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The Opioid Crisis: An Ongoing Legislative Priority

Summary

The House and Senate are advancing legislative packages aimed at mitigating the crisis.

Congress is currently pursuing three major legislative packages:

The Comprehensive Addiction and Recovery Act (CARA) 2.0

Introduced February 27 by Senator Rob Portman (R-OH), CARA 2.0 builds on infrastructure implemented in CARA 2016, a flagship legislation that authorized $180.9M in new funding for evidence-based OUD prevention programs, treatment initiatives, and recovery efforts. CARA 2.0 proposes $1B in funding to both extend the programs created by CARA 2016 and implement new initiatives (e.g., Youth Recovery Initiatives), which were removed from CARA 2016, and funding for programs to monitor infants affected by OUD. Senators are aiming to bring the legislation to the full Senate floor by August.

The Opioids Crisis Response Act of 2018

Introduced April 16 by Senators Lamar Alexander (R-TN) and Patty Murray (D-WA), the bill was crafted based on feedback gathered from administrative officials, local stakeholders, providers, and patient advocates in 7 hearings conducted over 6 months. The legislation includes over 40 proposals to mitigate the crisis, including expanded NIH flexibility to research chronic pain, FDA authority to develop non-addictive alternatives to opioid products, data-sharing requirements and infrastructure, treatment options for those impacted by OUD, and community-based recovery and prevention efforts. While the bill has not yet been scheduled for a full floor markup, lawmakers have indicated broad, bipartisan support for the measure.

House Energy and Commerce

The House E&C Subcommittee on Health has held a series of hearings targeting the opioid epidemic,advancing 57 individual pieces of legislation to the full committee on April 25. The bills, which address prevention, research, and treatment efforts in both the Medicare and Medicaid programs, are expected to be marked up by the full committee in May. E&C Chairman Greg Walden (R-OR) has indicated his intention to report a comprehensive package targeting OUD to the full House by Memorial Day (May 28).

While the three legislative options currently advancing through Congress address different aspects of the opioid crisis, common themes (including expanded access to medication assisted treatment (MAT), prescription drug monitoring program (PDMP) interoperability, medical record privacy, and an emphasis on local and state grants to support population-based recovery programs) from both the House and Senate offerings have broad bipartisan support and are expected to be reflected in the final legislation.

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