Accomplishments and Upcoming Priorities in Overdose Prevention

By Libby Jones

In November 2021, the Global Health Advocacy Incubator (GHAI) launched the Overdose Prevention Initiative, rooted in the belief that comprehensive support for addiction is within reach, and by advancing federal policies that address the disparities, inequities, and stigma in the addiction treatment system, we can make a difference in the lives of people across the U.S. and prevent overdose deaths. The creation of this Initiative is extremely timely —more than 100,000 Americans died of an overdose in 2021, making overdose one of the most urgent public health crises in the U.S. GHAI’s program can make a difference in the lives of people across the U.S. and prevent overdose deaths.

In 2022, GHAI advocated for strategic actions from Congress and the Administration that we believe are key to overcoming the overdose crisis in the United States. We advanced an important piece of legislation that can set the stage for state and local organizations to provide treatment and overdose prevention support, and we will continue this effort in 2023.

Our Accomplishments in 2022

The MAT Act removed a longstanding barrier to addiction treatment. Medications for opioid use disorder (MOUD), including buprenorphine, reduce the risk of overdose death from opioids by as much as 50%. Despite the efficacy of these medications and the gravity of the current crisis, onerous, outdated federal regulations limited the number of health care providers who could prescribe these life-saving medications.

GHAI led a national campaign advocating for passage of the Mainstreaming Addiction Treatment Act (MAT Act), a bill targeted at expanding access to MOUD by eliminating barriers to prescribing. GHAI assumed a leadership role in a coalition of hundreds of organizations advocating for passage of the MAT Act. Throughout the year, our team developed coalition digital toolkits, met with lawmakers and administration officials, and produced well-researched communications pieces, including published op-eds, in service of passing the MAT Act. After the MAT Act passed in December 2022, our team participated in a celebration ceremony at the White House, cementing the importance of our contributions in the effort to remove barriers to treatment.

By January 2023, implementation of the MAT Act was complete. This immediately expanded the potential of the U.S. health care system to treat addiction — the number of buprenorphine prescribers went from 130,000 to 1.8 million. At a time when the need for mental health and addiction care has never been more pressing, the MAT Act’s effects provide a lifeline for thousands of people seeking effective treatment for opioid use disorder.

Team members from the Overdose Prevention Initiative celebrated the passage of the MAT Act with ONDCP Director Dr. Rahul Gupta (second from right).

Our Priority for 2023

Congress can continue to expand access to effective treatment In the U.S., nearly two-thirds of the incarcerated population has a substance use disorder, yet a large majority of this population goes untreated. It has been reported that just 12% of jails and prisons offer medications for opioid use disorder, such as buprenorphine or methadone. The most frequently cited barrier to providing MOUD in jails and prisons is a lack of funding. Federal barriers such as the Medicaid Inmate Exclusion Policy require state and local prisons alone to fund inmate health care. This policy also forces federal benefits to be taken away from pre-trial detainees — individuals awaiting adjudication and who have not yet been convicted.

This can have dire consequences. Incarcerated individuals who are re-entering society are the most vulnerable population to experience a fatal overdose – during the two weeks post-incarceration individuals are 40 times more likely to overdose than the general population. But providing buprenorphine or methadone in jails and prisons has been associated with an 80% reduction in overdose mortality risk for the first month post-release.

GHAI will work with Congress to address this issue by advocating for two bipartisan pieces of legislation.

• The Medicaid Reentry Act would allow Medicaid-eligible individuals to resume receiving Medicaid benefits thirty days prior to their release.
• The Due Process Continuity of Care Act would permit incarcerated individuals to remain eligible for Medicaid benefits prior to conviction.

These two bills will maintain a continuity of care for substance use disorder patients. They ensure an individual’s rights and presumption of innocence are protected and allow these individuals’ access to treatment during this period to remain intact. And by allowing individuals to resume benefits prior to release, there will be more continuous and coordinated care resulting in fewer overdose deaths and lower recidivism rates.

The White House and the Office of National Drug Control Policy (ONDCP) have outlined steps to achieve universal access to addiction treatment by 2025. Since those steps were outlined, Congress and the Administration have made important progress in increasing access to effective, evidence-based treatments for opioid use disorder, such as methadone and buprenorphine.

In 2023, GHAI will continue working with the Biden Administration and the 118th Congress to improve access to addiction treatment and remove federal barriers that restrict medications for opioid use disorder. For more information about our Overdose Prevention Initiative, visit: actionforoverdose.org.