The Necessary Next Step in the Battle Against Substance Addiction

One area in which we have seen a great deal of bipartisanship in Washington is in the effort to prevent and treat substance use disorder.  In 2018, Congress passed groundbreaking legislation by overwhelming margins in both houses that gave states the resources they need to combat what was then commonly known as the opioid crisis.

But as U.S. Representative Diana DeGette (D-CO) pointed out at a recent congressional hearing, the battle is far from over.  As she said, this addiction crisis has come in waves – the first being prescription pain medicines, the second heroin, the third synthetic opioids like fentanyl, and now, “it looks like a ‘fourth wave’ of the crisis may have already arrived.  The opioid epidemic has fueled a huge increase in methamphetamine use.  In 2018, there were more than twice as many deaths involving meth as 2015, and meth is increasingly turning up in overdose deaths and drug busts across the country.”

Given this continued high level of addiction and overdose cases, it is imperative that we give healthcare providers the tools they need to effectively treat substance use disorder patients.  So, an essential next step in combating this drug crisis must involve addressing regulatory barriers that are standing between medical professionals and the information they need to provide effective diagnosis and treatment.

A law that is more than 40 years old, known as 42 CFR Part 2, places information sharing in substance use disorder cases on a different plane that that applied to all other patients under HIPAA laws.  42 CFR Part 2 places strict limitations on confidential data sharing among front-line caregivers and, in so doing, makes care coordination extraordinarily difficult.  This outdated law worsens the odds of substance use disorder patients surviving and recovering.

There are two bills that have been introduced in Congress to address this problem.  The Overdose Prevention and Patient Safety Act in the House and the Protecting Jessica Grubb’s Legacy Act in the Senate would remove these regulatory stumbling blocks and enable caregivers to have the information they need to do their jobs.

The necessity of these measures was underscored by an official with the North Carolina Department of Health and Human Services, who told Congress,  “We have invested a lot of resources through peer support and other tools to try to support that coordination, care management, etc. but there is still a huge limitation.  Even doctors within the same system can’t easily talk to each other to coordinate care around their patients.  North Carolina is fully supportive of modernizing 42 CFR in an attempt to maintain privacy but also move us to integrated care.”