FED UP! advocacy
A CALL TO ACTION!
Fall 2017 Update…
Our August FED UP Rally included a press event at the National Press Club calling for FDA removal of high dose opioids, a networking luncheon for partners to share advocacy practices, and a march to the White House and a candlelight vigil for hundreds of our followers. We believe our voices are being heard and reflected in a number of important addiction-fighting developments this fall.
First, we have seen FDA Commissioner Gottlieb publically announce a change in approach for the future review of abuse deterrent opioid formulations, known to be equally addictive and risky as other formulations, to ensure they produce ANY meaningful decrease in the frequency of misuse and addiction. We also note, with approval, recent strong endorsement of the use of medication-assisted treatment as THE standard of care for the treatment of opioid SUD. The FDA Commissioner correctly testified before the congress in September that patients receiving MAT coupled with therapeutic support “cut their risk of death in half.” FED UP’s platform has consistently supported expanded access and removal of barriers to buprenorphine and we will continue to do so in 2018.
We welcome the FDA Commissioner’s renewed commitment to reconsider the appropriateness of opioid drugs, commitments to review the process for addressing total risks of opioid drugs and required physician training related to prescribing and use of opioids. We will remain vigilant in 2018 to ensure FDA honors those commitments as well as positively responds to the FED UP Coalition-endorsed petition developed by Physicians for Responsible Opioid Prescribing (PROP) and the Association of State and Territorial Health Officials (ASTHO) to remove high dose opioids from the market immediately.
Second, the FED UP Coalition was pleased the President honored past commitments to declare an opioid public health emergency on October 26. The declaration is a needed step to ensure the public hears directly from the nation’s chief executive that we are in the midst of an unparalleled health crisis and that federal, state and local government coordinated action are needed to bring the devastation to an end. However, the declaration, disappointedly, did not indicate a commitment of federal resources were forthcoming.
The FED UP Coalition does not accept a re-shuffling of existing federal programs to bring the crisis to an end. We will continue to demand resources on a par with other past public health threats which included billions appropriated by our federal government to combat the Ebola virus that never reached our shores, the Zika virus which affected limited areas of our country and Avian Influenza that never took flight in the US.
Finally, the FED UP Coalition was pleased the President’s Commission released a final report on November 1 with over 50 recommendations for action by the Administration. Among those recommendations were calls for:
- Allowing government regulators to compel health insurers to meet requirements of parity laws which ensure addiction treatment equivalent to coverage of mental health issues – the afflicted and their families should not be left alone to ensure health insurers comply with the law.
- Reducing barriers to coverage of non-opioid solutions for the treatment of pain – past federal regulations limited reimbursement for effective alternative pain management solutions.
- More aggressively fighting to reduce importation of fentanyl/fentanyl analogues which are exploding overdose deaths throughout the country – fentanyl was implicated in over 40% of last year’s opioid-related overdose deaths.
- Expanding telemedicine approaches to bringing mental health and addiction treatment to underserved areas of the country – less than half of America’s 2,000 counties have a single mental health professional or MAT-authorized provider.
- Making access to medication-assisted treatment a cornerstone to addressing the crisis starting first in federal practice settings – ample clinical evidence exists proving greater recovery rates through effectively managed and monitored medication-assisted treatment approaches.
The President’s Commission recommendations are contained here:
As Congressman Tim Ryan, co-chair of the House Addiction Treatment and Recovery Caucus, recently said after the release of the President’s Commission Report, “there are many actions that can help mitigate this crisis, but at the end of the day, Congress must invest more money.” The FED UP Coalition strongly agrees.
Followers are encouraged to contact their members of congress to demand needed federal investment, especially to protect current and expand future treatment coverage. What our nation is doing is not working. Until and unless we develop the national will to fight the national public health emergency destroying thousands of individuals and families across America, we will continue to see ever expanding loss of life. Congressional member contact information is available on the website.
Thank you for your support!
August 2017 Update…
Since our last update and in the face of ever increasing overdose deaths, we have seen coverage of the opioid addiction epidemic increase nationally. The epidemic has generated additional interest in policy and legislative solutions as well.
