Should States be able to Use Opioid Addiction Treatment Grants for Cocaine & Meth Addiction Too? (S. 1925)
Do you support or oppose this bill?
What is S. 1925?
(Updated September 12, 2019)
This bill — the Combating Meth and Cocaine Act — would permit the Assistant Secretary for Mental Health and Substance Use to award opioid response grants to states for: education regarding opioid use disorders; treatment (including providing medication) for opioid use disorders; behavioral health services for people in opioid treatment programs; referral to treatment services for people with opioid use disorders; recovery support for people with opioid use disorders; medical screening associated with opioid use disorder treatment; and preventing or treating the abuse of psychostimulants, such as cocaine or methamphetamine.
This would be a five-year program, with $500 million appropriated in each fiscal year from 2020 to 2024 to carry out this bill’s requirements.
Argument in favor
Substance abuse is a rising problem across the country. Methamphetamine, cocaine and psychostimulant use are all on the rise, and states need additional federal funding to meet this challenge. They also need greater autonomy to spend funds as needed to adapt to changing conditions on the ground.
Argument opposed
The State Opioid Response (SOR) Grant program already gave out $1.4 billion in FY2019 and if the program needs to be extended the Dept. of Health and Human Services (HHS) will make that request. This legislation is premature — additional funding for SOR grants shouldn’t be appropriated until the results of the program’s FY2019 spending are better understood.
Impact
People with opioid use disorders; states; State Opioid Response Grant program funding; and the Assistant Secretary for Mental Health and Substance Use.
Cost of S. 1925
A CBO cost estimate is unavailable. However, assuming appropriation of the dollar amounts proposed in the bill text, this bill would cost $2.5 billion over FY 2020-2024.
Additional Info
In-Depth: Sen. Rob Portman (R-OH) introduced this bill to give states more flexibility to use federal funding to address the resurgence of psychostimulants, such as methamphetamine and cocaine, and expand the use of State Opioid Response Grant funding to addressing rising use of and overdose deaths attributed to methamphetamine and cocaine abuse:
"When I talk to law enforcement, treatment providers and others on the frontlines of the drug crisis, I am increasingly hearing about the resurgence of methamphetamine and cocaine overdoses across Ohio. I’m pleased that Congress has provided significant additional resources to support the efforts of states and local communities. Unfortunately, the State Opioid Response Grants cannot be used to combat the drug crisis beyond opioids. This legislation gives states more flexibility to use this funding to address the resurgence of methamphetamine and cocaine, which will better address the on-the-ground reality of addiction in my state and many others.”
In additional comments, Sen. Portman argued that Congress needs to keep its eye on the ball when it comes to combating the opioid crisis so as to ensure it doesn’t return with a vengeance:
“One of my concerns has been if we're making progress now in the opioid crisis. I want to make sure that Congress doesn't take its eye off the ball - because if we do, it'll just come back with a vengeance, so we've got to be sure that we are keeping funding and keeping the innovative programs that result from that funding at work in Ohio and around the country."
In its nationwide survey of states’ uses of federal funding to response to the opioid crisis, the Bipartisan Policy Center (BPC) found that states are using funding to build out treatment networks for people with opioid use disorder, using funds for direct payment to support treatment in at-risk populations, providing training and technical assistance, distributing naloxone and enhancing the treatment workforce. The BPC’s analysis found that federal funding is going to the areas in states with the highest numbers of deaths; which means rural counties are receiving relatively low levels of direct funding compared with more-populous cities. The BPC suggested building greater flexibility into federal grants to states — as this bill does — to allow them to adapt to changing conditions more quickly:
“Congress and the administration should build flexibility into federal grants to allow state agencies to adapt to quickly changing conditions on the ground. Flexibility in funding ensures that while states are responding to today’s opioid epidemic, they are also prepared for other emerging drug threats, such as methamphetamine and cocaine.”
However, the BPC also noted that better coordination of myriad federal grant programs is needed:
“There is substantial need for improved coordination of grant programs at the federal level, particularly with the aid of the White House Office of National Drug Control Policy. Enhanced federal coordination of opioid funding programs across federal agencies will improve program coordination at the state level. This is critical given the sheer volume of grants going to states, the need for coordination across state agencies and local governments, and the multifaceted nature of the epidemic.”
Of Note: In the past few years, Congress has made significant investments to curb the opioid epidemic. The 21st Century Cures Act, enacted in 2016, is one of these initiatives. This bill provided $1 billion in grants to states for FY2017 and FY2018 to combat the opioid epidemic. That funding — which is now referred to as State Opioid Response (SOR) Grants — provided another $500 million to states in FY2019, so 2019 funding to states under the SOR grant program totaled $1.4 billion in FY2019. Sen. Portman’s office notes that these grants “are designed to address the opioid epidemic broadly,” but currently have been interpreted to exclude resources for rising psychostimulant use.
According to a U.S. Substance Abuse and Mental Health Services Administration survey, 2.4 million Americans said they’d “recently” started using cocaine, methamphetamines or prescription stimulants in 2016. The Centers for Disease Control and Prevention (CDC) reports that deaths involving cocaine and psychostimulants have risen nationwide in recent years. From 2016 to 2017, death rates involving psychostimulants such as meth and cocaine both rose by approximately 33%. Of the over 70,000 drug overdose deaths in 2017, more than 23,000 (nearly a third) involved cocaine, methamphetamine or both.
There were only nine unintentional psychostimulant-related deaths in 2010, as found in an October 2018 report from Ohio University. In 2017, that number rose to 556 — a 6,000%-plus increase.
Media:
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Sponsoring Sen. Rob Portman (R-OH) Floor Remarks
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Hometown Stations
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Dept. of Health and Human Services (HHS) Press Release (Context)
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Bipartisan Policy Center (BPC) Report (Context)
Summary by Lorelei Yang
(Photo Credit: iStockphoto.com / DNY59)
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