White House Budget: Increased Funds for Opioid Addiction Prevention

President Obama’s Administration has introduced some major expansions to the 2016 fiscal budget to help aid states in preventing opioid deaths.

Reviewed by Forest Tennant, MD, DrPH

As most physicians are aware, overdoses from prescription opioids have risen at an alarming rate over the last few decades, with more people dying from opioids than from heroin and cocaine combined, and law makers in Washington have been taking notice.

Back in 2011, President Obama’s Administration created the Prescription Drug Abuse Prevention Plan, which began a government-wide effort to stem the tide in the opioid epidemic by increasing prevention efforts to stop opioid overdoses and help treat at-risk patients.

Now, the Administration’s 2016 Fiscal Budget introduces some major expansions and novel programs to this effort, totaling $133 million. The investments include increased aid to state prevention programs, support for medication-assisted treatment (MAT) programs, improvements to data collection, and more.

More Funding for Prevention

According to a White House press release, $48 million is going to “strengthen and evaluate state-level prescription drug overdose prevention,” which means a major expansion to the Prescription Drug Overdose Prevention for States program, thereby increasing the CDC’s funding to $68 million.¹ These funds will go to grants in all 50 states, aimed at improving interstate interoperability and proactive reporting, as well as enhancements to national-level data reporting.

With over 20,000 Americans dying every year from opioid overdose, getting first-responders prepared for these emergency situations could save many more lives, which is why the Administration’s budget also includes $12 million in federal grants to 10 states, which will facilitate the purchase of naloxone(Evzio, generic).

An opioid antagonist, naloxone is used to reverse the depression of the central nervous system and respiratory system caused by opioid overdose. Studies have shown that naloxone has been underutilized by physicians. The new federal grants will make sure first responders in high-risk communities are properly equipped and trained to administer naloxone safely and effectively.

The Budget also modifies Medicare Part D, establishing a new program that requires high-risk beneficiaries to obtain controlled substances from specific providers and pharmacies, which could help prevent “doctor shopping.”

Other funding measures introduced in the budget:

• $10 million for the Strategic Prevention Framework, a program headed by the United States Department of Health and Human Services’s (HHS) Substance Abuse and Mental Health Services Administration (SAMHSA) that helps states incorporate more substance abuse prevention through strategic efforts, like implementing more evidence-based practices to help reduce prescription drug misuse and abuse.
• $5.6 million for the CDC to collect near real-time emergency department and mortality data by integrating death certificate and toxicology information.
• $5 million for improvements to electronic death reporting, including on opioid overdose deaths.
• $5 million for the Office of the National Coordinator for Health Information Technology to improve the integration of Prescription Drug Monitoring Programs with health information technology.

Treating Addiction and Expanding Medication-Assisted Treatment

Medication-Assisted Treatment (MAT) combines medication, counseling, and behavior therapy to effectively treat substance abuse disorders with a whole-patient approach. Unfortunately, many vulnerable populations don’t have access to this form of treatment, so the Administration’s budget includes $13 million in SAMHSA grants to fund technical assistance and treatment resources to communities in great need of MAT services.

To study the efficacy of MAT treatments, another $5 million is going to the HHS’s Agency for Healthcare Research and Quality to review evidence of MAT in primary care, as well as develop and test new methods to further enhance substance abuse treatments.

The Budget also aims to increase MAT services for individuals in the criminal justice system, with $2.2 million to the Department of Justice’s Bureau of Prisons budget. Inside the Second Chance Act, $60 million is available to treat substance abuse, helping to reduce re-offenders and parole violations.

Lastly, $1.8 million is provided for Department of Justice International Organized Crime Intelligence and Operations Center (IOC-2), a single venue designed “to oversee operations against the most dangerous transnational organized crime groups,” involved in drug trafficking and other offences.