President Trump’s proposed 2018-2019 budget includes almost $17 billion to combat the opioid epidemic. Here’s an excerpt from the Office of Management and Budget document that explains how the money would be spent:
"The Budget requests $5 billion in new resources for the Department of Health and Human Services (HHS) over the next five years, including $1 billion in 2019, to combat the opioid epidemic by preventing opioid abuse and helping those who are addicted get access to overdose reversal drugs, treatment, and recovery support services. The Budget request includes: $50 million for a media campaign; $625 million for States to respond to the crisis; $50 million to improve first responder access to overdose-reversal drugs; $100 million for surveillance and opioid abuse prevention activities, including improving State-based Prescription Drug Monitoring Programs (PDMPs); $20 million for drug courts; $10 million for pregnant and post-partum women treatment programs; $10 million for the Food and Drug Administration’s (FDA) regulatory science activities to develop tools to stem the misuse and abuse of opioids; $65 million to support multisector, county-level teams in high-risk rural communities to improve access to care, and expand treatment and recovery services; $45 million for supplemental grants for opioid abuse prevention, treatment, and recovery services in American Indian and Alaska Native communities; and $25 million to evaluate the impact of medication assisted treatment on reducing overdose deaths.
"In addition to the requested $5 billion, the Budget also continues and expands existing activities in HHS that specifically address key strategies to combat the opioid crisis. The Budget requests $100 million for the National Institutes of Health to support a public-private partnership with the pharmaceutical industry to develop prevention and treatments for addiction, overdose-reversal, and non-addictive therapies for pain. The Budget requests $123 million in the Substance Abuse and Mental Health Services Administration for opioid abuse prevention, treatment, recovery support, and overdose reversal. The Budget also requests $126 million in the Centers for Disease Control and Prevention to support opioid abuse prevention and surveillance activities, including support to States to improve the capabilities and use of State-based PDMPs.
"Further, the Administration supports more rigorous research to better understand how existing programs or policies might be contributing to or mitigating the opioid epidemic.
"For Medicaid, the Budget calls for expanding coverage of comprehensive and evidence-based medication assisted treatment options, previews forthcoming guidance from the Centers for Medicare and Medicaid Services that would set minimum standards for State Drug Utilization Reviews to reduce clinical abuse, and requires States to track and act on prescribers that do not adopt best practices.
"For Medicare, the Budget proposes to test and expand nationwide a bundled payment for community-based medication assisted treatment, including Medicare reimbursement for methadone treatment for the first time. The Budget also proposes to prevent prescription drug abuse in Medicare Part D and protect beneficiaries from potentially harmful drugs by requiring plan participation in a program to prevent prescription drug abuse. In addition, the Budget proposes to authorize the Secretary of HHS to work with the Drug Enforcement Administration (DEA) to revoke a provider’s certificate (which allows a provider to prescribe controlled substances) when that provider is barred from billing Medicare based on a pattern of abusive prescribing. Cutting off Medicare funding for abusive prescription practices not only helps bring premiums down for seniors, it promotes sound public health policy.
"The President also recognizes that combatting the opioid crisis means not only helping those suffering from drug addiction but also dismantling drug trafficking organizations profiting from this deadly scourge. The Budget requests $2.2 billion for the DEA, including an additional $41 million to enhance efforts to target the illicit drug traffickers that prey on communities. In addition, the Budget requests $103 million within DOJ for opioid-related State and local assistance including: $20 million for the Comprehensive Opioid Abuse Program to support a variety of activities such as treatment and recovery support services, diversion, and alternative to incarceration programs; $59 million for Drug Courts, Mental Health Courts, and Veterans Treatment Courts; $12 million for Residential Substance Abuse Treatment; and $12 million to support PDMPs, in tandem with HHS efforts.
"The Budget also requests a range of investments that would strengthen efforts at DHS to identify, screen, and interdict drug shipments coming into the United States, and to investigate those responsible for bringing illegal drugs into the United States. The Budget request increases funding for CBP’s NTC by $79 million, for a total of $253 million, which would also allow the Agency to better target its efforts to stop illicit goods, including illicit drugs, from entering the United States. The Budget also requests a $44 million investment in new Non-Intrusive Inspection technology at Ports of Entry, which is used to examine cargo and conveyances for contraband and weapons of mass effect. The Budget requests an increase of $42 million, funded by both fees and discretionary appropriations, to enable CBP to screen inbound packages at express consignment carrier facilities such as FedEx, UPS, and DHL. The Budget continues investments in presumptive testing devices to improve customs officers’ capability to detect and interdict fentanyl and other opioids, and requests an additional $1.2 million, for a total of $46 million, for scientific support to CBP officers for rapid identification of suspected illicit materials, in particular suspected opioids. In addition, the Budget fully supports all 57 ICE Border Enforcement Security Task Force units around the United States, which are the Agency’s primary platform to investigate opioid smuggling, and continues support for DHS’s Joint Task Force—Investigations, which works to identify, disrupt, and dismantle TCOs that seek to import opioids and other drugs into the United States."