Bill Overview
Title: Opioid Treatment Access Act of 2022
Description: This bill expands access to substance use disorder treatment by modifying the regulation of opioid treatment programs and narcotic drugs used for treatment, including with respect to a patient's unsupervised use of such drugs. Specifically, the Department of Health and Human Services (HHS) must issue regulations to further increase patients' access to unsupervised use or handling of drugs for treatment. The Substance Abuse and Mental Health Services Administration (SAMHSA) must study the effects of these revisions, and HHS must, as appropriate, promulgate additional regulations based on the study's findings. SAMHSA must also study the impact of certain exemptions from certification requirements for opioid treatment programs that were granted as part of COVID-19 response efforts, including any additional costs or savings that resulted from the exemptions. The bill also (1) allows specified types of health care providers to prescribe (subject to certain requirements) methadone that is dispensed through pharmacies for a patient's unsupervised use, and (2) provides statutory authority for a regulation that allows registered opioid treatment programs to operate mobile medication units without separately registering the unit.
Sponsors: Sen. Markey, Edward J. [D-MA]
Target Audience
Population: people with opioid use disorder or seeking opioid treatment
Estimated Size: 10000000
- The opioid crisis affects millions worldwide, with a significant number of individuals suffering from opioid use disorder (OUD).
- The CDC estimated that in 2019, more than 10 million people aged 12 or older had misused opioids in the U.S. within the past year.
- HHS and SAMHSA, through this bill, aim to expand access to treatments, likely impacting those currently receiving or needing opioid treatment.
- The global burden of opioid addiction is substantial, with millions potentially seeking better access to treatment options.
- By allowing unsupervised use of treatment drugs, the bill could impact the accessibility and adherence to treatment globally.
Reasoning
- The population affected by the opioid crisis is vast, estimated to be around 10 million individuals in the U.S. This target group includes people actively using opioid treatment programs or those in need of such services.
- The Opioid Treatment Access Act aims to improve accessibility and flexibility in treatment options, crucial for those with opioid use disorder (OUD) who may struggle with consistent treatment adherence due to stringent supervision requirements.
- Considering the policy's budget and scope, the individuals most likely to benefit are those in or near urban centers with established treatment programs and resources to implement the changes.
- It's important to include a variety of perspectives, including those not directly using the prescribed medications, but impacted by the broader societal changes, such as healthcare professionals and family members of OUD patients.
Simulated Interviews
unemployed (Baltimore, MD)
Age: 35 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- The ability to take my medication at home would save me so much time and stress. It would make it easier to care for my kids.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 6 | 5 |
bartender (Portland, OR)
Age: 28 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Having more freedom with medication could help me hold down my job better.
- I'm worried about others potentially misusing if the medication is more accessible.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 7 |
social worker (New York, NY)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- This policy will provide a much-needed boost in flexibility and autonomy for clients seeking help.
- I'm concerned about the oversight of medication use and potential increases in misuse.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
factory worker (Louisville, KY)
Age: 42 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 7.0 years
Commonness: 6/20
Statement of Opinion:
- Being able to get medication more easily might help me stay on track and keep my job.
- I'm hopeful but cautious about how these changes will affect my recovery.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 6 |
| Year 20 | 6 | 5 |
student (Austin, TX)
Age: 23 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- The option for less stringent supervision is critical for continuing education without interruption.
- My family worries about this freedom leading to potential relapse.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
retired (Fargo, ND)
Age: 60 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- This bill could've given my child a fighting chance by keeping them in consistent care.
- I support anything that might save other families from the pain we've endured.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 4 | 3 |
| Year 3 | 4 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 4 |
nurse (Chicago, IL)
Age: 33 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 6/20
Statement of Opinion:
- This policy could improve treatment compliance and healthcare outcomes overall.
- However, it requires robust education and monitoring to prevent negative effects.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 6 |
homemaker (Rural Mississippi)
Age: 40 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Unsupervised use is significant since getting to the clinic is hard.
- I worry about potential abuses in less regulated areas.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 3 |
| Year 5 | 7 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 4 |
student (Philadelphia, PA)
Age: 26 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- Accessing meds without missing classes is vital for my progress.
- Peer influence and on-campus support are important factors.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 6 | 6 |
transportation manager (Los Angeles, CA)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- The policy could make increased treatment accessibility possible, which reduces stress on families.
- It requires checks to prevent harm due to greater access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Cost Estimates
Year 1: $500000000 (Low: $400000000, High: $600000000)
Year 2: $520000000 (Low: $420000000, High: $620000000)
Year 3: $540000000 (Low: $440000000, High: $640000000)
Year 5: $580000000 (Low: $480000000, High: $680000000)
Year 10: $650000000 (Low: $550000000, High: $750000000)
Year 100: $1000000000 (Low: $800000000, High: $1200000000)
Key Considerations
- Regulatory changes require careful implementation to prevent misuse of unsupervised prescriptions.
- Long-term studies are necessary to understand the full impact of expanded access on health outcomes.
- The balance between cost and savings will depend on the efficiency of new treatment distributions.
- Coordination with state healthcare regulations may be required to streamline mobile unit operations.