West Virginia’s Congressional delegation has been busy in recent weeks crafting legislation to battle the opioid crisis. Some of it passed into law and some is just getting rolling.
Here is a roundup of recent efforts by Sens. Shelley Moore Capito and Joe Manchin, and 1st District Rep. David McKinley.
Capito, R-W.Va., and Sen. Elizabeth Warren, D-Mass., together introduced the Reducing Opioid Risk Act. The bill is intended to improve implementation of the bipartisan law they worked to pass in 2016, called the Reducing Unused Medications Act.
The 2016 act allows prescriptions for opioid medications to be partially filled by pharmacists at the request of patients and doctors, cutting down on the number of unused painkillers in circulation. It was incorporated into the Comprehensive Addiction and Recovery Act.
After the legislation became law, the two surveyed governors and major medical organizations to see how it was playing out. They learned it needed tweaks.
The Reducing Opioid Risk Act clarifies the Food and Drug Administration’s (FDA’s) authority to require drug companies to educate health care providers about state and federal regulations of controlled substances, including the option to partially fill a prescription.
Capito and Sens. Edward J. Markey, D-Mass.; Marco Rubio, R-Fla.; and Sherrod Brown, D-Ohio, applauded inclusion of more than $65 million in the FY2018 omnibus, signed in January, to fund opioid detection devices and equipment called for in their INTERDICT Act.
The bipartisan bill will help stop the flow of the illicit opioid fentanyl across the U.S. border by equipping U.S. Customs and Border Protection (CPB) with high-tech scanning devices and other technologies to detect synthetic opioids, like fentanyl.
INTERDICT also provides CBP with sufficient resources, personnel and facilities — including scientists available during all operational hours — to interpret screening test results from the field.
Capito and Sen. Chris Murphy, D-Conn., introduced two bills to help improve addiction recovery efforts and prevent opioid overdoses.
The Preventing Overdoses While in Emergency Departments Act would provide hospital emergency departments with guidance and funding to treat overdose patients and help put them on the path to recovery.
It requires the development of protocols for discharging patients who are treated for a drug overdose and enhances the integration and coordination of care and treatment options for individuals with a substance use disorder after they are discharged. It also provides competitive grants for emergency departments, especially those in areas with high overdose rates or in rural areas to perform the assigned tasks.
McKinley and Rep. Mike Doyle, D-Pa., introduced the House version of this bill. McKinley further explained that the bill focus-es on Medication-Assisted Treatment in the emergency room, and engaging in what is called a “warm handoff” of the patient to a substance use disorder treatment provider.
Studies have shown, he said, that for non-fatal overdose patients, administering Medication-Assisted Treatment within 72 hours of the incident is cost effective as opposed to just simply referring them to outside treatment.
The Recovery Coaches Offer Addiction Counseling & Healing (COACH) Act would help expand access to recovery coaches for Americans who are struggling with addiction and embarking on the road to recovery. It provides states with grants to ensure those struggling with substance use disorder have access to specially trained coaches in the emergency department who can serve as a mentor, provide insight and encouragement, support for families, and help patients navigate treatment options.
Capito and Sen. Maggie Hassan, D-N.H., introduced a bill to establish comprehensive opioid recovery centers that provide coordinated and comprehensive care to Americans struggling with addiction.
The Comprehensive Opioid Recovery Centers Act would create a pilot program allowing the Department of Health and Human Services to award grants to eligible entities to create new or expand existing centers to serve as “Comprehensive Opioid Recovery Centers.”
These centers would provide a full range of treatment and recovery services — including medication-assisted treatment, recovery housing, job training and support reintegrating into the workforce, counseling, community-based and peer recovery support services, among others. States with higher overdose death rates, such as West Virginia and New Hampshire, would be given priority for these grants.
Manchin’s “Jessie’s Law” was signed into law as part of the new $1.3 trillion spending omnibus bill.
The language passed in the omnibus directs the Department of Health and Human Services to establish best practices for hospitals and physicians for sharing information about a patient’s past opioid addiction when that information is shared by the patient with the healthcare provider. The goal is to flag this history on the patient’s record in the same way as any other life-threatening medical issue, like a penicillin allergy.
The bill was sparked by the death of Jessie Grubb, of Charleston, who battled heroin addiction for seven years. She had completed her fourth stay in rehab in Michigan and was making a new life for herself there, training for a marathon. While there, she had surgery for a running-related injury.
Her parents — David Grubb, a Charleston attorney, and Kate Grubb — joined her there and alerted hospital personnel that she was a recovering addict. The fact was mentioned eight times in her medical records but was never displayed prominently, as are allergies and other potential complications.
But the discharging doctor, who didn’t know her and hadn’t treated her, prescribed 50 oxycodone pills for post-surgical pain. She died the day after her release, having apparently taken eight of the oxycodone pills.
The Grubbs worked with Manchin for two years to craft the legislation. “We believe that this legislation in honor of Jessie will actually save lives because doctors will now know from the very beginning that a patient is a recovering addict,” David Grubb, Jessie’s father, said.
Manchin also released a report detailing his plan to end the opioid epidemic.
His drug prevention component includes four bills: The Changing the Culture of the FDA Act; the FDA Accountability and Public Safety Act; the Protecting Americans from Dangerous Opioids Act, which would require the FDA to remove approval for an existing opioid medication for every new opioid medication that it approves; and the Student and Student Athlete Opioid Misuse Prevention Act, which would provide $10 million annually to support programs for students and student athletes.
The omnibus bill included funding for legislation sponsored by McKinley:
$1 billion in additional funding for State-Targeted Response grants, first authorized by the 21st Century Cures Act. It provides a 15 percent set aside for states with the highest opioid use mortality rates.
$100 million for a Rural Communities Opioid Response program at the Centers for Disease Control and Prevention, targeted to 220 of the highest risk counties in the country.
$30 million for a new Rural Communities Opioid Response program within the Office of Rural Health policy at the Health Resources and Services Administration.
$500 million within the National Institutes of Health to research opioid addiction and develop alternatives to opioids, pain management and addiction treatment.
McKinley in the House and Capito in the Senate are among those sponsoring the bicameral, bipartisan Alternatives to Opiates (ALTO) program, which decreased emergency department opioid prescriptions by nearly 60 percent in its first year, in New Jersey. The Colorado Hospital Association saw decreasing opioid usage by 36 percent in six months.
ALTO would establish a demonstration program to test alternative pain management protocols to limit to use of opioids in hospital emergency departments. The legislation would provide grant funding to build these programs. Following the completion of the program, the Secretary of Health and Human Services will submit a report to Congress on the results of the program and issue recommendations for broader implementation.
Compiled by The Dominion Post reporter David Beard. Follow him on Twitter @dbeardtdp. Email dbeard@dominionpost.com.
