Trump's opioid commission releases final report to combat drug addiction, abuse

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The commission recommended that the Trump administration and Congress administer block grant funding to states that can be used to implement evidence-based programs to fight opioid addiction.

A commission tasked by President Donald Trump to address the country’s opioid epidemic issued its final report on Wednesday, outlining more than 50 recommendations, including calling for clinicians who prescribe opioids to receive training on safe prescribing before they can renew their licenses with the Drug Enforcement Administration.

However, the 131-page report (PDF) doesn’t specify the amount of federal funding needed to implement the recommendations to combat the crisis, which Trump declared last week was a national public health emergency.

RELATED: Trump declares the opioid epidemic a national public health emergency

Trump established the commission in March in response to opioid overdose deaths, which the report said have reached epidemic proportions, exceeding all other drug-related deaths or traffic fatalities.

“The time for talk is passed. One-hundred and seventy-five deaths a day can no longer be tolerated,” wrote Gov. Chris Christie, chair of the commission, in a letter (PDF) to Trump about the report.

RELATED: CMS reveals new Medicaid policy aimed at the opioid crisis

The commission recommended that the Trump administration and Congress administer block grant funding to states that can be used to implement evidence-based programs to fight the disease.

Initial reaction

While block granting addiction treatment resources may ease some regulations, Chuck Ingoglia, senior vice president of public policy and practice improvement at the National Council for Behavioral Health, said in an emailed statement that it won’t do anything toward combating the opioid crisis.

“Like the President’s declaration last week, the Commission’s report falls short of providing the funding and access needed to truly make a dent in the opioid overdose epidemic. We have the equivalent of a plane crash every day in this country. While the report recommends some positive steps forward, it starves the country for the real resources it needs to save American lives,” he said.

But Premier, an alliance of approximately 3,900 U.S. hospitals and health systems and some 150,000 other providers and organizations, said in a statement that it is encouraged by the action steps the commission outlined. It was especially pleased to see that the report supported legislation to amend laws that deny healthcare providers access to health records for patients with a substance use diagnosis.

“Premier strongly encourages lawmakers to pass legislation (S.1850 and H.R.3545), which would align 42CFR Part 2 with HIPAA for the purposes of healthcare treatment, payment, and operations. This would allow CMS and other payers to share key information on patients’ substance use with their providers, enabling better and safer care management,” said Blair Childs, senior vice president of public affairs for Premier.

RELATED: Mandatory prescriber education among immediate steps recommended by Trump's opioid commission

Recommendations that impact providers

The report has a number of other recommendations that directly impact healthcare organizations and physicians, including calls for:

  • The development of federal statutes, regulations and policies that ensure informed patient consent prior to an opioid prescription for chronic pain
  • The Department of Health and Human Services to coordinate a national curriculum and standard of care for opioid prescribers
  • The creation of a model training program on screening for substance use and mental health status to identify at-risk patients
  • Amendment of the Controlled Substances Act to allow the DEA to require all prescribers who want to be relicensed to show that they participated in an approved continuing medical education program on opioid prescribing
  • A program to train pharmacists on best practices to evaluate legitimacy of opioid prescriptions and not penalize pharmacists for denying inappropriate prescriptions
  • CMS to remove pain questions entirely from patient satisfaction surveys so providers don’t have incentives to offer opioids to raise their survey scores
  • CMS to review and modify rate-setting policies that discourage the use of nonopioid treatment for pain, such as certain bundled payments that make alternative treatment options cost-prohibitive for hospitals and doctors, particularly those options for treating immediate postsurgical pain
  • Federal agencies to incorporate quality measures that address addiction screenings and treatment referrals
  • Federal agencies remove reimbursement and policy barriers to treatment, including those that limit patient access to forms of FDA-approved medication-assisted treatment, counseling, and inpatient/residential treatment programs
  • HHS review and modify rate-setting to better cover the true costs of providing treatment, including inpatient psychiatric facility rates and outpatient provider rates
  • Task the Health Resources and Services Administration with prioritizing addiction treatment knowledge across all health disciplines
  • Federal agencies to revise regulations and reimbursement policies to allow for treatment via telemedicine
  • Use the National Health Service Corps to supply needed healthcare workers to states and localities with higher-than-average opioid use and abuse
  • Ask HHS to develop new guidance for Emergency Medical Treatment and Labor Act compliance with regard to treating and stabilizing patients and provide resources to incentivize hospitals to hire appropriate staff for their emergency rooms

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