Congress

Lawmakers aim to double down with more opioids legislation

New efforts would double down on existing policies to curb illegal fentanyl use and authorize more funding

Reps. David Trone, D-Md., and Susie Lee, D-Nev., conduct a news conference at the House Triangle on Thursday, January 17, 2019. Trone heads the newly formed Freshmen Working Group on Addiction. He told CQ Roll Call the group will attempt to pass opioid-related bills it supports as individual measures to stem the opioid crisis, but that it’s possible the Senate could take up the bills as a package. (Tom Williams/CQ Roll Call file photo)

Lawmakers are showing renewed interest in continuing bipartisan work to combat the opioid epidemic, less than a year after the president signed a legislative package into law.

While the law focuses on various aspects of the crisis such as curbing prescription drug abuse, new efforts would double down on policies to curb illegal fentanyl use and authorize additional funding.

[Elizabeth Warren releases opioid plan ahead of Appalachian campaign stops]

The epidemic falls under the jurisdiction of a number of committees, but a unified plan to assemble some of the different ideas hasn’t materialized yet in either chamber. Some House and Senate leaders have already attached their names to individual bipartisan bills, though.

Senate Minority Leader Charles E. Schumer, D-N.Y., and six other senators from both parties back a bill that would place sanctions on drug manufacturers in China who attempt to traffic fentanyl — the highly potent synthetic opioid responsible for a large share of drug overdoses — to the United States. The Senate is expected to begin moving soon on it.

There are two similar bipartisan House bills – one from Rep. Max Rose, D-N.Y., and another from Rep. Vern Buchanan, R-Fla. A House Democratic aide said Rose’s bill is the one likely to move since it was introduced after including tweaks suggested by the Senate sponsors.

Another bipartisan bill, led by Rep. Paul Tonko, N.Y., which has the backing of Assistant Speaker Ben Ray Luján, D-N.M., would loosen restrictions on prescribing buprenorphine, a form of medication-assisted treatment.

Current law requires providers to apply for a separate Drug Enforcement Administration waiver to prescribe buprenorphine to treat substance use disorder, though they can already prescribe it for pain management.

The House Bipartisan Heroin and Opioids Task Force also plans to hold its second roundtable of the year in the coming weeks with a focus on synthetics like fentanyl, according to a spokesperson.

Moving forward

House and Senate leaders have not settled on a legislative vehicle for any legislation that moves forward.

Rep. David Trone, D-Md., who heads the newly formed Freshmen Working Group on Addiction, told CQ Roll Call the group will attempt to pass bills it supports as individual measures, but that it’s possible the Senate could take up the bills as a package.

“I believe the next steps are probably about a dozen or two dozen separate unique bills because not everybody can agree on everything. So by having some unique bills, we’re able to push things through that are bipartisan where folks have their interest,” said Trone. “In the Senate, it will probably get put together in an omnibus bill and move it that way.”

A spokesperson for Speaker Nancy Pelosi, D-Calif., did not comment on legislation but said the opioid epidemic is still a significant issue for Democrats and pointed to oversight actions already taken this year.

House aides involved with different bills hold mixed opinions on whether a broad package is likely this year. A House Democratic leadership aide said a few different ideas are currently being vetted.

One House Democratic aide sees an opening for the Rose fentanyl bill to ride along with a drug pricing package or with other bills related to addiction, while a House Republican aide placed a greater emphasis on revisiting individual House-passed bills that didn’t make it into law in 2018.

A Senate Republican aide said there’s less of a focus on opioids now compared to legislation to lower prescription drug costs, but added Republicans are leaving the door open to adding opioids legislation to a broader bill.

There’s also a possibility that a larger opioid bill could come together in time for the next election in 2020, two years after President Donald Trump signed the 2018 election year opioid law.

Five months before the 2016 elections, President Barack Obama signed another big anti-addiction law known as the Comprehensive Addiction and Recovery Act.

Both parties have benefited from messaging during campaigns on fighting the epidemic, but with a presidential election in the cards, action could also come sooner.

Funding push

Lawmakers are also looking at ways to beef up spending for existing programs to combat addiction.

Both the White House budget and the House 2020 fiscal budget increase opioid funding. But many lawmakers want more.

White House counselor Kellyanne Conway emphasized Trump’s commitment to pursuing federal action on combating opioids at a Tuesday event.

“A couple of the best things the federal government does and can continue to do is obviously the resource piece — making sure that the resources are there and making sure it’s enough,” said Conway. “We also want to encourage people to tell us what works. The resources are important but there are so many things that we can do for free, which is the education piece, the prevention piece, the access to treatment.”

Rep. Ann McLane Kuster, D-N.H., co-chairwoman of the Bipartisan Heroin and Opioids Task Force, plans to reintroduce her bill in the next two weeks to authorize $25 billion over five years to different government agencies including the National Institutes of Health and the Substance Abuse and Mental Health Services Administration.

“Congress has an important role to play in supporting the efforts of those on the frontlines combating the opioid epidemic,” said Kuster, emphasizing programs that expand treatment and recovery. "We need a two-pronged approach that includes increasing resources available to state and local efforts while also making legislative changes that empower stakeholders to better tackle the opioid crisis."

Sen. Elizabeth Warren of Massachusetts and House Oversight Chairman Elijah E. Cummings of Maryland, both Democrats, have also pushed for dramatically expanding funding.

The two lawmakers on Wednesday reintroduced a revised version of their bill  authorizing $100 billion in federal funding over 10 years to address the crisis, which would be administered through local grants and also used to fund research and expand access to naloxone.

This version makes a few substantive tweaks including creating a grant program that would help workers find employment while seeking substance use disorder treatment, expands access to evidence-based treatment, and emphasizes the prevalence of cooccurring mental health disorders.

It would also build off a provision in last year’s opioid law to fund expanding the ability of treatment providers to participate in Medicaid.

The bill has the support of over 200 national and local organizations including the American Medical Association.

Last week, the 55-member Freshmen Working Group on Addiction introduced its first bill, which would authorize an additional $1 billion per year for five years to fund state opioid response grants and tribal opioid response grants.

The fiscal 2020 House Labor-HHS-Education appropriations bill scheduled to be marked up Wednesday would provide $1.5 billion for state opioid response grants.

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