Call To Action

CARE ACT – WE NEED FEDERAL FUNDING FOR TREATMENT

Treatment is the most vital component in dealing with the opioid addiction epidemic. Treatment saves lives. Due to advocacy efforts, treatment is more available now than it was. In 2016, the NSDUH survey showed that 453,000 (21.6%) Americans with OUD received treatment for OUD. In 2017, that number rose to 603,000 (28.6%).  But this is far short of what is needed.

Obtaining treatment continues to be a real challenge to those with OUD. In general, accessing treatment remains more difficult than getting drugs. We have no simple universal route into treatment, no place where a patient can simply show up and be guaranteed entry. And the power of addiction is such that the OUD patient needs help now, or the opportunity for treatment may be lost.  Difficulty accessing treatment often results in no treatment at all.

Medicaid has provided simpler entry into treatment.  Americans with OUD who are on Medicaid are significantly more likely to receive OUD treatment (43%) than those who are uninsured (21%) or have private insurance (23%).   It is ironic that so few of those with private insurance are receiving OUD treatment, but many of those with insurance who have attempted to obtain treatment can attest to what a frustrating experience it can be. 

              Obamacare (The Affordable Care Act) made Medicaid available to millions of Americans living in the 36 states that accepted the terms of Medicaid Expansion, under which Medicaid eligibility criteria rose from 43% of the poverty line to 138% of the poverty line, making Medicaid newly available to 12.7 million Americans.  This has been of great value to the working poor needing OUD treatment.

              But 14 states did not accept the terms of Medicaid expansion.  Obtaining Medicaid is not possible in those states for many of the 2.2 million people in those states whose income falls between 43% and 138% of the poverty line.  These are the working poor who make too much money to be on Medicaid and are too poor to afford Obamacare insurance, even with subsidies.

Worse, the proposed 2019 Federal Government Budget would eliminate Medicaid for the 12.7 million Americans only recently covered by Medicaid expansion. 

              Over the past few years, the federal government has enacted several pieces legislation designed to improve the prospects of treatment for those with OUD.  These include The Comprehensive Addiction and Recovery Act (CARA), the 21st Century Cures Act, The Omnibus Spending Bill of 2018, and the SUPPORT for Patients and Communities Act of 2018 (see * below for elaboration on these pieces of legislation.) 

None of these have been comprehensive in the way that the successful Ryan White Comprehensive AIDS Resources Emergency Act of 1990 was. The Ryan White Act committed the federal government as the payer of last resort for treatment for all those with HIV or AIDS. None of these allow an OUD patient a guaranteed path of entry into treatment.  And the current legislation does not make a commitment to sustained funding. It is unreasonable to expect people to build a clinic knowing that the funding for treatment could dry up in 2 years.

And parts of the current legislation came with a price which undermined its very goals. The ACA did not allow Medicare to negotiate drug prices with manufacturers 

Last year, Sen. Elizabeth Warren (D-Mass.) and Rep. Elijah Cummings (D-Md.) introduced the Comprehensive Addiction Resources Emergency Act, a bill that would provide $10 billion per year over 10 years to deal with the opioid addiction epidemic.  This bill is modeled after the Ryan White Act.

A major step of this kind is vital if we are to develop easy availability of treatment for all those afflicted with OUD and truly diminish the impact of this epidemic.  Please contact your Congressman and Senators.

REPEAL The Ensuring Patient Access and Effective Drug Enforcement Act of 2016

The FED UP! Coalition also asks that you contact your Congressional representatives to repeal the Ensuring Patient Access and Effective Drug Enforcement Act since, as we wrote in a letter to the appropriate Congressional Chairmen, “the law constrains the D.E.A.’s ability to enforce the Controlled Substances Act and allows perpetrators of illegal opioid distribution to act with impunity.”

The Ensuring Patient Access and Effective Drug Enforcement Act dramatically increased the standard of proof required for the D.E.A. to suspend a D.E.A. registration. The law was passed because it was falsely promoted as a way to ensure patient access to narcotics and improve cooperation between the D.E.A. and industry. In reality, the law constrains the D.E.A.’s ability to enforce the Controlled Substances Act and allows perpetrators of illegal opioid distribution to act with impunity.

On Sunday, Oct 15, 2017, the Washington Post and 60 Minutes jointly brought national attention to this legislation and its impact to the D.E.A.’s ability to protect public health. The news coverage provided multiple examples of opioid distributors willfully neglecting their responsibility to report suspicious prescription opioid orders.

It is time for Congress to act. Until this law is repealed, the D.E.A.’s ability to enforce the Controlled Substances Act will be hampered. Repealing this law will save lives and help bring the nation’s most urgent public health crisis under control. Please contact your Congressman and Senators and urge them to Repeal this bill.

SOFA Act

STOPPING OVERDOSES of FENTANYL ANALOGUES (SOFA) ACT

This bill amends the Controlled Substances Act to add certain fentanyl analogues to schedule I. A schedule I controlled substance is a drug, substance, or chemical that: has a high potential for abuse; has no currently accepted medical value; and is subject to regulatory controls and administrative, civil, and criminal penalties under the Controlled Substances Act. Please, contact your senator and congressperson, and implore them to support the SOFA Act, and why they must pass the legislation ASAP!! 

Submit your comments to the FDA

The FDA is looking into how naloxone can be made more available.  They’ll be having an Advisory Committee meeting on December 17th and 18th to discuss this matter.

The FED UP! Coalition has long advocated for ready access to naloxone. Too many people have died because they did not have naloxone readily available.

The FED UP! Coalition plans to communicate to the FDA:

  1. All forms of naloxone should be sold over the counter
  2. The Federal government should subsidize over the counter naloxone to keep the price under $20 per dose.
  3. The Federal government should launch a public awareness campaign regarding Naloxone to cover such issues as:
    • Should you have naloxone in your home or place of business?
    • How do you know when to administer naloxone?
    • How do you administer naloxone?

The FDA is also asking what has worked in your community to expand naloxone access and in what circumstances you believe that naloxone should automatically be prescribed when an opioid is prescribed.  You may want to let them know your opinion on these issues as well.

Comments sent by Friday, Dec. 14, 2018, will be reviewed by the FDA Advisory Committee.