House Committee Holds Hearing on Opioid Epidemic Response

The House Energy and Commerce Health Subcommittee convened a hearing on potential solutions to address the opioid epidemic on Wednesday. The hearing featured testimony from National Council member, Richard Nance, who presented recommendations for improving access to medication-assisted treatment (MAT), the gold standard of opioid addiction treatment, via telemedicine. The hearing was the first of three hearings devoted to crafting a broad legislative package to curb the use of prescription and illicit opioids.

Making MAT Available via Telemedicine

Medication-assisted treatment (MAT), a treatment method that pairs cognitive/behavioral therapies with medication, is one of the most effective treatments for opioid addiction, yet most people with opioid dependence or addiction have no access to MAT. Hearing witness Richard Nance noted that access to MAT is even more scarce for people living in rural and frontier communities, despite these communities experiencing higher rates of opioid addiction than the rest of the population. As Director of Utah County’s Department of Drug and Alcohol Prevention and Treatment, Nance shared that in the frontier areas of Utah, such as the town of Bluff, “It can take up to ten hours round-trip including an overnight stay,” for an addiction provider to travel to see a patient in need of MAT.

One way to overcome this problem would be to empower community behavioral health centers to reach rural/frontier populations through telemedicine, Nance recommended. This would require the Drug Enforcement Administration (DEA) to permit community mental health and addiction treatment centers to register with DEA to provide controlled substances, such as MAT medications and certain psychiatric medications, per the terms of the Ryan Haight Act. Currently, community behavioral health centers cannot register with the DEA because the agency narrowly interprets what types of “hospitals and clinics” are permitted to register. See Nance’s full statement here.

Pending Telemedicine Legislation

To address this issue, the National Council for Mental Wellbeing and its members are working with Members of Congress to provide a telemedicine solution for addiction and mental health treatment. Reps. Doris Matsui (D-CA) and Gregg Harper (R-MS) have unveiled a discussion draft bill that would enable community mental health and addiction treatment centers to register with DEA to provide care via telemedicine. Buddy Carter (R-GA) and Cheri Bustos (D-IL) also have a discussion draft bill that provides a mechanism to expand access to telemedicine treatments. These bills would have the greatest impact if enacted simultaneously. These efforts would expand addiction and mental health care to underserved communities across the country and help to alleviate serious behavioral health workforce shortages.

Other Discussion

Beyond telemedicine, the subcommittee discussed a wide-ranging package of bills aimed at reducing the supply the opioids and detecting problem opioid use. Lawmakers spend a lot of time questioning Susan Gibson, Deputy Assistant Attorney at DEA, regarding the agency’s ability to investigate incidences of pill dumping. Committee members discussed other legislative proposals, including: requiring medical education on proper pain management and early opioid use disorder identification; allowing hospice workers to dispense of unused opioids; enabling pharmacists to better detect fraudulent opioid prescriptions, and more.