Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment for Patients and Communities Act

Floor Speech

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Mr. TONKO. Mr. Chair, I thank Chairman Walden for yielding.

Although I know my colleague plans to withdraw, I rise in opposition to this amendment, and I just want to articulate a bit of my reasoning.

I think my colleagues and I both share the same goal of safely expanding access to addiction treatment. Where we differ is that I believe that the provisions in H.R. 6 expanding buprenorphine prescribing privileges to advanced practice nurses meet that test.

We all know that there is a dire need for expanded treatment capacity to meet the demands of this current epidemic. As many as 40 percent of counties across the country lack even a single provider that is able to offer buprenorphine. Advanced practice nurses play an outsized role in providing care in rural America, and H.R. 6 will help expand addiction treatment capacity into these communities where it is most needed.

Expanding buprenorphine prescribing privileges to APRNs is supported by medical groups that serve on the front lines of this epidemic, such as the American Society for Addiction Medicine and the American Congress of Obstetricians and Gynecologists.

All advanced practice nurses who wish to prescribe medication- assisted treatment would have to receive a special waiver from the DEA and would have to undergo three times as much specialized addiction training as their physician colleagues.

In addition, in order to receive a waiver, practitioners are required to be able to provide appropriate counseling and ancillary services that are the hallmark of high-quality addiction treatment. All APRNs wishing to prescribe buprenorphine would still be subject to State laws regarding prescription authority, scope of practice, and collaboration or supervision requirements with a physician.

While I understand that providing addiction treatment is a complex and nuanced area of medicine with potential complications if done poorly, I would point out that we don't restrict advanced practice registered nurses in Federal law from providing such high-risk services as delivering babies, administering anesthesia, or prescribing as many opioids as they wish. Why would we want to maintain an outdated barrier in Federal law that prevents these practitioners from being part of the solution to the opioid epidemic?

So in closing, I appreciate that my colleagues are withdrawing this amendment today, and I would urge that, as we move forward toward a potential conference committee, we continue to recognize the role that advanced practice nurses can play in addressing this epidemic.

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Mr. TONKO. Mr. Speaker, I have a motion to recommit at the desk.

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Mr. TONKO. I am opposed in its current form.

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Mr. TONKO. Mr. Speaker, this is the final amendment to the bill, which will not kill the bill or send it back to committee. If adopted, the bill will immediately proceed to final passage, as amended.

For more than a year and a half, Republicans in the House have been engaged in an all-out ideological assault to weaken healthcare for Americans by working to repeal the Affordable Care Act and gutting protections for preexisting conditions. Republicans have repeatedly voted to strip Medicaid coverage for millions struggling with addiction. Thanks to Republican policies, we are seeing this uninsured rate rise sharply for the first time in years.

This attack on our healthcare has had serious consequences for our ability to adequately address the needs of those struggling with the opioid epidemic. I remind my friends that we can't have it both ways: We either are for fighting this epidemic every way we can, or we are not.

I have seen the carnage this epidemic can produce in my own backyard, where my hometown of Amsterdam, New York, with a population of a little over 18,000 people, saw four overdose deaths and a dozen close calls within a single month.

We know that, as of today, less than 20 percent of Americans who need substance abuse treatment are able to receive it. We need to move toward a system of treatment on demand so that, when an individual has that moment of clarity, we are ready with a helping hand to pull them away from the deadly grip of addiction.

While I am pleased that the bill before us will make some incremental progress in our fight against the opioid epidemic and is the product of a significant amount of bipartisan work, every single Member of this Chamber knows that we can and we should be doing more. This motion to recommit is our chance to do just that and to make additional progress in this fight.

First, the motion would invest in our addiction workforce by incorporating a proposal advanced by Representatives Crowley and Costello to add 500 new resident physician slots to hospitals that have developed or are developing training programs in addiction medicine, addiction psychiatry, or pain medicine. We all have seen firsthand the need for more addiction specialists out there, and we have a chance to take action on that right now.

Secondly, this motion would allot an additional $1 billion annually to States through 2021 so that we can continue to invest in locally designed prevention, treatment, and recovery solutions. It is clearly going to take more than 2 years to battle the epidemic, and we need to let providers in States know that we are making sustained, meaningful investments in this area.

Finally, our motion to recommit includes a commonsense prescription drug policy which will reduce prescription drug prices for all Americans by reducing gaming by drug manufacturers to prevent generics from coming to market.

The CREATES Act, introduced by Representatives Marino and Cicilline, is estimated to save the Federal Government some $3.8 billion and patients far more. This legislation has been passed by the Senate Judiciary Committee on a bipartisan basis, but we have been denied a vote on the House floor to consider this practical, positive policy to halt pharma gaming and mischief.

Each of the policies contained in this package is bipartisan, fully paid for, and would bolster our ability to respond to the crisis. We have the opportunity to provide a more robust response for the American people and to save the lives of countless of our friends and neighbors all across this country who could be the next to fall victim to this deadly disease of addiction.

Every day, every week, every month, every year that passes, the challenge rests in our collective laps: Will we do more?

We need to do more. Let's do it for those families living with the pain and loss. Let's do it for those individuals who struggle with the illness of addiction. Let's be the light, the candle that brightens their darkness. Let's go forward with the recovery that is inspired by this legislation.

Mr. Speaker, I urge all of my colleagues on both sides of the aisle to support this motion to recommit, and I yield back the balance of my time.

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Mr. TONKO. Mr. Speaker, on that, I demand the yeas and nays.

The yeas and nays were ordered.

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