In addition to critical legislation passed by Congress, multiple federal agencies initiated opioid abuse prevention mechanisms. In late 2017, President Donald Trump declared the opioid crisis a public health emergency. While this designation stops short of a national emergency declaration, it does provide government and law enforcement officials some flexibility to move funding where it is needed the most. The move also permits expanded telemedicine and prescribing authority to help treat addiction, according to a National Public Radio article last fall. Public health emergency declarations last for 90 days and this one has been extended three times.
Other important federal initiatives include:
- Food and Drug Administration (FDA): According to a May 30, 2018, press release, the FDA “launched an innovation challenge to spur the development of medical devices, including digital health technologies and diagnostic tests, that could provide novel solutions to detecting, treating and preventing addiction, addressing diversion and treating pain.” FDA’s stated goal is to “provide additional incentives for product developers to invest in products that can address aspects of the addiction crisis and advance the development of promising technologies.” The FDA will accept submissions until September 30 and announce selected applicants in November. The challenge application is located on www.fda.gov.
- Substance Abuse and Mental Health Services Administration (SAMHSA): Within HHS, SAMHSA has existed in the vanguard of mental health and addiction treatment since its inception in July 1992. Its core mission is to reduce the impact of substance abuse and mental illness on America’s communities. Among various efforts, SAMHSA administers Opioid State Targeted Response grants, which provide states up to $500 million per year to focus on areas of greatest need, including increasing access to treatment, reducing unmet treatment need and reducing opioidrelated deaths. The agency also provides funding to specific populations for medication-assisted treatment.
- US Department of Health and Human Services (HHS): In early May, HHS appointed 28 members to the new Pain Management Best Practices Inter-Agency Task Force (Task Force). As required by the Comprehensive Addiction and Recovery Act of 2016, the task force is responsible for:
- determining whether there are gaps or inconsistencies in pain management best practices among federal agencies; proposing updates to best practices and recommendations on addressing gaps or inconsistencies;
- providing the public with an opportunity to comment on any proposed updates and recommendations; and
- developing a strategy for disseminating information about best practices.
Vanila M. Singh, MD, chief medical officer in HHS’s Office of the Assistant Secretary for Health, chairs the task force. Members include representatives from relevant HHS sub-agencies, the US Department of Veterans Affairs and the Department of Defense, the Office of National Drug Control Policy, and experts in “areas related to pain management, advocacy, addiction, recovery, substance use disorders, mental health, minority health and more.” Other representatives include patients, veteran service organizations, the addiction treatment community and groups with expertise in overdose reversal, such as first responders, medical boards and hospitals.
As HHS Secretary Alex Azar affirmed in the Task Force announcement, “In order to defeat America’s crisis of opioid addiction, one of our top four priorities at HHS, we need to understand and address how we got here.”
It matters how we got here, but as harbingers of care, policymakers and providers must ensure the next place we find ourselves is a safer one. To this end, Congress, federal regulators, the ASC community and health care stakeholders at large are striving to help resolve the opioid crisis. As House Majority Leader Kevin McCarthy stated on June 13, “This is not the first step, and this is not the last step—it is simply the next step.”
For more information on opioid legislation and other federal legislative activity, write Jeff Evans.