Innovations-Magazine-September-2023 - 4

POLICY PERSPECTIVES
SUPPORT 2.0: Congress Renews Action to
Address the Opioid Epidemic
Nisha K. Quasba, MPH
Faegre Drinker Biddle &
Reath LLP
Megan S. Herber, MPH
Faegre Drinker Biddle &
Reath LLP
Six years ago this October, the opioid
overdose crisis was declared a public health
emergency (PHE) in the United States
by former President Donald J. Trump.
The declaration was made in response
to the significant increase in opioidrelated
overdose deaths and addiction
rates across the country. By declaring it
a PHE, the government aimed to bring
greater attention, resources, and focus to
combating the opioid epidemic and to
implement measures to prevent further
harm to public health.
Following the declaration of the PHE,
Congress developed the Substance UseDisorder
Prevention that Promotes Opioid
Recovery and Treatment for Patients
and Communities Act (SUPPORT Act),
which was ultimately signed into law in
October 2018. This bipartisan legislation
contained various provisions aimed at
combating the opioid epidemic, including
creating new grant programs for opioid
use disorder prevention and treatment,
updating policies to support improvements
to the state prescription drug monitoring
programs (PDMPs), and mandating the
use of e-prescribing for all Medicare Part D
controlled substances (CS).
Many of these programs were authorized
by Congress for five years. Thus, the
SUPPORT Act is up for reauthorization,
and Congress is currently working on
legislation to reauthorize and update the
act, known informally as " SUPPORT 2.0. "
This process serves as an opportunity for
lawmakers to revisit and assess the ongoing
2 | SEPTEMBER 2023
relevance and effectiveness of the legislation
and to ensure that it aligns with the current
needs and priorities related to containing
the epidemic that continues to evolve. This
lawmaking process also provides a platform
for stakeholders and the public to offer
feedback and participate in shaping the
future of important programs and policies.
House Committee Advances
SUPPORT 2.0
The House of Representatives began
its process with members of Congress
introducing individual bills on a variety
of related topics. The House Committee
on Energy and Commerce, which has
jurisdiction over public health and the US
Department of Health and Human Services
(HHS), held a hearing in June 2023 on
many of these bills. In July, the Committee
on Energy and Commerce's Subcommittee
on Health Chair Brett Guthrie (RKY),
along with Democratic committee
counterpart Representative Ann Kuster (DNH),
introduced HR 4531, the Support for
Patients and Communities Reauthorization
Act, which combined the committee's
priority policies into one package. The
committee moved swiftly to mark up and
vote on a bipartisan basis to advance this
legislation out of committee before Congress'
August recess, making its next step the
House floor before SUPPORT Act programs
expire at the end of October 2023.
As mentioned, the bill incorporates
elements from other introduced legislation,
notably HR 4099, the Reauthorizing the
Creating Opportunities that Necessitate
New and Enhanced Connections That
Improve Opioid Navigation Strategies Act
of 2023 (RECONNECTS Act of 2023),
from Representatives H. Morgan Griffith
(R-VA) and Angie Craig (D-MN). The
RECONNECTS Act of 2023 would
reauthorize the Centers for Disease Control
and Prevention's (CDC's) Overdose Data to
Action (OD2A) grant to states. According
to CDC, OD2A " supports jurisdictions in
collecting high quality, comprehensive, and
timely data on nonfatal and fatal overdoses
and in using those data to inform prevention
and response efforts. " In many states, some
of this funding is put toward the state
PDMP, a key clinical tool used to prevent
doctor shopping and overprescribing and
analyze trends in the epidemic.
The bipartisan, bicameral Combating
Illicit Xylazine Act, which would classify
xylazine as a Schedule III CS, was
also included in the committee-passed
SUPPORT 2.0 bill. The federal government
and public health organizations have
been keeping a close eye on the presence,
effects, and repercussions of xylazine, a
potent non-opioid animal tranquilizer (also
known as " tranq " ), in the market for the
past year. In November 2022, Food and
Drug Administration (FDA) issued an alert
cautioning health care professionals about
the increasing prevalence of xylazine in
illicit drugs and counterfeit opioids. This
situation poses challenges in distinguishing
opioid overdoses from xylazine exposure,
as the latter does not respond to naloxone
treatment. In April of this year, the White
House Office of National Drug Control
Policy issued a statement acknowledging the
emergence of fentanyl mixed with xylazine
as a significant threat in the ongoing
opioid epidemic. Though the drug is not
approved for human use by FDA, Congress
introduced legislation aiming to reclassify
xylazine as a Schedule III substance under
the Controlled Substances Act. This
change would require manufacturers to
report production and distribution to
Drug Enforcement Administration (DEA),
enabling the agency to intercept any
diversion to the black market.
States have also started to restrict access
to this animal tranquilizer. Most recently,
Pennsylvania Governor Josh Shapiro added
xylazine to the state's list of CS, Ohio
Governor Mike DeWine signed an executive
order restricting xylazine through the state's
board of pharmacy, and West Virginia
Innovations-Magazine-September-2023

Table of Contents for the Digital Edition of Innovations-Magazine-September-2023
