The Senate Just Passed a Sweeping Opioid Bill. It’s Still Not Nearly Enough.

Critics consider it a Band-Aid for a crisis that killed some 72,000 Americans last year.

Education Images/Getty

Fight disinformation: Sign up for the free Mother Jones Daily newsletter and follow the news that matters.

In a rare moment of bipartisanship, the Senate passed a sweeping legislative package Monday evening aimed at the opioid epidemic. It includes a number of important provisions, including funding for treatment and recovery programs, but many drug policy experts say the package is an incremental, election year response that doesn’t do enough to tackle the overdose epidemic that killed an estimated 72,000 Americans last year.

The bill, which passed on a 99-1 vote and merges proposals from five Senate committees and more than 70 senators, largely matches the House version that passed in June, although lawmakers still need to work through a handful of contentious differences. In any case, here are the basics on the Opioid Crisis Response Act of 2018:

What the bill does:

  • Expands access to addiction treatment and recovery services, particularly through a grant program for “comprehensive opioid recovery” centers where people getting drug treatment could access other social services, including job training and temporary housing
  • Gives the National Institutes of Health authority to fast-track research on nonopioid pain therapies
  • Reauthorizes the Office of National Drug Control Policy, the White House office charged with spearheading drug policy, which President Donald Trump’s budget writers nearly eliminated last year
  • Requires the Department of Health and Human Services to publish best practices for recovery housing and sober homesā€”which are largely unregulatedā€”and guidelines on treating prenatal opioid abuse
  • Allows the Food and Drug Administration to require drug manufacturers to package certain opioids in blister packs with a three- or seven-day supply to prevent overprescribing
  • Authorizes $20 million for states to develop evidence-based, family-centered substance abuse prevention and treatment services for families with children at risk of entering foster care
  • Provides loan repayments for behavioral health providers practicing in areas that have too few addiction-treatment providers

What the bill doesn’t do:

While the bill outlines a number of far-reaching goals, drug policy experts say Congress hasn’t allocated nearly enough money to execute them well. In fact, according to the Congressional Budget Office, the act would be revenue-neutral. How much money was Congress willing to spend on the worst opioid epidemic in US history? None,” said Keith Humphreys, a Stanford psychiatry professor and former drug policy adviser under President Barack Obama.

The current legislation authorizes $500 million in annual spending under the 21st Century Cures Act, meaning states will have to compete for competitive grants. For perspective, earlier this year, Sens. Elizabeth Warren and Elijah Cummings sought to pass a bill that would have provided states $100 billion over 10 yearsā€”modeled directly after the legislation Congress passed in 1990 that provided an infusion of federal funding to combat the HIV/AIDS crisis.

Given that there was no consensus in Congress in favor of a really big investment such as we employed for AIDS, the two sides did the next best thing which was agree on many second-tier policies that were smaller bore,” Humphreys said. “There are good things in the bill that will save lives, but it will not be transformational.”

What’s yet to be determined:

There are some big differences between the House and Senate bills that have yet to be resolved. The House bill calls for Medicare to cover opioid treatment, including methadone, whereas the Senate bill requires a five-year “demonstration project to test Medicare coverage.”

Both the House and Senate bills bring up a rule that prohibits Medicaid from paying for residential addiction treatment facilities with more than 16 beds. The rule, known as the ā€œIMD exclusionā€ (short for institutions for mental disease), draws its origins from efforts half a century ago aimed at deterring mass institutionalization of people with mental illness, but drug policy experts say the rule is hindering access to substance abuse treatment. The House bill partially overturns the IMD exclusion, limiting it to mental health patients addicted specifically to opioids. The Senate bill would repeal the rule only for drug-addicted pregnant and postpartum women.

Sen. Lamar Alexander (R-Tenn.), the head of the Senate health committee, has said Senate staffers are already talking with their House counterparts in the hope of finalizing legislation for Trump to sign within the next few weeks.

