Letter to the Hon. Paul Ryan, Speaker of the House, and the Hon. Nancy Pelosi, Minority Leader - Target Drug Addiction Resources At The Hardest Hit Regions

Letter

Dear Speaker Ryan and Leader Pelosi:

We are pleased that the House has embarked on efforts to renew our commitment to addressing the nationwide opioid and heroin epidemic. Communities in our states continue to struggle with rising overdose death rates and the financial strain this crisis has put on local governments. Expanding upon the bipartisan, opioid response framework developed by Congress in the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act are necessary to keep up with an ever-growing need. As discussions about how best to build upon this foundation continue, we write to urge your consideration of H.R. 5109, the Federal Opioid Response Fairness Act, and its goal of helping states disproportionately impacted by the opioid crisis respond effectively.

As you know, the 21st Century Cures Act provided $1 billion over two years for the State Targeted Response to the Opioid Crisis grant program, and outlined a formula which the Substance Abuse and Mental Health Services Administration (SAMHSA) used to determine allocations for each state. This grant funding is designed to help states increase access to treatment and reduce opioid related deaths. However, the formula failed to distribute the funds based on the severity of need, leaving certain states, especially smaller states, with a grant allotment that was insufficient to address their need.

As it is currently written, the formula favors larger states, as it considers the total number of overdose deaths, not the rate of death due to overdose. For example, the state of West Virginia received among the smallest awards, despite having the largest overdose death rate in the nation, at 52 deaths per 100,000 in 2016.

The Federal Opioid Response Fairness Act offers a framework for how to address this disparity should SAMHSA distribute additional funds through the Sate Targeted Response grant program. Specifically, it directs SAMHSA to consider both per capita prescription opioid, heroin, and synthetic opioid mortality rates and the prevalence of opioid use disorders in each state when determining funding allotments under this grant program. It would also set a minimum award of $5 million, an amount that more appropriately reflects the severity of the crisis in even the smallest states.

This meaningful change will ensure that our federal investment properly targets the regions that face the most severe and deadly aspects of this growing and pervasive public health danger. We appreciate your leadership and look forward to working with you to renew our nation's commitment to ending this crisis.

Sincerely,