Letter to the Conferees, House-Senate conference committee - Capito Urges CARA Conferees to Include Provisions to Address West Virginia's Drug Epidemic

Letter

As we all have become sadly aware, the United States is experiencing an epidemic of drug overdose deaths. Since 2000, the rate of deaths from drug overdoses has increased 137%, including a 200% increase in the rate of overdose deaths involving opioids. My home state of West Virginia has the unfortunate distinction of leading the nation in drug-related overdose deaths -- more than twice the national average.

The Comprehensive Addiction and Recovery Act (CARA) is an excellent first step in the national response to the drug epidemic. It expands prevention and education efforts and promotes resources for treatment and recovery. It also includes reforms to help law enforcement respond to the drug epidemic and provides resources for treatment alternatives to incarceration, such as the successful drug court programs that operate in West Virginia and many other states.

In addition to these broad themes, both the Senate and House bills contain several specific common sense bipartisan provisions I worked with my colleagues to craft in response to the needs of our communities. These include:

Language making the provision of follow up services to those who have received opioid overdose reversal drugs an allowable use of grant funding authorized under S. 524,Title II, Section 202.

A provision which would require the Attorney General to expand or make available disposal sites for unwanted prescription drugs found in S. 524, Title II, Section 203.

Provisions of S. 1641, the Jason Simcakoski Memorial Opioid Safety Act, which would provide safer and more effective pain management services to our nation's veterans, that were approved by the Senate Committee on Veterans' Affairs. While Title III of the House passed version of S. 524 contains similar language, I ask the Conference Committee to show deference to the language referenced above.

A provision based on S. 2226, the Improving Treatment for Pregnant and Postpartum Women Act, which would reauthorize and amend an existing grant program supporting residential treatment of pregnant and postpartum women with a primary diagnosis of a substance use disorder found in S. 524, Title V, Section 501. A very similar version is included as Title X of the House passed version of S. 524.

A provision of Title VIII of the House passed version of S. 524, based on S. 2872 and H.R. 4978, the Nurturing and Supporting Healthy Babies Act (NAS Healthy Babies Act) which would require a GAO report on Neonatal Abstinence Syndrome (NAS).

Title IX of the House passed version of S. 524, Co-Prescribing to Reduce Overdoses Act, based on S. 2256 and H.R. 3680, which would authorize grants to encourage co-prescribing of naloxone (a drug to reverse the effects of opioid overdose) with prescription opioids and grants to support development of co-prescribing guidelines. A provision very similar to Title IX, authored by Senator Kaine and me, was included with bipartisan support in S. 2680, the Mental Health Reform Act of 2016 passed by the Senate Health, Education, Labor and Pensions (HELP) Committee in March.

Title XIV of the House passed version of S. 524, Reducing Unused Medications Act, based on S. 2578 and H.R. 4599, which would amend the Controlled Substances Act (CSA; 21 U.S.C. §§801 et seq.) to allow partial fills of prescriptions for controlled substances on Schedule II of the CSA. A provision very similar to Title XIV, authored by Senator Warren and me, was included with bipartisan support in S. 2680, the Mental Health Reform Act of 2016 passed by the Senate HELP Committee in March.

In addition, I ask that the Conference Committee pay particular attention to provisions concerning the prescribing of opioids in the treatment of acute pain. Both the Senate (Section 101) and the House (Title I) contain language requiring the convening of a Pain Management Best Practices Interagency Task Force. This Task Force will be charged with reviewing, modifying, and updating best practices for prescribing pain medication and managing chronic and acute pain.

S. 2680, the Mental Health Reform Act of 2016, passed by the Senate HELP Committee in March included language crafted by Senator Gillibrand and me requiring the Centers for Disease Control and Prevention (CDC) to issue best practices for prescribing opioids in the treatment of acute pain. Such guidelines, similar to those CDC recently released for the prescription of opioids in the treatment of chronic pain, aim to prevent opioid addiction by encouraging responsible prescribing of opioids by providers, thereby limiting exposure to opioids and reducing the overall supply of opioids in circulation.

As the Conference Committee begins the difficult task of reconciling the Senate and House bills, I urge the provisions listed above be reviewed and included in the final legislation. Including these provisions will further strengthen a bill which promises to make a real difference in the lives of individuals, families and communities across the nation.

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