“I am hopeful that by passing this bipartisan legislation we can move forward with giving communities and families some of the support that they need,” said Sen. Maggie Hassan (D-N.H.), a member of the committee, in a statement. ā€œBut the biggest mistake that anyone could make is thinking that our efforts are anywhere close to being done.ā€

WE'LL BE BLUNT

It is astonishingly hard keeping a newsroom afloat these days, and we need to raise $253,000 in online donations quickly, by October 7.

The short of it: Last year, we had to cut $1 million from our budget so we could have any chance of breaking even by the time our fiscal year ended in June. And despite a huge rally from so many of you leading up to the deadline, we still came up a bit short on the whole. We canā€™t let that happen again. We have no wiggle room to begin with, and now we have a hole to dig out of.

Readers also told us to just give it to you straight when we need to ask for your support, and seeing how matter-of-factly explaining our inner workings, our challenges and finances, can bring more of you in has been a real silver lining. So our online membership lead, Brian, lays it all out for you in his personal, insider account (that literally puts his skin in the game!) of how urgent things are right now.

The upshot: Being able to rally $253,000 in donations over these next few weeks is vitally important simply because it is the number that keeps us right on track, helping make sure we don't end up with a bigger gap than can be filled again, helping us avoid any significant (and knowable) cash-flow crunches for now. We used to be more nonchalant about coming up short this time of year, thinking we can make it by the time June rolls around. Not anymore.

Because the in-depth journalism on underreported beats and unique perspectives on the daily news you turn to Mother Jones for is only possible because readers fund us. Corporations and powerful people with deep pockets will never sustain the type of journalism we exist to do. The only investors who wonā€™t let independent, investigative journalism down are the people who actually care about its futureā€”you.

And we need readers to show up for us big timeā€”again.

Getting just 10 percent of the people who care enough about our work to be reading this blurb to part with a few bucks would be utterly transformative for us, and that's very much what we need to keep charging hard in this financially uncertain, high-stakes year.

If you can right now, please support the journalism you get from Mother Jones with a donation at whatever amount works for you. And please do it now, before you move on to whatever you're about to do next and think maybe you'll get to it later, because every gift matters and we really need to see a strong response if we're going to raise the $253,000 we need in less than three weeks.

payment methods

WE'LL BE BLUNT

It is astonishingly hard keeping a newsroom afloat these days, and we need to raise $253,000 in online donations quickly, by October 7.

The short of it: Last year, we had to cut $1 million from our budget so we could have any chance of breaking even by the time our fiscal year ended in June. And despite a huge rally from so many of you leading up to the deadline, we still came up a bit short on the whole. We canā€™t let that happen again. We have no wiggle room to begin with, and now we have a hole to dig out of.

Readers also told us to just give it to you straight when we need to ask for your support, and seeing how matter-of-factly explaining our inner workings, our challenges and finances, can bring more of you in has been a real silver lining. So our online membership lead, Brian, lays it all out for you in his personal, insider account (that literally puts his skin in the game!) of how urgent things are right now.

The upshot: Being able to rally $253,000 in donations over these next few weeks is vitally important simply because it is the number that keeps us right on track, helping make sure we don't end up with a bigger gap than can be filled again, helping us avoid any significant (and knowable) cash-flow crunches for now. We used to be more nonchalant about coming up short this time of year, thinking we can make it by the time June rolls around. Not anymore.

Because the in-depth journalism on underreported beats and unique perspectives on the daily news you turn to Mother Jones for is only possible because readers fund us. Corporations and powerful people with deep pockets will never sustain the type of journalism we exist to do. The only investors who wonā€™t let independent, investigative journalism down are the people who actually care about its futureā€”you.

And we need readers to show up for us big timeā€”again.

Getting just 10 percent of the people who care enough about our work to be reading this blurb to part with a few bucks would be utterly transformative for us, and that's very much what we need to keep charging hard in this financially uncertain, high-stakes year.

If you can right now, please support the journalism you get from Mother Jones with a donation at whatever amount works for you. And please do it now, before you move on to whatever you're about to do next and think maybe you'll get to it later, because every gift matters and we really need to see a strong response if we're going to raise the $253,000 we need in less than three weeks.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate