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Lawmakers, government target actions, plan hearings to address US opioid crisis

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Lawmakers, government target actions, plan hearings to address US opioid crisis

When House and Senate lawmakers return to Capitol Hill next week from their February break, efforts to confront the opioid epidemic will be among their top priorities, committee leaders said.

The Senate Health, Education, Labor and Pensions Committee plans to hold a hearing on Feb. 27, with various academic and other stakeholders, including Snezana Mahon, vice president of clinical product development at Express Scripts Holding Co., testifying on the role technology and data play in preventing and treating addiction.

The hearing is the fifth in a series convened by the Senate panel.

Systems like prescription drug monitoring programs have shown "great promise in helping fight this heartbreaking crisis," Sen. Lamar Alexander, chairman of the committee, said in an emailed statement. "I am looking forward to hearing about ways the federal government can help states and local communities take full advantage of the potential that technology has to offer."

The House Energy and Commerce Health Subcommittee is expected to hold a Feb. 28 hearing focused on helping communities balance law enforcement efforts with patient safety.

The session is expected to be the first in a series of three hearings intended to discuss possible legislative solutions for the epidemic and review bills related to the Controlled Substances Act, according to the chairman of the panel, Rep. Michael Burgess, R-Texas.

"As we continue our efforts to tackle this epidemic, it's imperative we strike the right balance between necessary enforcement and patient safety," Burgess said in a Feb. 21 statement.

He said the committee would examine a number of policies, such as improving access to treatment for mental health and substance-use disorders, revamping outdated laws, reviewing ideas on how providers and pharmacists can better inform patients — "all with the common goal of protecting our family, friends and neighbors."

The committee has not yet revealed the witnesses for the Feb. 28 hearing. Two more hearings are planned for March.

Funding new and ongoing efforts

Earlier this month, Congress authorized $6 billion in a two-year spending agreement to fight the opioid epidemic, which is largely responsible for the 64,000 overdose deaths in 2016.

The Trump administration has asked Congress for $10 billion to put toward new and ongoing efforts to address the crisis.

The administration acknowledged in a Feb. 21 White House economics report that additional federal actions were needed to rein in opioid abuse beyond awarding grants— funds appropriated under bills enacted during the previous administration — declaring the crisis a public health emergency and convening a short-lived commission, whose recommendations have mostly gone unheeded.

Blaming Medicaid

In its report, the administration suggested that the expansion of Medicaid under the 2010 Affordable Care Act had something to do with the growth of the opioid epidemic — an argument that has been promoted on Capitol Hill by Sen. Ron Johnson, R-Wis., chairman of the Senate Homeland Security and Government Affairs Committee, who held a hearing on the matter in January.

Ranking member Sen. Claire McCaskill, D-Mo., however, called Johnson's assertion "total hogwash" and "not supported by the facts."

The public health community has also argued that Medicaid helped reduce, not increase, the number of people addicted to opioids and is an important program in fighting the epidemic.

FDA activities

As part of the Food and Drug Administration's efforts to address the opioid crisis, Commissioner Scott Gottlieb, who has made tackling the epidemic a top priority for 2018, plans to convene a public meeting on April 17 on patient-focused drug development, or PFDD, for opioid-use disorder.

The PFDD meeting is part of the FDA's efforts to promote innovation and access to treatment to help those with an opioid-use disorder, Gottlieb tweeted on Feb. 16.

"We're devoting equal vigor to preventing new addiction and ensuring access to potentially lifesaving treatment for those currently addicted," he said.

The FDA said the meeting would provide regulators with the opportunity to better understand the patient perspective on the impacts of opioid-use disorder and treatment approaches for the condition.

Gottlieb said the addiction problem in the U.S. is migrating to substances his agency would not have suspected five or 10 years ago to be agents people use to get high, such as the anti-diarrhea drug Imodium and the botanical substance kratom.

On Feb. 6, Gottlieb declared kratom to be an opioid and said the product was helping to fuel the U.S. addiction epidemic.

On Feb. 21, the FDA said a Missouri dietary supplement maker had voluntarily recalled and destroyed a large volume of kratom-containing products. On Twitter, Gottlieb urged other companies to take similar steps to get the product out of circulation.

The FDA and the Centers for Disease Control and Prevention reported that there had been a multistate outbreak of salmonella infections linked to kratom.

NIH still waiting

Meanwhile, the National Institutes of Health has been waiting since May 2017 for government funding to get a public-private partnership off the ground aimed at accelerating the development of nonaddictive alternatives to opioids and better overdose-reversal agents.

The biopharmaceutical industry has been unwilling to commit money to the project until the federal funds are secured.

A spokeswoman confirmed to S&P Global Market Intelligence on Feb. 21 that the agency has still not sealed the deal with industry partners.