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The Senate is about to pass a fat stack of opioid bills. Advocates say it’s not enough.

Advocates want to see more dollar signs, which the package can't offer.

by Emma Ockerman
Sep 12 2018, 3:16pm

The U.S. Senate is likely to green-light a fat package of bipartisan bills to address the opioid epidemic this week. It’s just not the sort of comprehensive change that advocates were gunning for.

In the bundle of nearly 70 proposals are measures that would allow the National Institutes of Health to research a new, non-addictive painkiller; impose new requirements on the United States Postal Service in an attempt to better screen packages for fentanyl; and authorize $60 million for a “plan of safe care” for babies born dependent to opioid drugs. It’s similar to a package the House passed in June, and the proposals will have to be reconciled between the two chambers before reaching President Donald Trump’s desk.

Advocates want to see more dollar signs in the meantime, though. And this package — the result of months of negotiations between Democrats and Republicans — can’t offer that. Congress already directed $6 billion to the opioid epidemic over two years in its most recent spending bill. In a separate appropriations bill to fund the Department of Health and Human Services, the Senate committed an additional $3.7 billion to the opioid epidemic.

Advocates urge that this package can’t be sold as a solution to the epidemic. It’s a lot of small proposals they want, certainly, but not the sweeping action they had hoped to see.

“It’s not what I would say is enough to have a major impact on the opioid epidemic,” said Joshua Sharfstein, professor of the practice in health policy and management at Johns Hopkins Bloomberg School of Public Health. “There needs to be a much greater commitment of funds, and there also should be a rethinking of some of the approaches that the country takes to addiction treatment.”

Democrats and advocates, however, have called for a solution similar to the Ryan White HIV/AIDs program, which has authorized nearly $20 billion in funding since 2010. One Congressional proposal modeled off that program would offer $100 billion over a decade to the opioid crisis, for example.

Trump’s administration has been criticized for a perceived slow response to the opioid epidemic — which contributed to an estimated 72,000 overdoses in 2017 — or, in some camps, for taking a more punitive, criminal justice-based approach. And when Trump declared a public health emergency nearly a year ago, his administration didn’t authorize the sort of funding that an emergency declaration would unlock.

Mental health advocate and former Congressman Patrick J. Kennedy, who served on Trump’s commission to address the opioid epidemic, told VICE News in an interview on Aug. 29 that existing funding is “anemic” and “a fraction of what we did for HIV/AIDS.”

“Now everybody is doing a rain dance thinking we’re all hunky-dory because Congress put out $4 billion,” Kennedy said of the amount in the omnibus spending bill earlier this year.

So far, Trump has been outspoken about at least one aspect of this legislation: the USPS bill, known as the Synthetics Trafficking and Overdose Prevention (STOP) Act. It’s been something of a passion project to Sen. Rob Portman, a Republican from Ohio and chairman of the Senate’s Permanent Subcommittee on Investigations. His committee led an alarming report on fentanyl pooling into the country earlier this year.

If passed, the legislation would require the post service to collect more information on packages bound for U.S. addresses so customs inspectors could screen them, or even levy civil fines on the agency if it fails to meet certain requirements. The postal service would have to provide information — like the name and address of the sender and a description of the contents of packages — on 70 percent of international mail shipments by the end of this year.

“It is outrageous that Poisonous Synthetic Heroin Fentanyl comes pouring into the U.S. Postal System from China,” the president tweeted in August. “We can, and must, END THIS NOW! The Senate should pass the STOP ACT – and firmly STOP this poison from killing our children and destroying our country. No more delay!”

Although Trump has talked tough on Mexico and China, he hasn’t said much on treating substance use disorders. This package, at least, would authorizes a pilot program to provide individuals in recovery with temporary housing, and could address recovery worker shortages by offering more providers access to loan repayment programs.

“Absolutely, it’s a positive step forward,” said Andrew Kessler, founder of Slingshot Solutions, which specializes in behavioral health policy consulting. “But that’s all it is; it’s a step.”

Cover image: This June 1, 2018, file photo, shows syringes of the opioid painkiller fentanyl in an inpatient pharmacy. (AP Photo/Rick Bowmer, File)

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