Senate HELP weighs more access to opioid treatment
Illustration: Shoshana Gordon/Axios
The Senate HELP Committee is trying to boost treatment for opioid addiction with a bill that would expand access to methadone sponsored by the unlikely duo of Ed Markey and Rand Paul.
Driving the news: The HELP Committee will mark up the bill, the Modernizing Opioid Treatment Access Act, on Tuesday. It's being considered alongside reauthorization of a range of opioid addiction programs known as the SUPPORT Act.
What we're watching: It's unclear how many committee Republicans other than Paul will back the measure.
- "Can you talk to me in a week?" HELP Ranking Member Bill Cassidy replied when asked about the bill Tuesday. "There's a lot going on there. I'd rather withhold comment until closer to that point [the markup]."
Between the lines: Methadone is available only at specialized clinics, and many patients have had to go in-person every day to get the medication.
- The bill would open access to allow a broader group of addiction medicine doctors to prescribe it outside of the specialized clinics.
- "In too many states across the country, every morning people have to travel for miles and miles to reach a clinic — if there's one around at all — where they line up behind other patients waiting to get the medication they need," Markey said this year when introducing the bill.
Yes, but: The idea has been a source of friction in the past, drawing criticism from the specialized clinics that have warned that expanding access could result in misuse of methadone and other harms.
- Law enforcement groups, including the National Sheriffs' Association, wrote to the HELP committee this week expressing concerns and calling for more study.
- "We are concerned the changes proposed by this legislation could contribute to a rise in crimes associated with the illegal trade of methadone," the groups wrote.
- Concerns from law enforcement groups could dampen support in the Senate, particularly among Republicans.
What they're saying: Backers of the bill argue that those concerns are the product of an outdated mindset.
- "Other countries are already doing what this new bill would propose," said Paul Joudrey, assistant professor of medicine at the University of Pittsburgh.
- "[This bill] alone won't solve the overdose epidemic," he said. "But it's probably one of the simplest, most concrete steps we could take to expand treatment access in the coming years."
What's next: Even if the measure advances out of HELP, its fate is uncertain, in part because it's not being considered as part of the SUPPORT Act, which has a clearer path into law.
- But backers of the bill are still pushing. "We still don't have nearly enough access to medications for opioid use disorder to address this national crisis," said Brian Hurley, president of the American Society of Addiction Medicine. "We need more options for patients."
