureau of Investigation (FBI), and the DEA to quickly develop fentanyl detection sensors and disseminate them to federal, state, local, and tribal law enforcement agencies. Support federal legislation to staunch the flow of deadly synthetic opioids through the U.S. Postal Service (USPS).
• Provide federal funding and technical support to states to enhance interstate data sharing among state-based prescription drug monitoring programs (PDMPs) to better track patient-specific prescription data and support regional law enforcement in cases of controlled substance diversion. Ensure federal health care systems, including Veteran’s Hospitals, participate in state-based data sharing.
• Better align, through regulation, patient privacy laws specific to addiction with the Health Insurance Portability and Accountability Act (HIPAA) to ensure that information about SUDs be made available to medical professionals treating and prescribing medication to a patient. This could be done through the bipartisan Overdose Prevention and Patient Safety Act/Jessie’s Law.
• Enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) with a standardized parity compliance tool to ensure health plans cannot impose less favorable benefits for mental health and substance use diagnoses verses physical health diagnoses.
Other Commission members include Governor Charlie Baker of Massachusetts, Governor Roy Cooper of North Carolina, former congressman from Rhode Island, Representative Patrick Kennedy, and Professor Bertha Madras, Ph.D. Established through an executive order issued by President Trump, the Commission met earlier this summer to discuss treatment and prevention strategies and explore opportunities to address the opioid epidemic.
During the meeting, all Commission members voted in favor of sending the report to the President. The Interim Report is the beginning of the Commission’s work and they will release another report in Fall 2017.
As ASA reviews this report in greater detail, we look forward to identifying opportunities to provide input and work with the Commission in the future to ensure multimodal and multidisciplinary pain management strategies are advanced, including non-opioid therapies.
