House bills recognize role of pharmacists in curbing opioid addiction

Final version of legislative package expected to reach the president’s desk this summer

The U.S. House of Representatives has passed a package of 18 bills dealing with opioid misuse and abuse. A joint conference committee will be convened to reconcile the differences between these and the U.S. Senate–approved Comprehensive Addiction and Recovery Act (CARA) before sending it back for congressional approval and then on to the White House. The final version of the legislative package is expected to reach the president’s desk this summer.

“Pharmacists are the medication experts on the health care team and play an integral part in preventing prescription drug abuse and misuse,” said APhA Senior Lobbyist Michael Spira. “Because of this role, APhA was pleased to work with the committees of jurisdiction during the legislative process, and we look forward to working with the conference committee to send the president the best possible package—one that incorporates patients, families, communities, and team-based care.”

The House legislative proposals include: requiring FDA to work with an advisory committee before approving opioids that are not abuse-deterrent; creating a task force, which would include pharmacists, to develop “best practices” for acute and chronic pain treatments; raising awareness and promoting prevention; increasing the cap on the number of patients to whom a physician can provide certain medication-assisted treatments, such as buprenorphine; and allowing partial fills for Schedule II controlled substances. The package also requires the U.S. Government Accountability Office to submit reports on certain opioid issues, including access to treatment, to help inform future policy decisions.

“Pharmacists are an important, but often an underutilized, resource in the fight against prescription drug abuse,” said APhA Associate Director of Health Policy Jenna Ventresca, JD. “Pharmacists work closely with patients to provide education about pain medications, improve pain management, and monitor for signs of abuse, misuse and overdose.”

The bills enjoyed broad bipartisan support and did not face significant barriers to passage. However, the bills have been criticized by many stakeholders, including Michael Botticelli, director of the White House Office of National Drug Control Policy, for failing to provide funding—the bills authorize spending but stop short of allocating funds.

House Democrats have called for $600 million in emergency funding to support the bills, but these proposals were rejected by House Republicans. Republicans argue that there is $400 million already dedicated to programs for opioid abuse, and that additional spending should be considered during the appropriations process. However, Republicans did signal an openness toward making funds available if cuts were made elsewhere to offset the costs.

APhA sent a letter to the leadership of the House Energy & Commerce and Judiciary Committees urging one bill to be amended to remove language that would have required pharmacists to review patients’ records in prescription drug monitoring programs before filling Schedule II, III, and IV prescriptions. This language was ultimately removed from the House bill but is still included in the Senate version.