On the legislative front, attempts to repeal and replace the Affordable Care Act have captured the attention of addiction fighting organizations across the country including FED UP. Recent bills introduced in the House and Senate included provisions which could have far-reaching implications for coverage of addiction treatment. Included in those bills were proposals to allow health insurers to offer streamlined health insurance coverage which may eliminate mental health and addiction treatment as essential benefits as well as new limits on coverage of pre existing conditions. In addition, House and Senate proposals included dramatic cuts in Medicaid which now provide addiction treatment to thousands of economically disadvantaged citizens suffering from SUD. While the bills did not ultimately pass, we will remain steadfast in opposition to any future healthcare reform proposals that lessen access to life-saving treatment.
In the policy arena, the President’s Commission on Combating Drug Addiction and the Opioid Crisis released an interim report on July 31. Noteworthy among many recommendations were calls for the declaration of a national public health emergency, dramatically expanding and funding access to medication-assisted treatment, mandating prescriber education, removing regulatory barriers that limit sharing of needed patient information and increasing efforts to interdict the arrival of imported fentanyl. While the Commission recommendations are proposals, the Administration and the Congress will be required to accept and implement them. While FED UP broadly supports nearly all of the recommendations, many details remain unanswered. We intend to closely monitor recommendation implementation, especially the declaration of a public health emergency, which based on statements from the Administration, seemingly emphasize a return to failed “war on drugs” policies of the past.
The FED UP Coalition remains committed to ensuring the FDA be part of the solution to the epidemic rather than a contributor – fighting for industry free opioid use guidance, more careful and considered opioid approval processes and mandatory prescriber education. FED UP will demand FDA improve opioid labeling, consistent with CDC’s prescribing guidelines which include dosage and duration limits.
We invite supporters to learn more by attending the FED UP Rally event in Washington, DC on August 31. Rally events will include a press conference at the National Press Club to discuss our demands followed by a networking luncheon to discuss and share advocacy issues for 2017. In the evening, a remembrance vigil and march to the White House grounds to have our voices heard have been organized. Please learn more about the August 31 Rally events on the website.
Thank you for your support!
June 2017 Update…
The FED UP Coalition is saddened to report that opioid-related overdose deaths continue to rise, seemingly unabated. Nationally, opioid overdose deaths rose 15% from 28,647 in 2014 to 33,091 in 2015. Heroin overdose deaths are skyrocketing because fentanyl is frequently mixed in with the heroin or sold as heroin. Final 2016 statistics, when reviewed and released by the CDC, are expected to be even more horrific.
Since our last rally in Washington, DC, we did see some federal action including the addition of new funding to implement the Comprehensive Addiction and Recovery Act and $920M in new state-directed treatment grant resources included in the 21st Century Cures Act. Also, the cap on the number of patients a practitioner may treat with buprenorphine was lifted to 275.
Since January, the Trump administration has assumed responsibility for providing leadership and for implementing needed federal solutions to the continued surge in opioid addiction in the country.
Despite new actions implemented late last year and the arrival of a new administration, we remain greatly disappointed in the lack of action. Since January, we have seen the following:
- The appointment of an FDA Commissioner with a long, well documented list of financial conflicts with the industry he is charged with overseeing.
- The selection of a now withdrawn nominee at the Office of National Drug Control Policy (ONDCP) who previously co-sponsored a bill to shield drug distribution companies clearly supporting pill mill operations.
- The dramatic slashing of the budget for ONDCP (now partially restored in the President’s recent budget).
- A health care reform proposal that, in its current formulation, may reduce access to opioid addiction treatment.
- An Attorney General who continues to express an interest in bringing back the failed “war on drugs”.
- A DHHS Secretary who repeats a false contention that Medication Assisted Therapy substitutes one addiction for another.
And, as we all know, the epidemic of addiction and deaths rages on into 2017. FED UP is poised to continue exerting pressure on Congress and the Trump administration to bring this public health catastrophe under control. In 2017 we will:
- Demand that FDA be part of the solution to the epidemic rather than a contributor – (We are pleased by the decision to pull Opana off the market. But there are other opioid formulations that should also be removed. And FDA must stop approving new opioids).
- Fight to ensure the prescriber education in the FDA Risk Evaluation and Mitigation Strategy (REMS) is free from pharmaceutical industry bias.
- Advocate for FDA to add an upper dosage and duration limits to opioid labels.
