In this Wednesday, Sept. 27, 2017 file photo, former Rep. Patrick Kennedy, D-R.I., greets people as he arrives for a President's Commission on Combating Drug Addiction and the Opioid Crisis meeting in the Eisenhower Executive Office Building on the White House Complex in Washington. Kennedy, a Democrat who served on Trump’s opioid commission, said Congress needs to recognize the epidemic as “a huge gorilla on the nation’s shoulder” and spend billions more. Credit: Andrew Harnik | AP

The House and Senate have passed bills that will increase treatment for substance abuse disorder, slow the flow of illegal opioids into America and provide funding for more research into substance use. Both bills include long-needed changes that will help states tackle the deadly opioid crisis. What they don’t include is enough money to achieve their goals.

To be sure, the authorized funding — nearly $8.4 billion through 2023 — is substantial. But, so is the scope of the opioid crisis, with millions of Americans unable to access needed treatment. By contrast, the federal government spent $20 billion a year on the HIV/AIDS epidemic.

When House and Senate negotiators get together to work through the differences between the two bills, authorizing additional funding should be a priority.

The bills build on the recommendations of a presidential commission to focus heavily on treatment. According to recent data from the Substance Abuse and Mental Health Services Administration, nearly 21 million Americans needed substance abuse treatment last year. However, only 4 million of these people received any treatment in the past year and only 2.5 million received treatment at a speciality facility.

Nearly a third of those who did not receive treatment said they couldn’t afford it, often because they don’t have health insurance. More than a third worried that accessing treatment would negatively affect their job, or make their friends or neighbors have a negative opinion of them. Nearly 11 percent didn’t know where to go to get treatment.

This legislation is a good start to overcoming these hurdles.

“By providing support for prevention, treatment and recovery, this all-of-the-above approach will provide vital assistance to individuals and families who are struggling with addiction,” Sen. Susan Collins said after the 99-1 Senate vote this week.

A provision from Collins that creates grants to support peer support networks, like that of the Bangor Area Recovery Network, is included in the Senate bill. Research shows that peer support reduces relapses and improves long-term recovery. Another provision, backed by Collins and Sen. Angus King, aims to stop shipments of illicit drugs, like fentanyl, through the postal service. A King-sponsored provision will allow Medicaid to cover care for infants with neonatal abstinence syndrome.

“This legislation isn’t perfect — but it’s an important step in the right direction on an issue that desperately needs progress,” King said.

A centerpiece of the legislation is an expansion and extension of the 21st Century Cures Act, which provides grant funding to states and Native American tribes for prevention, response and treatment efforts. Funding local efforts is crucial, but the $500 million annually authorized in the bill is far too little. It is also distributed mostly based on population. Rep. Bruce Poliquin has co-sponsored legislation to distribute the money based on per capita opioid addiction rates. This would benefit states like Maine that has been disproportionately hit by the epidemic. Under the Senate bill, 15 percent of the state funds would be distributed based on opioid death rates. This is a move in the right direction but more fully distributing the money based on the severity of the epidemic is a change the conference committee should strongly consider.

The Senate bill, which includes dozens of provisions, also supports research on nonaddictive pain medication and requires the Food and Drug Administration to expedite approval of such medications. It expands a grant program to train first responders to administer naloxone, an overdose-reversing drug. It also includes funding to expand prescription monitoring programs and related data collection and analysis, and to share this data among states.

It would allow the use of telehealth treatment for substance abuse disorder for Medicare recipients and encourage the same for Medicaid subscribers.

These bills, which also boost law enforcement efforts, are important steps forward. The final bill can be improved with funding that better matches the scope of the crisis.

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