On Senate Floor, Portman Highlights Troubling Increase in Drug Overdoses Due to Coronavirus Pandemic
WASHINGTON, DC — Today on the Senate floor, U.S. Senator Rob Portman (R-OH) shared sobering statistics highlighting how the ongoing coronavirus health and economic crisis has caused a marked increase in drug overdose deaths in Ohio and nationwide.
While the United States still suffers from the most annual drug overdose deaths in the world according to a recent U.N. report, legislation like Senator Portman’s Comprehensive Addiction and Recovery Act (CARA) and the 21st Century CURES Act have provided unprecedented federal resources to respond to the addiction epidemic in America, particularly with regards to the epidemic of opioid use. As a result, the CDC reported that in 2017, nationwide fatal drug overdoses fell for the first time since 1990, with Ohio seeing one of the most significant declines in overdose deaths of any state. However, according to a recent Washington Post report, new data from the collaborative Overdose Detection Mapping Application Program show that fatal and non-fatal overdoses were 18 percent higher in March of this year than March of 2019, 29 percent higher this April, and 42 percent higher this May.
During the coronavirus pandemic, social distancing guidelines have disrupted traditional addiction treatment services and necessitated the use of telehealth services to help individuals with recovery. That’s why Senator Portman has introduced legislation entitled the Telehealth Response for E-Prescribing Addiction Treatment Services (TREATS) Act to make permanent a number of temporary waivers for telehealth services and to bolster telehealth options for addiction treatment services. Specifically, it will allow for a patient to be prescribed lower scheduled drugs like through telehealth on their first visit. Current law requires an in-person visit to receive any controlled substance, but this is a deterrent to patients in crisis and in urgent need of treatments from Schedule III or IV drugs.
The bill will also allow Medicare to bill for audio-only, or telephone, telehealth visits if it’s not a patient’s first visit. In-person visits or telehealth visits with video components are important, because they can allow for more robust checkups and evaluations, but due to distance or access to broadband, these types of appointments aren’t always possible.
Transcript can be found below and a video can be found here.
“I’m here on the floor today to talk about some recent troubling statistics that ought to serve as a call to action for every single one of us. Last Friday in observance of World Drug Day, the United Nations Office on Drugs and Crime released its annual world drug report detailing the impact of drug use and trafficking across the world. Frankly, the report paints a grim picture that reminds us that America has a unique addiction crisis, especially as it relates to opioids.
“The report says that in recent years the United States has lost more men, women, and children to drug overdose deaths -- 60,000 to 70,000 people a year -- than the next 20 countries combined. Let me say that again. The United States has lost more people to drug overdose deaths than the next 20 countries combined. That is unacceptable. This sad comparison of the United States to other countries is a reminder that we have got to do better, and we can do better. Even more concerning to me is the recent data we’re now receiving about what’s happening as a result of the current coronavirus pandemic. It was bad enough as the world drug report shows but now during the last few months during this pandemic, things have gotten worse.
“The Overdose Detection Mapping Application Program is a collaborative federal organization that tracks overdose data from 3,300 emergency agencies. According to data that has been obtained by the Washington Post, fatal and nonfatal overdoses were 18 percent higher in March of this year as compared to March of 2019, 29 percent higher this April compared to a year ago, and 42 percent higher this May than they were a year ago in 2019. These are overdoses that being tracked through EMS, ambulance, hospitals, emergency rooms. This is really concerning. One of the findings of this UN report was that most dangerous class of drugs worldwide are opioids, including prescription painkillers, heroin, and of course, synthetic opioids, like fentanyl. These drugs were the cause of about two-thirds of the overdose deaths in the world in recent years according to the UN.
“Well recent data shows that fentanyl use in particular has gone up in the United States during this pandemic, especially when it’s laced with other drugs like heroin, meth, cocaine. As many of my colleagues know, one of my top priorities here in Congress for the last several years has been to combat this opioid addiction crisis that's hit communities in my home state of Ohio so hard. This new information about the resurgence of addiction is particularly discouraging because in recent years we’ve made great progress. We’ve actually finally after years and years of increased overdose deaths every single year, finally in the last few years we had begun to see a reversal of that and here we have, during this pandemic, the opposite happening. In 2017, Ohio’s overdose opioid death rate was almost three times of the national average. We were one of the top three states in the country in terms of opioid deaths. Nearly a dozen Ohioans dying from these dangerous drugs every day, surpassing car crashes as our country’s top killer among young people and for Ohio, overall the state’s number one killer. But that next year in 2018, we were one of the leaders in turning the tide with a 22 percent reduction in one year in overdose deaths. That was the same year, by the way, when nationally, overdose deaths also declined for the first time since 1990. Think about that from 1990 until 2018 it increased every year and then finally we saw a reduction and in Ohio a significant reduction.
“Over the last couple of years, prior to the coronavirus, we continued to make steady progress. Not 22 percent, but we made steady progress in declining. We achieved these strides in part thanks to legislation we passed here in this Congress, a significant commitment of new resources by the Republicans and Democrats here on this floor and by the administration. The CARA Act and CURES Act provided local and state governments and nonprofit groups with additional resources to help use proven prevention, treatment, and recovery programs effectively. As the author of the CARA legislation, we spent four years putting it together, national folks coming in from all over the country helping us and we put together something that made sense and it actually was working. We have also ensured that our first responders on the front lines of this crisis had what they needed including the miracle drug naloxone, which has this miracle effect of reversing the effects of an overdose. This kind of continued support was critical to our communities making the progress we’ve made in combating this disease of addiction and I’ve been proud to help lead the effort here at the federal level, although at the state level and the local level everybody has kicked in, including so many volunteers and so many families. And it’s made a difference.
