[Pharmwaste] Congress considering an intigrated stratagy to address opioid crisis.

[Margaret Shield]

CARA (S. 524 / H.R. 953) seems likely to me to move forward given strong
support from substance abuse prevention advocates of the overall approach.
And given Congress' desire to do something to address our terrible epidemic
of prescription opioid abuse which is fueling a heroin epidemic.  It's a
crisis in our communities that is devastating families, so I am glad to see
this focus. But I am dismayed by the bill's policy on expanding drug
take-back (which is in Section 203) because it really does so little and not
in the most constructive way.

*       See the full bill info and text on CARA S. 524 / H.R. 953 on
Congress.gov: http://hdl.loc.gov/loc.uscongress/legislation.114s524 

*       Link to 1/27/16 Senate Judiciary Committee hearing, and statements
of speakers:
http://www.judiciary.senate.gov/meetings/attacking-americas-epidemic-of-hero
in-and-prescription-drug-abuse

CARA's federal medicine take-back grant program is perhaps best viewed as
temporary start-up funding that could aid a transition to more sustainable
programs that are industry-financed. The amount of $2.5 million for the
entire nation is woefully inadequate to solve the problems our communities
face with finding sustainable funding for robust, convenient medicine
take-back systems..  And each grant is limited to $250,000 for term of 2
years, which leaves law enforcement and local governments in the familiar
bind of applying for a grant, spending lots of time on grant administration,
and then losing the grant support in a short amount of time.

*       As comparison, a cost estimate I did while staffing the King County
Board of Health was that a pharmaceutical extended producer responsibility
(EPR) program for King Co WA would cost manufacturers roughly $1 million per
year, depending on program design and amount of medicines collected. $1
million annually for 1 county of ~ 2 million population. And that's a EPR
program, which I believe is less costly to administer and operate in a
number of ways than a grant-funded/government-operated program.

It is also inappropriate in my view to make federal grants from taxpayers
available to drug manufacturers, and perhaps even to other entities in the
supply chain, who already receive revenues and profits from pharmaceutical
sales. These federal bills have simply copied the list of potential
authorized collectors of controlled substances from the DEA Rule and made
them all eligible to receive taxpayer support.  Not a very thoughtful
approach about who actually needs the support at the community level.  Our
law enforcement and local government agencies have been holding the bag on
medicine take-back for years, and they need to be relieved by a transition
to a public-private partnership financed by the pharmaceutical industry.

I encourage medicine take-back advocates to work together to improve some
details of this proposal, such as targeting the grants to appropriate
recipients other than multibillion dollar pharmaceutical companies.  I also
think a block grant approach to states would probably also be preferable to
a competitive grant program that pits communities against each other for a
tiny pot of funds.

Margaret Shield, PhD

Community Environmental Health Strategies

Seattle, WA 

 <mailto:margaret.shield at CEHstrategies.com>
margaret.shield at CEHstrategies.com

mobile:  206-499-5452

https://www.linkedin.com/in/margaretshield

 

From: pharmwaste-bounces at lists.dep.state.fl.us
[mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Ed Gottlieb
Sent: Thursday, January 28, 2016 6:19 AM
To: pharmwaste at lists.dep.state.fl.us
Subject: [Pharmwaste] Congress considering an intigrated stratagy to address
opioid crisis.

 

The Senate Judiciary Committee is considering "the Comprehensive Addiction
and Recovery Act (CARA), which would invest approximately $70 million a year
to enhance opioid abuse prevention and education nationwide, expand the
availability of Narcan and fund treatment programs for incarcerated addicts.
The bill also expands drug take-back programs, strengthens prescription drug
monitoring and launches a prescription opioid and heroin treatment program.

Democratic Sen. Jeanne Shaheen, a CARA co-sponsor, took advantage of the
hearing to voice support for Ayotte's legislation, and to promote two bills
of her own - an Opioid and Heroin Crisis Supplemental Appropriation of $600
million, and a separate grant program to reduce the backlog of heroin and
Fentanyl cases at state police crime labs across the country."

http://www.unionleader.com/NH-senators-Manchester-chief-testify-on-drug-cris
is-heavy-toll

 

Ed Gottlieb
Chair, Coalition for Safe Medication Disposal

Industrial Pretreatment Coordinator

Ithaca Area Wastewater Treatment Facility
525 3rd Street

Ithaca, NY  14850

(607) 273-8381

fax: (607) 273-8433

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