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Congress tackles mounting opioid epidemic

Congress tackles mounting opioid epidemic
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House Republicans are beefing up their efforts to tackle the nation's deadly opioid crisis, but some experts question how effective their piecemeal approach will be.

Congress is touting its recent flurry of action — the House is on track to pass more than 50 bills addressing the issue by the end of this week — on an issue that is hitting many constituents hard, and one that lawmakers are sure to hear about on the campaign trail this year.

Still, many public health advocates, who applaud the steps taken by the House, also caution that more work is needed to truly end the scourge of overdose deaths, underscoring the scale of the challenge facing congressional leaders. 

The top Democrat on the House Energy and Commerce Committee has expressed some skepticism of the effort.

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“Republicans are touting this opioid package, which really doesn’t do a lot,” Rep. Frank Pallone Jr.Frank Joseph PalloneDems eye ambitious agenda if House flips Hillicon Valley: Facebook rift over exec's support for Kavanaugh | Dem worried about Russian trolls jumping into Kavanaugh debate | China pushes back on Pence House Democrat questions big tech on possible foreign influence in Kavanaugh debate MORE (N.J.) said at a press conference Wednesday. “I would say it doesn’t really do much for treatment, it really doesn’t do much for helping people recover.” 

Yet the effort has largely remained bipartisan. Democrats have authored and co-sponsored bills, and all but three pieces of legislation passed largely without opposition.

And House Energy and Commerce Chairman Greg WaldenGregory (Greg) Paul WaldenVulnerable Republicans throw ‘Hail Mary’ on pre-existing conditions GOP senator wants Apple, Amazon to give briefing on reported Super Micro hack Overnight Health Care: Bill banning 'gag clauses' on drugs heads to Trump's desk | Romney opposes Utah Medicaid expansion | GOP candidate under fire over ad on pre-existing conditions MORE (R-Ore.), who calls the latest effort to fight the drug epidemic “historic,” emphasized that this does not represent the last of their actions.

“We’re going to legislate and evaluate. We’re not done,” Walden told The Hill on Friday. “There will be more opportunities coming because we want to get it right. We’ll need to come back. That’s part of being good legislators.”

The opioid epidemic is a perplexing public health problem that’s only getting worse. An estimated 115 Americans are dying every day of an opioid-related overdose, and the number of deaths increased nearly 28 percent from 2015 to 2016, according to the latest data from the Centers for Disease Control and Prevention.

The issue is top of mind for lawmakers, who hear story after story of the harrowing impact on their home districts. 

During a press conference this week, GOP leaders and lawmakers lined the stage holding up pictures of people the crisis has impacted and sharing their heart-wrenching stories.

And during a separate press conference this week, Speaker Paul RyanPaul Davis RyanPelosi, Schumer: Trump 'desperate' to put focus on immigration, not health care Trump urges Dems to help craft new immigration laws: ‘Chuck & Nancy, call me!' Sanders, Harris set to criss-cross Iowa MORE (R-Wis.) pointed to a large chart showing the spike in opioid deaths over the years.

“This is costing us lives. This is why we’re so focused on ending this opioid epidemic,” Ryan told reporters Thursday. “This is all hands on deck, and we’re going to keep at this for the sake of the families that are hurting right now.”

This past week, the House passed 38 bills aimed at the opioid epidemic. They included measures that would repay student loans of up to $250,000 for those who work as a substance use disorder treatment professional in areas in need, establish a database of the nation's efforts to combat the opioid epidemic, give the National Institutes of Health more authority to research nonaddictive pain medications and make it tougher to smuggle opioids through international mail.

Next week, the House plans to consider at least another 19 measures, according to the majority leader’s office.

But fighting the crisis isn’t easy. 

Experts agree that there isn’t a silver bullet to solve the thousands of deaths per year from prescription painkillers, heroin and a powerful synthetic opioid called fentanyl. Rather, it requires a comprehensive response, in part aimed at bolstering prevention, treatment and recovery support services.

On the whole, addiction advocates say they’re thankful the issue is getting national attention and that Congress is working to tackle it. Yet some say that even more work is needed, as the rate of opioid-related deaths keeps rising each year.

“These bills are a good step forward, but we need additional focus and resources and investment to really turn the tide of the opioid epidemic,” said Rebecca Farley David, vice president of policy and advocacy at the National Council for Behavioral Health. 

She pointed to expanding funding for community mental health and addiction centers as one she thinks would make a difference, and wishes would pass. 

“I think they have taken action on some very important issues,” Farley David said, but she has concerns about bills centering around grant-funded initiatives. Grants are needed, but they’re time-limited, she said, and more permanent solutions are necessary so the grantees don’t have to worry that their funding will get cut off in a few years.

“It seems like we’re doing a lot of poking around, seeing what works, we’ll evaluate it, which is good, but a lot of the bills don’t necessarily get to the urgency that we have,” said Andrew Kessler, the founder of Slingshot Solutions, a consulting firm specializing in behavioral health policy. 

“I’ll never be one to criticize something that’s deliberate, that requires collection of data — that’s good — but this is a problem that needs two approaches: one in the long term and one in the short term,” he said, echoing concerns about funding for certain programs possibly ending in a few years. 

One of the bills Kessler believes straddles both lines is the student loan repayment bill.

Other advocates offered mostly words of praise for the effort. 

“The big news here is that Congress is finally being confronted with the fact that this issue affects every other issue,” said former Rep. Patrick Kennedy (D-R.I.), who served on the president’s commission to tackle the opioid epidemic but has since been critical of the administration’s response.  

In particular, Kennedy highlighted legislation allowing more flexibility for providers to treat patients with a medication for opioid addiction, which was included in an underlying bill. He also touted legislation passed Tuesday to develop and disseminate best practices for operating recovery housing. 

“It’s exciting that we’re dealing with the obvious must-dos,” said Kennedy, a vocal addiction advocate.

But in terms of funding, Kennedy has called for billions more dollars to combat the opioid epidemic, saying “we’re still well shy of what would even be considered a modest response just in terms of the dollars.”

On the other side of the Capitol, both the Senate Health and Finance committees have passed bipartisan opioid legislation. If the bills are approved on the Senate floor, then the two chambers will have to go to conference to hammer out a final opioid package to send to President TrumpDonald John TrumpDemocrats slide in battle for Senate Trump believes Kushner relationship with Saudi crown prince a liability: report Christine Blasey Ford to be honored by Palo Alto City Council MORE’s desk. 

Congress is building on its past efforts to address the epidemic. In 2016, lawmakers passed the Comprehensive Addiction and Recovery Act, which President Obama signed, and then subsequently allocated $1 billion for the law. 

Earlier this year, Congress passed a two-year budget deal that included $6 billion to tackle the opioid epidemic and mental health reform. 

Republican leaders recognize the complexities in fighting the crisis.

“It is multipronged,” Ryan told reporters. “It’s treatment and recovery, it’s stigmatism reduction, it’s pharmaceutical, it’s the way prescriptions are written, and it’s awareness … We’ve got to get on top of this.”