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Omnibus bill includes changes to federal drug treatment programs

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A portion of the $1.7 trillion in the federal government's proposed omnibus bill will go to opioid treatment programs, as the U.S. continues to see high rates of substance use and overdose deaths. The bill was passed by the Senate Thursday, and now heads to the House. 

Opioid Treatment Programs (OTPs) are outpatient treatment options that allow people to take medications that treat substance use disorder. Colloquially known as methadone clinics, the programs can also dispense medications, including buprenorphine and naltrexone. All three medications are approved by the Food and Drug Administration. 

However, they can be hard to access: Patients must prove they have been dealing with substance use disorder for at least one year before they can receive the medications. The clinics can be hard to access, especially in rural areas, and most patients are required to come to the clinic daily to have their dosage dispensed. 

Some of the provisions in the omnibus bill — including increased federal funding for state opioid response grants that support OTPs in rural communities, and increased telehealth flexibility — aim to make the medications more accessible. 

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Under the spending bill, each state and the District of Columbia would "receive not less than" $4 million which can be used to support OTPs or other substance use disorder treatments. Native American tribal organizations will also be eligible for grants, according to Section 1003 of the bill. 

The omnibus bill would also eliminate the requirement that patients have opioid use disorder for one year before being admitted to one of the programs. The change must be made within 18 months of the bill's enactment. 

"(This change) is really, really important because it allows people to get into services and allows them to get care without having to sort of run out a clock in order to qualify, and incur all the danger and risk of a fatal overdose that can happen while people are in the midst of an active opioid use disorder," said Dr. Ben Nordstrom, an addiction psychiatry specialist in New York City, and the chief medical officer at an OTP. 

In 2021, the U.S. saw a record number of drug overdose deaths, with over 107,000, according to data from the Centers for Disease Control and Prevention. The trend has gone down slightly in 2022, based on provisional data, but overdose deaths are one of the leading reasons for the country's falling life expectancy rate

"The overdose crisis has gotten the attention of everybody, from those of us in the opioid use disorder treatment space, to public health to policymakers, and I think that this is a reflection of how seriously people are taking it," Nordstrom said. "These provisions really are are good steps in the right direction.

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