- Hold the Trump administration accountable for installing a leadership team which is fully committed to public health solutions, not just criminal justice solutions and avoids conflicts of interest with the pharmaceutical industry.
- Advocate for the Trump Administration to seek adequate funding for addiction treatment.
- Advocate for Congress to allocate adequate funding for addiction treatment.
- Advocate for federal requirements to make use of state Prescription Data Monitoring Systems mandatory.
The 2017 FED UP! events will include a series of activities in Washington DC on August 31 coincident with International Overdose Awareness Day remembrance events around the country.
Thank you for your support of the FED UP! Coalition to End the Opioid Epidemic!
January 2017 Update…
As 2017 begins, we all are numbed by the continued horrific increase in overdose deaths involving opioids which rose from 28,647 in 2014 to 33,091 in 2015. Heroin overdose deaths rose from 10,574 in 2014 to 12,990 in 2015, an increase of 23 percent. Heroin continues to flood our communities and new threats in the form of Fentanyl and Carfentanil are continuing to emerge virtually unstopped. When final 2016 statistics are revealed by the CDC, those deaths are expected to be even more gruesome.
Despite some progress in changing federal policies and legislation as well as the commitment of additional dollar resources in 2016, much more needs to be done.
FED UP is poised to continue exerting pressure on the Congress and the new incoming administration to turn around the continued expansion of opioid addiction and death. Our focus areas for 2017 include the following:
- Reaching out to the new administration and members of Congress to ensure stemming the tide of the opioid addiction epidemic is a priority public health issue. Prior legislation and policy changes are not enough.
- Encouraging the new administration to install a leadership team which is fully committed to public health solutions, not just criminal justice solutions, avoids conflicts of interest with the pharmaceutical industry, and fights to secure adequate funding to ensure our loved ones suffering from substance use disorders receive evidence-based treatment.
- Demanding the FDA be part of the solution to the epidemic rather than a contributor – we must end the excessive influence the pharmaceutical industry has on FDA decisions and we will not allow the FDA to underestimate the risks associated with opioids, approve new uses or formulations, or shorten approval processes without our voices being heard. In 2017, FED UP will make our presence at hearings and public comment meetings loud and clear.
Look for future updates about hearings, public comment opportunities, meetings/events as well as our 2017 platform.
Thank you for your support!
December 2016 update…
In the final days of 2016, the federal government took an important step toward controlling the opioid addiction epidemic. A bill signed into law on December 13th called the 21st Century Cures Act includes $1 billion in grants to states to expand access to opioid addiction treatment. FED UP fought long and hard for this funding. In recognition of our efforts, Judy Rummler (FED UP’s chairperson) was invited to the signing ceremony at the White House.
While pleased with the desperately needed funding, we have concerns that the 21st Century Cures Act may weaken an already too weak FDA. The law will make it easier for pharmaceutical companies to get new drugs (including opioids) on the market before they are proven safe and effective. This aspect of the bill puts the interests of pharmaceutical companies ahead of public health and it shows that Big Pharma continues to wield enormous influence in Washington.
As you know, the opioid crisis is still getting worse. Opioid overdose deaths in 2015 exceeded the record high-level set in 2014. Deaths from prescription opioids, heroin and fentanyl are all still increasing. We have lots of hard work ahead of us. We will continue to focus on getting the federal government to do its part to bring the epidemic to an end.
We remain hopeful the new President-elect will keep his promise to take on the pharmaceutical companies and expand access to opioid addiction treatment. FED UP will do everything in its power to make sure this happens.
Your yearend gift to FED UP! would be greatly appreciated. It would help us continue to do our important work. Thank you for your continued support!
November 2016 update …
In 2016, CARA was passed. But much more needs to be done or overdose deaths will continue to mount. Previous calls for $920M to address the nation’s treatment gap have been ignored. Your member of Congress needs to hear from you now! They need to hear ASAP that every day without funding for treatment means more lost lives.
We are urging you to take the following actions:
1. Send a personal message to your member of Congress requesting immediate support for $920M in treatment funding. To email your Congress member click here. If you’re not sure what to write, here’s a sample message:
I am urging you to support the $920 million funding request for opioid addiction treatment. This funding is a bare minimum of what’s needed to help states expand access to effective addiction treatment. Overdose deaths will continue to mount and heroin will continue to flood into our neighborhoods until treatment becomes more available.
