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(Photo: Spencer Platt / Getty Images)

Congress is working on the next phase of its response to the opioid epidemic, but experts say the effort so far — particularly funding for treatment — is falling short, compared to the scope of the problem.

What they're saying: Experts say states need more money over a longer period, and that the country's overall treatment infrastructure needs a significant upgrade, as most of the country is ill-equipped to deal with the epidemic.

What's happened so far: Congress recently provided more than $4.5 billion to help combat the opioid epidemic — almost a 200% increase over 2017. It has addressed the issue several times, in spending bills as well as stand-alone measures, and is working on another legislative package now.

  • "A lot of money has gone to states to support treatment for opioid addiction ... These grants have provided valuable impetus to get health organizations and communities to buy into addiction treatment," aid Anna Lembke, an associate professor and medical director at Stanford's School of Medicine.

Yes, but: Experts say this response is still behind schedule, because the epidemic has been raging for years now and millions of Americans are addicted.

"It's an important start, but ultimately it’s a fraction of what needed. This epidemic has been 20 years in the making."
— Caleb Alexander, co-director of John Hopkins Center for Drug Safety and Effectiveness

Federal funding needs to be sustained over several years, so states can hire more health care workers and build up their treatment infrastructure, experts said.

  • Andrew Kolodny, co-director of Opioid Policy Research at Brandeis University, told me he thinks that $60 billion is needed for opioid treatment over 10 years. “You can’t give states one-time money and expect them to start building a new system," he said.

Between the lines: It's not clear how much of Congress' new funding will be set aside for treatment programs. Some is reserved for other priorities, including research into new, less addictive pain treatments.

Funding for treatment is sometimes seen as the equivalent of the emergency room — a way to get the problem under control while working on longer-term solutions. But treatment systems also need long-term repairs, experts said.

  • "All of the proposals with any traction on the Hill are short-term, when what is needed is to permanently enhance the funding of addiction treatment within Medicaid and Medicare so that the system provides high-quality care integrated with the rest of the health care system for the long-term," said Keith Humphreys, a professor at Stanford.
  • "The treatment infrastructure necessary to fight this epidemic also requires a work force of trained physicians and other health care providers who know how to treat addiction," Lembke said. "Currently medical training in addiction treatment is poor or nonexistent."

The bottom line: "Where we need to be spending the bulk of this money is to build out a new treatment system that doesn’t really exist yet," Kolodny said.

Go deeper

Updated 15 mins ago - Politics & Policy

House passes George Floyd Justice in Policing Act

Photo: Stephen Maturen via Getty Images

The House voted 220 to 212 on Wednesday evening to pass a policing bill named for George Floyd, the Black man whose death in Minneapolis last year led to nationwide protests against police brutality and racial injustice.

Why it matters: The legislation overhauls qualified immunity for police officers, bans chokeholds at the federal level, prohibits no-knock warrants in federal drug cases and outlaws racial profiling.

2 hours ago - Politics & Policy

Senate Republicans plan to exact pain before COVID relief vote

Sen. Ron Johnson. Photo: Stefani Reynolds/Bloomberg via Getty Images

Republicans are demanding a full, 600-page bill reading — and painful, multi-hour "vote-a-rama" — as Democrats forge ahead with their plan to pass President Biden's $1.9 trillion COVID-19 relief package.

Why it matters: The procedural war is aimed at forcing Democrats to defend several parts the GOP considers unnecessary and partisan. While the process won't substantially impact the final version of the mammoth bill, it'll provide plenty of ammunition for future campaign messaging.

The new grifters: outrage profiteers

Illustration: Sarah Grillo/Axios

As Republicans lost the Senate and narrowly missed retaking the House, millions of dollars in grassroots donations were diverted to a handful of 2020 congressional campaigns challenging high-profile Democrats that, realistically, were never going to succeed.

Why it matters: Call it the outrage-industrial complex. Slick fundraising consultants market candidates contesting some of their party’s most reviled opponents. Well-meaning donors pour money into dead-end campaigns instead of competitive contests. The only winner is the consultants.