Opioid Use Disorder Treatment Expansion and Modernization Act

Floor Speech

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Mr. TONKO. Mr. Speaker, I thank the gentleman from Texas for yielding.

I rise in support of H.R. 4981, Opioid Use Disorder Treatment Expansion and Modernization Act, which I have had the honor of working on with my colleague and friend, Representative Larry Bucshon, in introducing.

At the outset, I would like to thank Representative Bucshon and his staff, as well as the hard work of individuals on the committee staff, and our committee leaders, Chairman Upton and Ranking Member Pallone, to get this bill to this point.

I would also like to praise my colleague and fellow New Yorker, Representative Brian Higgins, for his introduction and leadership on the TREAT Act, without which we would not be making this progress today.

It is no hyperbole to announce that we are in a crisis when it comes to the opioid epidemic sweeping our Nation. More than 47,000 people have died of drug overdoses in 2014--family members, friends, and neighbors within that 47,000, for each and every one of us--a vast majority of which were opioid-related.

It is a sign of the times that when you drive down the thruway in my district in upstate New York, instead of billboards advertising for McDonald's or Taco Bell, you see billboards advising to you call 911 in case of an opioid overdose.

It is disturbing how quickly this has become the new normal. This crisis has affected our neighbors, our families, and our beloved communities.

Having worked with the addiction recovery community, I know that one of the most important things we can do as policymakers is to ensure that when an individual struggling with addiction cries out for help, that there is someone there to answer the call. That is what this bill endeavors to do.

Right now, treatment capacity for those seeking help for opioid use disorder in an office-based setting is artificially capped at 100 patients. What this means in reality is that if you are patient 101 or 102, you get a closed door and have to wait weeks, if not months, for treatment. Expectedly, these delays can be deadly.

The legislation before us will support the goal of raising the caps for qualified physicians to 250, expanding existing opioid treatment capacity by some 150 percent, all while ensuring the care that individuals receive is high quality and minimizes the risk of diversion.

In addition, this legislation will, for the first time, expand buprenorphine-prescribing authority to nurse practitioners and physician assistants who meet certain training requirements and comply with applicable State laws.

By bringing these practitioners into the fold, we can expand treatment capacity, especially in rural areas where physicians oftentimes might be few and far between.

Importantly, this bill expands access to high-quality addiction treatment, promoting the full range of psychosocial services that makes recovery possible, and providing HHS with new tools to remove bad actors from the system.

Any Member interested in decreasing the unlawful diversion of buprenorphine should support this legislation.

This legislation is not perfect, and I would still like to see a higher patient limit for the top class of physicians.

In the midst of this crisis, ensuring access for all needs to be our utmost top priority. No matter where we ultimately land on this arbitrary number, we will still be closing the door on someone who needs our help. We would not accept this in any other field of medicine, so we all need to think long and hard about why we are allowing this situation to persist in the field of addiction.

In addition, I would like to draw attention to two changes made to this bill before floor consideration. First, instead of statutorily lifting the DATA 2000 caps, this legislation includes a sense of Congress, if you will, that the caps should be lifted.

Secondly, this legislation would time-limit the expansion of prescribing authority to nurse practitioners and physician assistants to some 3 years.

Both of these temporary changes were made to bring the bill into compliance with PAYGO procedures for floor consideration and must be fixed as we move this bill into conference.

I would just ask, Mr. Speaker, are we firm in our commitment to combat the addiction to heroin? Are we firm in our efforts to assist those who struggle with the illness of addiction? Do we stand for providing true hope to individuals who count on us to provide the resources along with the legislation to make life available to them?

I would suggest that this House and the Senate look hard and fast at providing resources that are real and that provide for an effective outcome. If we fail to find a path forward for a meaningful expansion of the physician caps and certainly the nurse practitioners' and physician assistants' prescribing authority, then we are rationing care, pure and simple.

The starting point for any conference discussion should be the bill as reported out of the House Energy and Commerce Committee. In any final legislation, we must include a statutory lifting of the DATA 2000 caps as well as full authority for our NPs and PAs. I would ask for the commitment of my colleagues on the other side of the aisle in continuing to work toward these goals.

Notwithstanding these issues, I believe it is critically important to keep up the momentum and to pass this bill. Even in its imperfect form, this bill will make a huge difference in the lives of those who struggle with this disease. If we cannot find a way to get a bill to the President's desk that will provide needed relief in the midst of this epidemic, shame on us.

While this legislation is not a cure-all for the opioid epidemic, I believe the Opioid Use Disorder Treatment Expansion and Modernization Act will go far in helping to alleviate our acute treatment capacity issues and put more people on the path to recovery. I ask my colleagues in this House and down the hall in the Senate to support a bill--this bill--so that we can bring hope, truly bring hope into the lives of those individuals, those families, and those communities who grapple with this crisis on a daily basis.

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