White House opioid commission releases final report

Report’s recommendations support PDMP law, expanded access to MAT, and more

Days after President Donald Trump declared the opioid abuse and misuse epidemic a public health emergency, the President’s Commission on Combating Drug Addiction and the Opioid Crisis released its final report on November 1.

The report’s 56 recommendations include calling for pharmacists to be trained on best practices to evaluate legitimacy of opioid prescriptions and not to be penalized for denying inappropriate prescriptions. Support is also laid out for the Prescription Drug Monitoring (PDMP) Act of 2017 (S. 778/H.R. 1854) that makes state grant funding contingent on state mandates regarding the use of PDMPs, including a requirement that dispensers (i.e., pharmacies) report to the PDMP no later than 24 hours after the controlled substances is dispensed to the patient. In addition, the bill directs states to adopt a data-sharing single technology solution, which is expected to help facilitate data sharing among states.

The recommendations also include expanded access to medication-assisted treatment (MAT), improved prevention programs, and identification of areas to improve guidelines, such as more research regarding existing patterns of opioid use and then developing condition-specific guidelines on optimal dosing.

“The Commission’s report will impact pharmacists and the patients they serve, if the recommendations are reinforced and eventually implemented by state and federal level policy makers,” said APhA Director of Health Policy Jenna Ventresca, JD.

APhA advocates for considering the possible effects any policy change may have on legitimate patient access to prescription drugs, in addition to the epidemic, given the Institute of Medicine’s estimate of 100 million Americans living with chronic pain and CDC’s estimate of an additional 46 million individuals in acute pain due to surgery, according to the Association’s August 24 comments to commission members on the interim report.

The Association’s comments addressed several concepts in the interim report, including mandatory prescriber education, MAT, expanded access to naloxone, PDMPs, patient privacy, and prescription drug disposal options.

HHS has already began responding to the commission’s report and the President’s declaration by clarifying data sharing options for health professionals and announcing a new Medicaid policy that allows states to design demonstration projects that increase access to opioid use disorder and other substance use disorder treatment programs. Under the policy, states will be able to pay for a fuller continuum of care, including care in residential treatment facilities that Medicaid is unable to pay for without a waiver.