Baltimore City Health Commissioner Responds to Passing of Opioids Package


Baltimore, Maryland Yesterday, Congress passed legislation focused on fighting the opioid epidemic. Included in the package are provisions that provide federal support to innovative programs ranging from stabilization centers to peer support services.

These are programs that will support ongoing efforts in Baltimore. In April of 2018, we opened Maryland’s first stabilization center, which provides patients with medical screenings, referrals to treatment, and connections to social services. This legislation provides sustainable funding to similar centersAn additional provision directs the Government Accountability Office (GAO) to study and submit a report on how Medicaid covers peer support services. In Baltimore, we have led efforts with our hospitals, and 10 now offer pilot peer recovery specialists in Emergency Departments.

We also support a provision to permanently allow nurse practitioners and physician assistants to prescribe buprenorphine. This is necessary but not sufficient. The federal government should go further to abolish this unnecessary requirement. In Baltimore, we are already doing what we can, with starting a “hub and spokes” model of buprenorphine treatment that increases the availability of addiction treatment in the primary care setting. The impact of this program could be so much greater if this requirement—which is not based on science or evidence—is removed.

We commend Congress on passing some important provisions, but the legislation, as a whole, does not go nearly far enough. Comparable to similar previous opioid-focused legislation authorized by Congress, this package simply tinkers around the edges of the crisis. In 2017, we lost nearly 50,000 Americans to opioid overdose. When will Congress decide to allocate resources proportional to this public health emergency and to fund programs and initiatives we know work? Those of us on the front lines need resources to save lives now, expand access to treatment, and fight stigma with education.

As we on the ground are experiencing every day, the top-down funding approach of this package does not guarantee that federal funding will be distributed in an amount proportional to the severity of the crisis among local jurisdictions. Approximately one-third of all overdose deaths in the state of Maryland occur in Baltimore City, yet we do not receive one-third of the state’s resources to fight the opioid epidemic.

The Comprehensive Addiction Resources Emergency (CARE) Act, introduced by Senator Elizabeth Warren and Congressman Elijah Cummings, will dedicate twenty times the amount of money of the Senate’s proposed package, and it will allocate funds directly to the local jurisdictions hardest hit. This is the first proposal of its kind that would scale up what we know works, save lives now, and support long-term solutions. If Congress is serious about turning the tide of the opioid epidemic, they have to be willing to commit the resources needed to the people and places who need them the most.

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