A View from Capitol Hill
By: Chris Fox, Executive Director, Voices for Non-Opioid Choices
Congress is currently at an impasse negotiating the next relief package for those most affected by the COVID-19 pandemic. In May, the House of Representatives passed a $3 trillion relief package. This package was immediately dismissed in the Senate. Now, the White House and the Senate are at odds over the details of the forthcoming relief package and, with unemployment benefits set to expire, millions of Americans are left with more questions than answers.
With all this uncertainly swirling around Capitol Hill, there is one thing that we can state with certainty: the opioid epidemic continues to ravage the American public. In 2019, nearly 72,000 Americans died from an opioid-related overdose. This year, opioid overdose deaths continue to be on the rise as some estimates show that deaths are more than 11 percent higher than they were in 2019.
Absent additional Congressional action, this problem will not go away and, in fact, has been made worse by the current pandemic. To date, Congress has passed multiple packages to address the opioid epidemic. These packages have focused on approaches to increase access to substance use disorder (SUD) treatment, naloxone availability and provide community resources to combat overdose deaths.
These efforts are undoubtedly important, but they are not comprehensive. Notably absent from these efforts are any attempts to prevent opioid addiction. One way to do this would be to minimize unnecessary patient exposure to opioids, including after a short-term pain incident such as an accident, surgery, sports injury, or trauma.
In the United States, despite making up less than 5 percent of the world’s population, we consume 80 percent of the world’s opioids. In fact, the Centers for Disease Control and Prevention estimates that there are nearly 170 million opioid prescriptions dispensed in the United States in 2018. One reason that opioids are prescribed is to help individuals dealing with a short-term pain incident. These patients are oftentimes prescribed in excess of 80 pills.
This does not have to be the case. There are several FDA-approved, safe, and effective non-opioid approaches that can help patients manage their pain and offer several benefits including lowering patient-reported pain scores, helping patients recover more quickly and return home faster after surgery, greatly reducing opioid consumption following acute pain incidents and preventing opioid misuse. Unfortunately, these solutions are often out of reach for patients and providers. If we are to tackle the opioid epidemic in this country, this must change.
The best way to increase utilization of these approaches – and reduce unnecessary patient exposure to opioids – would be to ensure adequate reimbursement for these strategies. Current reimbursement policy prioritizes the utilization of lowest-cost approaches, which all too often means patients are prescribed opioids. In short, non-opioid approaches, despite the numerous benefits they offer patients and providers are underutilized because they are slightly more expensive and reimbursement policy does not do enough to make them available to patients and providers.
Fortunately, this can be fixed. Members of Congress and their staff are working on addressing this reimbursement issue and making these approaches available to patients and providers around the country. Specifically, the Non-Opioids Prevent Addiction in the Nation (“NOPAIN”) Act would provide reimbursement for these approaches. By improving reimbursement for these approaches, more and more patients and providers will finally have access to these evidence-based solutions for acute pain management. In doing so, we can decrease unnecessary exposure to opioids in patients around the country and reduce the number of Americans who go on to misuse opioids following a pain incident.
We need urgent action now. It is our hope that as this next COVID-19 relief package is being negotiated, lawmakers will seize the opportunity to include the address the opioid epidemic in the United States. Including the NOPAIN Act in this package would rid our communities of unused, excess opioid pills and reduce the number of Americans who go on to misuse opioids following a pain incident. The time is now: write your member of Congress and tell them to include the NOPAIN Act in this final package.