OP-ED: Working together to defeat the opioid epidemic
As partisan battles rage in Washington at the onset of the new administration, a struggle in our own communities quietly, and lethally, continues. You might not see it on CNN or in your Twitter feed, but I am reminded every time I drive past the Levittown-Fairless Hills Rescue Squad in my hometown, where a grim tally shows the number of drug-related overdoses and deaths just in that community.
Sadly, this crisis shows no signs of slowing. Last year in Bucks County, we lost 185 lives to opioids — a 50 percent increase from the prior year. In neighboring Montgomery County, opioid abuse claimed a staggering 240 lives — one of the highest counties in Pennsylvania with opioid-related deaths. Nationally, heroin deaths have risen sharply and now surpass 30,000 a year, with each fatality representing a family crushed by the overwhelming loss of a loved one.
As lawmakers, there is work to be done legislatively; passing the Comprehensive Addiction Recovery Act was a good first step, but there is more we can do. The Bipartisan Heroin Task Force has outlined a bold legislative agenda to address all angles of this issue — including enhancing medical education for prescribers and providers, increasing the availability of Narcan and ensuring federal health-care systems share data with Prescription Drug Monitoring Programs. Additionally, the agenda contains pieces of legislation I’ve introduced to stem the tide of deadly illicit fentanyl and address the IMD exclusion.
Fentanyl, a manufactured opioid, has contributed to tens of thousands of deaths. Although pharmaceutical fentanyl can be misused, most fentanyl deaths are linked to illicitly manufactured fentanyl and versions of chemically similar compounds known as fentanyl analogs. According to the Drug Enforcement Administration, Mexico is the primary source for illicit fentanyl trafficked into the United States. Distributors in China produce the precursor chemicals used to manufacture fentanyl and its analogs. Illicit fentanyl producers smuggle the drug across the southwest border of the United States or deliver it through mail and express consignment couriers.
Online fentanyl purchases from overseas vendors primarily ship to the United States through the mail or express consignment carriers, often concealed as legitimate goods. Because illicit fentanyl is so powerful — just a few salt-sized grains can kill an adult — small amounts go a long way for drug traffickers. These relatively small and potent amounts — compared to bales of marijuana, for example — make fentanyl difficult and hazardous to detect.
That’s why Rep. Niki Tsongas (D-Mass.) and I introduced the INTERDICT Act (H.R. 2142) — bipartisan legislation that provides U.S. Customs and Border Protection access to the latest in chemical screening devices and scientific support to detect and intercept synthetic opioids before they can cause more harm.
On the recovery side, it is crucial we increase access to addiction treatment — including for some of our most vulnerable populations. One step is eliminating the Medicaid Institutions for Mental Diseases (IMD) exclusion for substance use disorder and help states expand access to inpatient treatment for its enrollees.
The IMD exclusion is a long-standing policy that prohibits the federal Medicaid matching funds to states for services rendered to Medicaid-eligible individuals who are patients for substance use disorders and mental health treatment. Some states — including Pennsylvania — have used an “in lieu of services” provision allowing for inpatient treatment, but with limitations on patient population, facility size and length of stay. These limitations disproportionately affect Medicaid beneficiaries.
The “IMD exclusion” blocks access to treatment for people who need inpatient treatment for addiction including some of society’s most vulnerable: veterans, pregnant addicted women, women with dependent children and low-level drug offenders. My bipartisan Road to Recovery Act (H.R. 2938) eliminates the IMD exclusion for substance use disorder and helps states expand access to inpatient addiction services for Medicaid enrollees in a fiscally responsible manner while not intruding on a state’s flexibility to implement care.
We are all stakeholders in the mission to eradicate this epidemic — be it through education, community involvement, recovery efforts or law enforcement support. Constant engagement between federal, state and local leaders partnering with law enforcement, health-care professionals and educators will set us on the path to free our community from the advance of opioid abuse. A solution is possible, but only if we are willing to work together.
Fitzpatrick represents Pennsylvania’s 8th District, which includes all of Bucks County as well as a portion of Montgomery County. He is a former FBI supervisory special agent and special assistant U.S. attorney and is a certified publicaccountant and emergency medical technician. He is vice chair of the Bipartisan Heroin Task Force.