Federal focus on opioid crisis has been historic and must continue

This week’s signing of the SUPPORT for Patients and Communities Act marks the third consecutive year that Congress and the administration have taken significant bipartisan action to address the nation’s opioid overdose epidemic and broader addiction crisis. Those of us working on the front lines of this public health problem are deeply grateful and hope the sustained federal focus will continue.

The SUPPORT Act includes an array of helpful new programs and reforms. Among them:

• A national ban on “patient brokering”—the unethical buying and selling of patient referrals;
• Partial repeal of an outdated rule called the “IMD exclusion,” which will expand residential care options for people with Medicaid;
• The identification and development of best practices for recovery residences;
• A crackdown on mailed shipments of illicit fentanyl;
• School loan forgiveness for addiction treatment professionals who choose to work in underserved areas;
• New grants and demonstration projects to expand access to medication-assisted treatment; and much more. 

{mosads}The federal government’s action—not just this year but over the past decade—has been historic. For generations, addiction has been misunderstood and marginalized as a moral and criminal problem, rather than an illness worthy of mainstream health care. But thanks to the Mental Health Parity and Addiction Equity Act of 2008, the Patient Protection and Affordable Care Act of 2010, the Comprehensive Addiction and Recovery Act and 21st Century Cures Act of 2016, recent increases in funding for state grants and research, and this year’s SUPPORT Act—along with the 2016 “Surgeon General’s Report on Alcohol, Drugs and Health” and a huge uptick in grassroots advocacy around the country—America is poised to finally change the trajectory of this longstanding problem.

It will take more time, though—and further action. America continues to have a serious substance use problem, and the impact on our society is staggering. In economic terms, substance use costs the country almost a half-trillion dollars a year. More than 20 million Americans have an active substance use disorder. Millions more, while not using substances at a disordered level, report binge drinking or other substance misuse. In 2017 alone, substance use resulted in almost 50,000 opioid-related overdose deaths, more than 22,000 other overdose deaths, almost 90,000 alcohol-related deaths, immeasurable strains on families and relationships, compromised physical and mental health among people from every age and walk of life, increased spread of infectious disease, loss of productivity, and huge health care expenditures.

Another significant action Congress can take this year is to pass the Overdose Prevention and Patient Safety Act (OPPS). The OPPS Act—H.R. 6082—would modernize the 1970s-era “42 CFR Part 2” regulations that govern addiction treatment records by making them consistent with the Health Insurance Portability and Accountability Act (HIPAA) law that governs all other health records. It also would strengthen anti-discrimination protections for patients.

Establishing consistency when it comes to record sharing in the health care industry will facilitate improved patient care coordination, accelerate the needed integration of specialized addiction treatment with mainstream health care, and encourage more rapid development and implementation of telehealth and other technology solutions. By regulating addiction treatment records like other health records, the OPPS Act will reduce institutionalized stigma and support the legal concept of “parity,” helping to ensure that people with addiction get the full benefits of modern health care and nothing less than they would for other health conditions.

The OPPS Act is essential to ushering in the next generation of addiction treatment and bringing the full force of health care to bear against this enormous public health issue. The House already passed it on a bipartisan 357-57 vote. So today, let’s celebrate the enactment of historic legislation to prevent and treat opioid addiction. And tomorrow, let’s get back to work with swift action on the OPPS Act in the Senate.

Mark Mishek is the president and CEO of the Hazelden Betty Ford Foundation, a nonprofit addiction treatment leader with 17 sites in nine states.