The COVID-19 pandemic has only intensified the United States’ other health crisis: the opioid epidemic. Last month, the CDC reported 81,230 overdose deaths from May 2019-May 2020, the largest number of opioid-related deaths ever recorded in a 12-month period. The opioid epidemic is not only costing lives, but hundreds of billions of dollars, stemming from a combination of health care expenses, criminal justice costs, and lost productivity: Between 2015 and 2018, the U.S. economy lost an estimated $631 billion. As the access to in-person treatment services remains limited and states buckle under continued economic pressure, it’s all the more important for the federal government to devote resources to improving outcomes for people with opioid use disorder (OUD) and their families.
Here are some steps the Biden administration should take to save lives, optimize resources, and expand access to evidence-based, life-saving interventions.
#1 Review existing federal policies that act as a barrier to methadone and buprenorphine access.
Opioid use disorder is a treatable disease, and evidence shows methadone and buprenorphine treatments are highly effective at reducing overdose risk. However, they are subject to regulations stricter than those for comparable prescription medications. The Biden administration should review existing federal methadone regulations and identify opportunities — like finalizing the Drug Enforcement Agency’s(DEA) proposed February 2020 rule to ease access to mobile methadone — that will expand methadone access while limiting unintended consequences.
#2 Expand and streamline access to evidence-based treatment.
Public and private insurers are gateways to lifesaving treatment, and federal action can help ensure insurers are providing OUD patients with quick, convenient access to the services they need. Centers for Medicare and Medicaid Services (CMS) should issue guidance to address overly restrictive utilization management and other policies related to substance use disorder (SUD) treatment, and can support grants and waivers that enable states to explore innovative approaches to providing treatment. We also need more providers to deliver evidence-based treatment to OUD patients — and the Biden administration should support legislation and work through the Office of National Drug Control Policy (ONDCP) to expand training for medical professionals.
#3 Ensure funding is going to health services that work.
Congress just appropriated billions more dollars for states to address the opioid crisis. Historically, there have been relatively few measures to ensure those dollars are being spent on the most effective programs and interventions. The Biden administration should take steps to ensure that Substance Abuse and Mental Health Services Administration (SAMHSA) dollars and other SUD appropriations are allocated towards evidence-based services — like MAT, naloxone, and syringe service programs — and health care providers that meet strong quality standards.
#4 Invest in harm reduction approaches to the opioid epidemic.
Given the prevalence of fentanyl in illegal drug markets nationwide, it is more important than ever to invest in harm reduction approaches that will help prevent overdose deaths. The Biden administration should provide funding that communities can use for naloxone, syringe service sites, and other effective interventions. The administration should also continue efforts at the FDA to explore making naloxone available over the counter.
There’s a critical humanitarian need — and strong bipartisan support — for prioritizing federal responses to the opioid epidemic. The Biden administration should act swiftly to save the lives of people with substance use disorders.