This week, U.S. Reps. David B. McKinley, P.E. (R-W.Va), Terri Sewell (D-AL),Ann Kuster (D-NH), and Brian Fitzpatrick (R-PA), introduced H.R. 3259, the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act. This legislation would help break down barriers to non-opioid pain management by offering alternatives to highly additive opioids.
Specifically, the bill would address payment disincentives for practitioners to prescribe non-opioid treatment alternatives in surgical settings by requiring the Centers for Medicare and Medicaid Services (CMS) to place non-opioid treatments on par with other separately paid drugs and devices in Medicare Part B.
"While most of the attention has been paid to the Covid pandemic in the last year, our nation's substance abuse epidemic has grown event worse. Yet, our healthcare system still unnecessarily encourages the use of opioids," said Rep. McKinley. "Our bill would ensure that non-opioid options to treat and manage pain are not put at a disadvantage. While pain management for all patients should be handled between a patient and doctor, opioids should not be the first or only option given."
"The opioid epidemic has devastated families and communities across this Nation, and it is incumbent upon all of us in Congress to make addressing this crisis a priority," said Rep. Sewell. "Fortunately, many non-opioid treatments and therapies exist that can successfully replace, delay, or reduce the use of opioids in treating post-surgical pain and lessen the risk of addiction. The NOPAIN Act would make critical changes to the way Medicare classifies non-addictive opioid alternatives and would empower doctors to prescribe treatments that are best-suited for their patients' needs. I am proud to introduce this critical legislation to prevent the continued needless loss of life."
"I am pleased to help introduce this bipartisan legislation which will expand access to non-opioid pain management alternatives for patients," said Rep. Kuster, lead Democratic co-sponsor. "The NOPAIN Act marks a critical step in our national efforts to curb the opioid epidemic and ensure that patients have viable non-opioid alternatives that present a lower risk of addiction and misuse. I look forward to working with my colleagues on both sides of the aisle in advancing this bipartisan legislation."
"The substance and opioid use disorder crises have affected countless families and communities across the United States," said Rep. Fitzpatrick. "I am proud to cosponsor the bipartisan NOPAIN Act, which would limit unnecessary exposure to opioids by ensuring access to non-addictive therapy alternatives for Americans who have undergone outpatient surgical procedures. Now, more than ever, Americans should have access to medical treatment without fear of developing a substance use disorder as a result."
According to the Centers for Disease Control and Prevention (CDC), opioids are the main driver of drug overdose deaths in the United States, accounting for 70,630 deaths in 2019 which comprise 70% of the total drug overdoses that year. Additionally, the CDC estimates that the economic costs associated with prescription opioid misuse exceed $78.5 billion annually. These costs include those associated with health care, lost productivity, addiction treatment, and the judicial system.
Research shows that patients receiving an opioid prescription after short-stay surgeries have a 44% increased risk of opioid use. One 2018 study showed that 12 percent of patients who had a soft tissue or orthopedic operation in the year prior reported that they had become addicted to or dependent on opioids.
"The United States continues to battle a wide-ranging drug overdose epidemic fueled by illicitly manufactured fentanyl and fentanyl analogs, methamphetamine, cocaine, and heroin. Deaths related to prescription opioids also remain too high," said Susan R. Bailey, M.D., President of the American Medical Association. "To counter this grim reality, the AMA supports a comprehensive approach to help patients with pain, including removing barriers to non-opioid alternatives. The AMA applauds Reps. McKinley, Sewell, Kuster, and Fitzpatrick for introducing the NOPAIN Act. Providing separate payments for non-opioid alternatives is a vital part of the overarching strategy of offering patients options for coping with pain while simultaneously aiding the fight against the epidemic of drug overdose and death."
The NOPAIN Act is also supported by the following organizations:
A Voice in the Wilderness Empowerment Center
A.C.T Drug Free Community Coalition
Acupuncturists Without Borders
Adult & Teen Challenge
Ambulatory Surgery Center Association
American Association of Colleges of Nursing
American Association of Nurse Anesthetists
American Association of Oral and Maxillofacial Surgeons
American College of Surgeons
American Massage Therapy Association
American Psychological Association
American Society of Anesthesiologists
Arizona Association of Alcoholism and Drug Abuse Counselors
Arizona Nurses Association
Arizona Public Health Association
Attack Addiction Foundation in Delaware
Aurora Sober Living
Colorado Coalition for the Homeless
Community Anti-Drug Coalition
Delaware County Community Partnership
Drug Free America Foundation
Herren Project in Rhode Island
Indiana Rural Health Association
Medical Alley Association
Medical Device Manufacturers Association
Mental Health Association of Delaware
Michigan Association of Nurse Anesthetists
National Alliance for Healthcare Purchaser Coalitions
National Certification Commission for Acupuncture and Oriental Medicine
National Rural Health Association
National Safety Council
National Transitions of Care Coalition
Nebraska Association of Behavioral Health Organizations
Oklahoma CART Association
Outpatient Ophthalmic Surgery Society
Partnership for Healthy Iowa
Partnership to End Addiction
Pennsylvania Nurse Anesthetists
Pennsylvania Nurse Practitioners
Physical Medicine Management Alliance
Reckless Saints of Nowhere
Save Our Society From Drugs
Second Chance Center, Inc
Society for Opioid Free Anesthesia
The Kennedy Forum
The Substance Use and Mental Health Leadership Council
Students for Opioid Solutions
Will Bright Foundation