May 13, 2016
Area(s) of Interest: Drug Prescribing/Dispensing Public Health
The U.S. House of Representatives passed a series of bills this week to combat opioid abuse. The bills include provisions that would encourage the prescription and distribution of opioid overdose reversal drugs; permit the partial filling of prescriptions to avoid overuse; create an advisory committee within the Food and Drug Administration to review opioids without abuse-deterrent properties before they are approved; and evaluate opioid treatment infrastructure.
Instead of allocating new funding, all of the bills redirect existing funding within the U.S. Justice Department and other agencies.
The opioid bills passed include:
HR 4981: The Opioid Use Disorder Treatment Expansion and Modernization Act. This bill modifies the rules regarding the administration of medication-assisted treatment for opioid addiction and expands such treatment without raising the current patient cap. It would allow qualified nurse practitioners (NP) and physician assistants (PA), not just physicians, to provide such services and would allow drugs administered in a medical office to be exempted from the patient caps. This provision only applies where NPs and PAs can already prescribe schedule III-V drugs, they are still subject to training requirements and state supervision requirements. The bill also allows prescriptions for Schedule II drugs to be partially filled in order to reduce the potential for abuse. The partial fill provision is voluntary and up to the physician and the patient.
HR 4063: The Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act. This bill would require the Department of Veterans Affairs to update the chronic pain therapy guidelines at veterans' medical facilities.
HR 4641: Interagency Task Force. This bill would establish an interagency task force to review, modify and update best practices for pain management and prescribing pain medications.
HR 4843: Infant Plan of Safe Care Improvement Act. This bill requires states that receive grants for child-protective services to certify that they have a program for the care of drug-dependent newborns.
HR 4978: Nurturing and Supporting Healthy Babies Act. This bill requires a report from the GAO on the prevalence of neonatal abstinence syndrome (NAS) and services that are covered under state Medicaid programs to treat infants with this syndrome.
HR 5022: The Opioid Program Evaluation Act. This bill directs the U.S. Department of Health and Human Services to evaluate the effectiveness of drug control programs and grant programs that provide assistance in addressing opioid abuse.
HR 5046: The Comprehensive Opioid Abuse Reduction Act. This bill would authorize the U.S. Attorney General to make grants to assist state and local governments in addressing the national epidemic of opioid abuse. It includes grants for addiction treatment, prevention and the management of controlled substances.
HR 5048: The Good Samaritan Assessment Act. This bill would require the Government Accounting Office to perform a review of state medical liability Good Samaritan laws regarding emergency responses to opioid overdoses.
In February, the U.S. Senate voted 94-1 to pass the Comprehensive Addiction and Recovery Act, that would fund opioid education and prevention initiatives, improve treatment programs and expand the availability of the overdose prevention drug naloxone. All of these bills are expected go to a formal House-Senate conference committee to develop a final compromise package.