December Public Policy Update
As 2023 ended, answers from Congress to several important questions remain unanswered. Chief among them is how programs that address recovery support services will be funded in Fiscal Year 2024 (which we are already several months into).
While we spent most of 2023 advocating for increases to programs such as the State Opioid Response Grant and Building Communities of Recovery, it is highly unlikely that any significant change is in the cards for the Department of Health and Human Services. HHS, and most other governmental agencies, will be funded via a Continuing Resolution at current levels until February 2, 2024, at the latest.
At that point, we will either see Congress pass a funding bill for the remainder of FY 2024, or potentially another Continuing Resolution, which could last the entirety of the fiscal year. The House and Senate remain diametrically opposed on funding across government. The bill responsible for funding both HHS and the Department of Labor is a prime example: the two chambers differ by over $100 billion on proposed funding levels.
Faces & Voices of Recovery has spent last month advocating zealously for the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act, legislation that would increase access to telehealth services for Opioid Use Disorder, waive regulatory restrictions for accessing care, and preserve safeguards that saved lives during the COVID-19 pandemic.
This bill echoes sentiments from many of our other efforts, including the comments we sent to the DEA earlier in 2023 on policies that governed the prescribing of Buprenorphine (Suboxone). For now, the DEA will preserve prescribing regulations from the COVID-19 pandemic in place (Buprenorphine can be prescribed without a physical, in-person visit to a physician). But that’s only through the end of 2024. TREATS would make such an allowance permanent.
We also await a vote on the Modernizing Opioid Treatment Access Act (MOTAA), which had its first congressional December in the Senate. MOTAA is groundbreaking legislation that would modernize prescribing practices for methadone.
MOTAA makes two crucial changes to FDA regulations that have governed methadone prescribing practices since the 1970s and are not supported by modern medical science:
- Allowing board-certified addiction physicians and addiction psychiatrists to prescribe methadone; and
- Allowing pharmacies to dispense methadone.
Currently, authority for prescribing and dispensing methadone is strictly controlled by Opioid Treatment Programs (OTPs), commonly referred to as methadone clinics. As it stands, a medical provider can only prescribe methadone if they’re associated with an OTP. And to pick up that methadone prescription, patients must travel — often every single day — to the OTP, where they must take that medication under the direct observation of OTP staff.
Here’s the problem with that: 70% of America’s counties do not have an Opioid Treatment Program. A daily travel requirement is inequitable, creating barriers to care for patients who are required to travel long distances, have mobility issues, or lack access to reliable transportation.
Andrew D. Kessler, JD, is founder and principal of Slingshot Solutions LLC, a consulting firm that specializes in behavioral health policy. With 20 years of policy experience- and over a decade in behavioral health- Kessler is a fixture in circles that advocate for substance abuse treatment, prevention, recovery, and research. He collaborates frequently with congressional offices, the White House Office of National Drug Control Policy, the National Institute on Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and other federal actors. He is a frequent contributor to Politico, The Hill, and Alcohol and Drug Abuse Weekly,
Kessler has written legislation and report language published by both the House and Senate, and has presented orally before such bodies as the Scientific Management Review Board, the College on Problems of Drug Dependence, and the National Conference on Addictive Disorders. He is highly sought after as a speaker on substance abuse policy, as well as on advocacy training. He has presented on these subjects around the nation, and on several webinars as well.
Kessler received his Bachelor of Arts in 1993 from Washington University in St. Louis. In 1999, he graduated from American University’s Washington College of Law, where he received multiple awards and recognition for his legal analysis and moot court performance. He lives in Fairfax, Virginia, with his wife and two children.