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Senate Passes Opioids Bill Responding to Infections and Workforce Shortages

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NEWS RELEASE

The U.S. Senate voted overwhelmingly last night to approve the Opioids Crisis Response Act of 2018 – their version of the comprehensive legislation (HR 6) passed by the U.S. House of Representatives in June. The Infectious Diseases Society of America, the HIV Medicine Association, and the Pediatric Infectious Diseases Society support the bill as an important step to improve access to substance use treatment and to responding to the significant rise in infectious diseases associated with injection drug use.

The bill will expand surveillance of infections (including HIV, hepatitis B and C, endocarditis, and other communicable health threats) associated with substance use disorders, authorize provider training to respond to infectious diseases arising from substance use disorders, and provide loan repayment for health professionals caring for patients with substance use disorders, including those treating related infections.

As Societies with more than 12,000 infectious diseases, pediatric, and HIV physicians, IDSA, HIVMA, and PIDS made recommendations reflected in the Senate-passed legislation including the addition of endocarditis, a heart valve infection, to the list of infections related to the opioid epidemic. Not currently under national surveillance, endocarditis in most cases is a severe, acute illness requiring hospitalization that is different from viral infections associated with injection drug use such as HIV and hepatitis C virus (HCV). For HIV and HCV, individuals can live with the conditions for years before prominent symptoms occur requiring acute care and engagement with the medical system. Surveillance or monitoring of endocarditis and other bacterial infections will lead to more timely identification of injection drug-related outbreaks.

The provision that creates a new loan repayment opportunity through the National Health Service Corps for substance use treatment providers will help to address the need for a trained health workforce sufficient to treat addiction and substance use treatment disorders in addition to providers to detect, control and deliver coordinated care for the rising number of infections acquired through injecting drug use. Compared to five years ago there are 20 percent fewer physicians entering training programs for infectious diseases and HIV medicine, raising great concern about shortfalls in expertise exactly when most needed. This provision will help to attract the diversity of healthcare providers necessary to provide prevention, care, and treatment services to individuals with substance use disorders, including infectious diseases and HIV providers.

These provisions are part of comprehensive bills to address the opioid crisis passed by the U.S. House of Representatives and the U.S. Senate, and the effort reflects a bi-cameral, bipartisan commitment to confronting the combined public health threats of the growing opioid epidemic and the outbreaks of infectious diseases the crisis has fueled. While additional policy changes and enhanced resources will be needed to leverage a response that expands access to prevention and treatment on a scale commensurate with the impact of this public health crisis, the U.S. House of Representatives and U.S. Senate have taken critical steps in the right direction. Now we urge House and Senate lawmakers to move quickly to reconcile their bills and advance an agreement for the President to rapidly sign into law.

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