Congress applauds as president signs sweeping opiate reform bill

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WASHINGTON (Gray DC) -- The left and right come together to take on the opiate epidemic. But, some experts warn billions of dollars and dozens of changes to the law may not be enough.

With a thick-tipped marker, President Donald Trump signed a sweeping attack on addiction into law. “It really takes into account, I would say, the modern drug problem,” White House Opiate Czar KellyAnne Conway said.

The collection of more than 70 proposals passed with near unanimous support in both the House and the Senate. “It’s hard to single out one,” said Sen. Bill Cassidy (R-LA) when asked which aspects would have the biggest impact on his home state, “because they attach to different areas.”

Most notably, the bill calls for a variety of new treatment options for groups ranging from military veterans to newborn babies.

Sen. Shelley Moore Capito (R-WV) worked on portions ensuring states hit hardest by addiction get a disproportionate amount of federal help, doing more for children in foster care because of their parents’ addiction, and increased efforts to screen out foreign drug shipments sent through the mail.

“I think those will have big impacts in West Virginia,” she said. She added that the effort to tackle addiction has come a long way over the last three to four years.

Sen. Bill Cassidy (R-LA) also highlighted new abilities to track over-prescription, funding for research into pain-killers with the strength of opiates but not their addictive potential, and improvements to Medicaid addiction services.

Rep. Bob Latta (R-OH) told us about the importance of getting more resources into rural areas, and efforts to help those who get clean, stay clean. To do so, the legislation calls for helping former addicts get a job, and roof over their head. He also emphasized that this bill gets the country closer to being able to provide treatment immediately after an addict realizes they need it.

But outside of the White House and Congress, public health experts said this massive effort doesn’t go far enough.

“I think we’re just scratching the surface of the steps that are necessary,” said Dr. Joshua Sharfstein, “while it’s a long bill is actually not that aggressive.”

Sharfstein is the Vice Dean of the Bloomberg School of Public Health at Johns Hopkins University. Previously he essentially served as a top general in Maryland’s battle with addiction, as the Department of Health and Mental Hygiene Secretary.

Sharfstein argues perhaps the best step the country could take to kick addiction would be to expand Medicaid coverage – health insurance for low-income Americans -- in states that haven’t already. He said that would opening up treatment options for newly-insured addicts. The new law does increase the level and length of some addiction services covered by Medicaid – but does not dramatically alter the number of people with Medicaid coverage.

Sharfstein’s other big suggestion: invest more, a lot more. He echoed lawmakers who said immediate treatment options are sorely needed, but he doesn’t believe the new law will come close to providing the capacity necessary to significantly decrease wait times.

“If this legislation is a step toward a greater commitment, then I think we’ll look back and say it was a good move,” Sharfstein said in summary, “if it’s sort of like ‘mission accomplished,’ it’s not going to be successful.”

There are signs of progress in the opioid fight. Recent data from the American Medical Association said fewer prescriptions are resulting in fewer addictions, and early numbers for this year from the Centers for Disease Control suggest the ever-rising death toll may be leveling off.

As for what else needs to be done – lawmakers have more ideas, but many also suggested evaluating the impact of the brand-new changes before making more.

Sharfstein recommended states looking to do more look to the examples set by Rhode Island and Vermont. He praised the Ocean State’s effort to screen every prisoner for drug dependence, and provide extensive treatment to those who need it.

In the Green Mountain State, Sharfstein praised its efforts to work with the federal government to get Medicare and Medicaid to cover more addiction services. He also spoke highly of its hub-and-spoke model to provide treatment as efficiently as possible in a rural state.

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