“But these new reports show that now we’re going the other way. We’ve got a long way to go in this fight against the addiction crisis in America. And I’m afraid we’re in danger now of taking a step backwards. Thanks to the coronavirus our lives have changed in so many ways. Many individuals have lost their jobs or have had to radically change the way they work. Unfortunately, the disruptions have extended to this field of addiction treatment as well. As states have begun to order a suspension of elective procedures -- this happened back in March and in April, people were not able to get elective procedures in hospitals and there was a shift toward more telehealth to help preserve the personal protective gear, the PPE for frontline workers -- many patients and caregivers who relied on face-to-face interaction and around-the-clock care to be able to stay the course on recovery from drug addiction and from mental health issues have lost vital access to care. And I think that’s one of the reasons we see this uptick. Some have fallen off their treatment plans. Some have relapsed. Unfortunately, this is happening right now as we talk.
“If we combine that with the feelings of isolation so many people feel being quarantined or being isolated, the feeling of frustration, the feeling of despair many Americans have felt with these dual health care and economic crises, you’ve got a perfect storm for the resurgence in opioid deaths. And that’s exactly what has happened in Ohio and around the country. Officials in Hamilton County, which is Cincinnati, Ohio, where I’m from, say there were 42 overdose deaths in May. At least 23 people died in June. In Cuyahoga County, our state’s most populous area, the home of Cleveland, the medical examiner’s office has reported 235 fatal drug overdoses so far in 2020. At least 66 fatal heroin, fentanyl, and cocaine overdoses in May alone. Those figures, by the way, match the deadliest months for overdoses on record in the county. And that would be back in 2017.
“Remember, we talked about how the deaths kept going up year after year and 2017 was the peak and then they went down in 2018. Well this year already in Cleveland we’re back up to where we were in 2017. The Columbus coroner’s office has had to move to a space three times larger than its old office to accommodate the increases in overdoses and overdose deaths. We’re not alone in this uptick. According to the Centers for Optimal Living, 30 states have seen an increase in overdose deaths during this pandemic.
“The federal response to the coronavirus pandemic has included certain measures to ensure those suffering from addiction can continue to get the care they need and I’m glad we were able to provide some provisions both in the CARES legislation that was passed about a month ago but also the other legislation we passed around that time. We have done a number of things to cut red tape and the regulatory relief to expand telehealth, and telehealth options specifically for opioid treatment, as well as increasing the number of alternate delivery methods for patients quarantined at home so they can maintain their access to opioid treatment providers. These reforms have been helpful in offering a lifeline for those working hard to stay sober and clean and in some instances, according to addiction and mental health leaders from across the state, these reforms have even allowed addiction specialists to reach new patients who are hesitant to come to the doctor’s office in the first place, sometimes due to the stigma that attaches to addiction.
“These aren’t perfect solutions, of course, because the numbers show that addictions are actually up. But ultimately they have been helpful. We’re going to have to find a way to get a handle on this coronavirus pandemic, in a way that we can resume these traditional in-person addiction treatment services that have helped so many recover from this debilitating disease. We are going to have to ensure that we can get away from some of this isolation and sense of despair that people feel. One thing we do know is that the benefits of telehealth for treating addiction are real, and I think we should act now and in this next COVID-19 bill that we’re talking about passing next month or maybe even later this month, that legislation, in my view, should include provisions that allow providers to have the flexibility to continue to offer alternative forms of care via telehealth to people when this pandemic is over so that the providers are readily adapt in the event that another pandemic or other disaster forces us to shift health care services back to virtual care.
“So we need to continue telehealth now, provide the reimbursement, but also ensure that it is going to be there for the future because it is working. I am committed to working with my colleagues on bipartisan solutions to the challenges we’ve talked about today. Yesterday, I introduced legislation called the Telehealth Response for E-Prescribing Addiction Services Treatment Act, or TREATS, to make permanent a number of temporary waivers for telehealth services and bolster telehealth options for addiction treatment services. Specifically, the bill is going to do a couple things. First, it will allow for a patient to be prescribed lower-scheduled drugs like suboxin or buprenorphine through telehealth on their first visit. Current law requires you go to an in-person visit when needing any controlled substances but this has been a deterrent to patients in crisis and in urgent need of treatments from Schedule III or Schedule IV drugs. So our bill is important.
“By the way, it also limits abusive practices by limiting telehealth visits to those who have both audio and video capabilities to be able to interact with the treatment providers to reduce fraud and abuse when it’s your first visit. And we’d also prohibit prescribing Schedule II drugs, like opioids, that are more prone to being abused through these telehealth visits. So we have provisions in there to avoid abuse, but it’s important to continue this telehealth when the other options aren’t there.
“Second, our bill would allow for Medicare to bill for audio-only or telephone telehealth visits if it is not the patient’s first visit. In-person visits or telehealth visits with video components are important and I think it is important to have that on the first visit because they can allow for more robust checkups and evaluations. But due to distance or access to broadband, these types of appointments aren’t always possible. We still need to focus on safety and robust treatment options but in order to balance the needs of patients, we have proposed to allow our nation’s seniors to use phones for subsequent behavioral health visits when they do not have access to the internet.
“There’s no question that the greatest priority facing our country at this moment is this unprecedented coronavirus pandemic. But this new UN report and the rising number of overdoses in Ohio and around the country show that there’s even more at stake here than we realize. We know of the direct impacts of the coronavirus pandemic, but losing ground on addiction and behavioral health is one of the indirect casualties. Not only must Congress ensure our addiction health services have the resources they need to adapt to this new reality, but we’ve also got to redouble our efforts to slow the spread of the coronavirus so we don’t lose ground on this addiction crisis just as we were making progress. So that we don’t keep more Americans from achieving their God-given potential.”