Feb 27, 2018

$1 billion opioid bill would limit prescriptions to 3 days

Photo: Tom Kelley / Getty Images

Sens. Rob Portman and Sheldon Whitehouse — the cosponsors of the opioid bill passed last Congress — introduced an opioid bill today that includes $1 billion in yearly funding to evidence-based programs. It also limits opioid prescriptions to three days to cut down on overprescribing, with exceptions for chronic pain treatment.

Why this matters: The authors' goal is to use this bill as a roadmap for appropriators to determine how to spend the $6 billion over two years in opioid and mental health funding. But it also includes important policy reforms that experts generally say could make a dent in the crisis. Portman said in an interview he hopes his bill gets attached to the upcoming spending bill.

“Overprescribing continues to be a problem. Still, most people who die of heroin overdoses, fentanyl overdoses, started with prescription drugs. Sometimes legally prescribed, sometimes not."
— Portman, in an interview with Axios

Policy changes included in the bill beyond the three-day opioid prescribing limit for acute pain:

  • Permanently allows physician assistants and nurse practitioners to prescribe buprenorphine, which addresses a prescriber shortage.
  • Also allows states to waive the limit on the number of patients physicians can treat with buprenorphine. There's currently a limit of 100 patients per doctor.
  • Requires physicians and pharmacists to use their state prescription drug monitoring program when they prescribe or dispense opioids, which helps track potential prescription opioid abusers.
  • Helps monitor opioid prescriptions across state lines, so that a potential abuser can't get multiple prescriptions from different states.
  • Increases penalties for opioid manufacturers that don't report suspicious opioid orders or use effective misuse controls.
  • Creates a national recovery residence standard.

What the $1 billion per year includes:

  • $300 million to expand first responder training and access to naloxone, an opioid overdose reversal drug.
  • $300 million towards medication-assisted treatment.
  • $200 million towards recovery support services, which will help transition people from opioid addiction treatment into long-term recovery, which Whitehouse called a "gaping hole" in the previously-passed opioid bill.
  • $100 million on treatment for pregnant and postpartum women addicted to opioids
  • $10 million for an educational campaign on the dangers of opioids.

“I wish I could tell you that just by spending $6 billion, we’re going to have a major impact. I think it’s got to be spent carefully. And so what we’re saying is let’s take part of it, it’s 1/3 of it…over two years and direct it towards evidence-based programs," Portman said.

What happens next:

  • "I don’t want to prejudge what the appropriators do, but they have a very significant new commitment of funding that they need to distribute among the different programs. To have this new authorization I think would be very helpful to them in providing support and guidance," Whitehouse said.

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