(Insert in a few sentences explaining how you have been personally affected by the opioid crisis.)
I urge you to address the critical treatment gap in the remaining days of the 114th session by fully supporting a minimum of $920M for states to increase treatment capacity. Every day Congress fails to provide this funding means the loss of more of our loved ones.
2. After you send your message to Congress, please let us know. Send us an email (email@example.com) with your city and state. Our goal is to make sure that every member of Congress hears from at least one constituent.
October 2016 update …
Thanks to all followers who descended upon Washington to attend the FED UP Rally, National Press Club Reception and Hill Day educational briefing. Only by aiming our voices at federal health and elected officials will we achieve the changes needed in federal policy and legislation to stem the tide of the opioid addiction epidemic.
As many of our followers are aware, much of our advocacy focus this year has been to obtain adequate funding to meet the dramatic treatment gap in our nation.
Many of you know that Congress passed an incomplete measure in the CARA bill. Many of the bill’s deficiencies will need to be re-addressed in the next session of Congress. Funding, even for the current bill is $7M now under a temporary funding measure and $37M for the entire bill once appropriators act after the November elections. Three alternatives, the President’s proposal to provide $920M to support the states in providing evidence-based treatment and two different emergency funding measures of over $600M, have been rejected on party lines.
On October 10th, the Senate Finance Committee minority members issues a report on the treatment gap in our country. It is a must read: http://www.finance.senate.gov/imo/media/doc/101116%20Opioid%20Treatment%20Gap%20Report%20Final.pdf
- 1 in 112 Americans suffer from opioid use disorder,
- There are enough providers to treat only 1 in 238,
- Only 1 in 834 are actually accessing the treatment they need.
- In 2016, federal spending will be nearly $4 trillion. Comparatively, the White House request for $920 million over two years is a drop in the bucket — yet it would be a dramatic exponential increase in needed treatment funding.
- Every day Congress ignores this funding need, means another 78 of our loved ones will lose their lives.
Whether we are red team, blue team, conservative or progressive, we are all struggling with the pain and suffering from opioid use disorder and the horrific loss of life we are experiencing. Please continue to call out those members of Congress seeking our votes but not acting responsibly. Doing so is not partisan, it is compassion.
September 2016 update …
Click here for our Hill Day flyer
By now, we are hopeful all FED UP! Coalition followers have made arrangements to attend the fourth FED UP! Rally on the grounds of the Washington monument on September 18. Rally details and logistical information are available on the website. As a follow-up to this year’s Rally, we have organized a Hill Day educational briefing on Capitol Hill on Monday, September 19. We will gather in Rayburn House Office Building (HOB Rm B-339) from 8:30 AM to 10:30 AM to discuss needed next steps in policy and legislation to stem the tide of the nation’s opioid addiction and mortality epidemic. Light morning refreshments will be provided.
As many of our followers are aware, much of our immediate advocacy focus will be on obtaining adequate funding to address the epidemic before us. Last year, we called upon the executive branch to step up and address this national public health crisis. The Administration responded by implementing a number of program activities, policy changes, legislative proposals and a budget request of over $1.1B for prevention and treatment. When 2015 opioid-related mortality statistics are compiled by the federal government, they will be more gruesome than any prior year. We consider the executive branch funding to be the minimum required to reverse the continually expanding deaths occurring across the country.
It is now time for the Congress to respond with a serious effort to fund prevention, treatment and recovery programs. Sadly, current proposals from the Congress to fund the opioid addiction and mortality crisis or the recently passed Comprehensive Addiction and Recovery Act are woefully inadequate. Our educational program on September 19 will address deficiencies in the CARA act as well as the lack of serious funding needed that must be addressed in the weeks ahead. Please come to our educational briefing and schedule a meeting with your member of Congress now to ensure our voices are heard and that Congress provides adequate, mandatory funding this year!
August 2016 update …
The FED UP! Coalition has created a petition to Congress expressing strong disappointment with the failure to include new mandatory funding in the Comprehensive Addiction and Recovery Act (CARA). We can not politely and patiently remain quiet as the opioid epidemic continues to worsen. Please read, sign and share our petition at: https://www.change.org/p/federal-funding-required-now-to-control-opioid-addiction-epidemic
July 2016 update …
On July 13, the Senate passed the Comprehensive Addiction and Recovery Act legislation. The CARA legislation is the only bill to make it out of congressional committees and make it to the floor of the House and Senate – it is likely the only attempt to get something done in the 114th congress. But even if the measure is signed into law, much more needs to be done.
The measure expands federal efforts to prevent addiction, increases access to life-saving naloxone, attempts to encourage alternatives to incarceration for drug offenses, expands access to buprenorphine and establishes (but does not fully fund) new grant programs for recovery and treatment among other provisions.
Attempts to fund the opioid bills (House bills combined with the Senate version of CARA) with emergency funding were rebuffed. Further opposition to the President’s budget request for $1.1B which included $920M directed to expand treatment access will now require congressional appropriators to fund the bill during the upcoming budget resolution process. Current levels of funding now being discussed are less than a third of that requested by the President.
While we fight to get every dollar possible to provide much needed treatment funding, the bill includes a Medicaid rebate to pharmaceutical companies for Abuse Deterrent Formulations (ADFs) of opioids. ADFs are just as highly addictive as regular formulations and Pharma does not need additional financial incentives from the federal government. The bill also includes, yet again, another task force to examine pain management issues with representatives from pain organizations funded by Pharma. This appears to be a backdoor process to undermine the CDC opioid prescribing guidelines issued this spring. The prescribing guidelines will save lives.
CARA also fails to ensure interstate operability and mandatory use of PDMPs which have both been shown to be effective in reducing the overprescribing of opioids.
While advocates across the country may applaud Congress’ first attempt to address the opioid addiction epidemic striking the nation, please keep in mind that much more will need to be done to address additional policy and legislative changes and certainly to provide funding for greater access to treatment.
Please keep pressing your federal representatives to address deficiencies in the CARA legislation and to demand full funding for treatment. Attend the FED UP! Rally on September 18th and make your voices heard!
Contact information for your US Senators is available here:
Contact information for your US House Representative is available here:
If you are unsure of your Congressional district, you can search for it here:
After stating your name and where you live, you could use the following sample message:
“The prescription opioid and heroin crisis is devastating families and communities in our state. Until we improve access to treatment we know overdose deaths will remain at historically high levels and heroin will keep flooding in to meet demand for it. Please support the President’s 2017 budget request for $1.1 billion. This is a crucial step toward controlling the opioid epidemic.”
For information on how to schedule a visit with your members of congress click here.
For those supporters living in the Washington, DC area or those who will remain in the area after the September 18th FED UP! Rally, please contact and visit your members of congress – we need our message heard.
We are seeking your support for the legislation and advocacy efforts listed below:
-US Senate Finance Committee Letter
On September 16, 2015 a letter (http://feduprally.org/wp-content/uploads/2015/09/US-Senate-Finance-Committee-Letter-Sept-2015-_Final-1.pdf) from the FED UP! Coalition was sent to the current chairman and ranking member of the Senate Finance Committee seeking public release of their findings as part of an 2012 investigation into financial ties between the opioid industry and nonprofit groups that advocated for the use of prescribed opioids in treating pain. You can read more about this investigation here:
-Contact the FDA to let them know that they are not doing their job!
You can contact them at 888-463-6332 or at firstname.lastname@example.org.
Let them know about actions they should take that would save thousands of lives a year. They should (1) place a moratorium on the approval of new opioid painkillers; and (2) change the labeling on opioid painkillers to accurately reflect the risks.
– Check your state’s progress in addressing the opioid epidemic. The National Safety Council has published their review of state progress in addressing the prescription opioid addiction epidemic. In their report, “Prescription Nation each state is assessed against six meaningful measures. See the attached report to review your state’s progress. Clearly, there is much more to do at the state level.
– Attend the FED UP! Rally and support the FED UP! Coalition. This is a grassroots coalition of families, medical experts and advocacy organizations who understand the devastation caused by our nation’s epidemic of addiction and overdose deaths. FED UP! is calling for immediate federal action to end the epidemic of addiction and overdose deaths attributed to opioids (including heroin) and other prescription drugs.