Opioid Work Continues with Legislative Proposals
In late February, eight senators introduced bipartisan legislation to address the ongoing opioid addiction epidemic. Known as the Comprehensive Addiction and Recovery Act (CARA) 2.0, this piece of legislation increases funding authorization levels for the CARA programs enacted in 2016 and puts in place additional policy reforms to help combat the opioid epidemic.
“CARA became law on July 22, 2016 [and is] starting to make a difference by transforming the way the federal government treats addiction and ensuring that federal resources are devoted to evidence based prevention, treatment, and recovery programs that work,” stated Senator Rob Portman (R-OH). “CARA 2.0 builds on the original CARA by increasing the funding authorization levels to better coincide with the recent budget agreement. Coupled with policy changes to strengthen the federal government’s response to this crisis, CARA 2.0 authorizes $1 billion in dedicated resources to evidence-based prevention, enforcement, treatment, and recovery programs. CARA 2.0 is part of the necessary response to the urgent call for adequate and sustained resources that appropriately reflect the magnitude of the crisis.”
AAOS has serious concerns about language in the bill that would limit prescriptions for opioids to three days. The authors of the legislation provided some exceptions for the three-day rule, such as chronic pain and as part of a cancer treatment plan, but AAOS strongly opposes any limits to opioid prescriptions that do not include exceptions for post-operative and trauma care. Representatives from AAOS are working with these members of Congress to share our concerns and messaging.
AAOS does support a wide range of activities to help alleviate some of the causes of the current opioid crisis, including mental health screening, increased access to medication therapy management, and better interoperability between prescription drug monitoring programs (PDMP) systems. To this end, AAOS has also responded to two requests for information from congressional committees in both the House and Senate that address these issues. You can read those letters online here and here.
AAOS also supports the MONITOR Act, which would establish minimum standards that PDMPs must meet to receive funding from the State Targeted Response to the Opioid Crisis Grants. The legislation mandates that PMDPs must meet a uniform electronic format for reporting, increase sharing and disclosing of information, meet minimum standards for interoperability, and make information available to physicians on a timely basis. You can read our letter of support here.
Finally, AAOS supports the Every Prescription Conveyed Securely Act, which would require electronic prescriptions for controlled substance under Medicare Part D. By requiring prescribers to use an online database where prescriptions are easily monitored and tracked, this bill could help eliminate doctor shopping and duplicative or fraudulent handwritten prescriptions that fuel the opioid epidemic. You can read our letter of support here.
You can find all opioid-related advocacy information online at www.aaos.org/advocacy/fda/.