In Rare Bipartisan Accord, House and Senate Reach Compromise on Opioid Bill


It will require the United States Postal Service to start collecting information on international mail shipments, just as private carriers like Fed Ex and DHL already have to do. By the end of this year, the Postal Service will need to provide the name and address of the sender and the contents of the package, as described by the sender, for at least 70 percent of all international packages, including all of those from China. It will have to provide the information on all such shipments by the end of 2020.

The Postal Service could block or destroy shipments for which the information is not provided.

The bill would provide funds for researching and developing new nonaddictive painkillers. It would also allow the Food and Drug Administration to require that certain opioids be dispensed in packaging that limits their abuse potential — for example, in blister packs that provide only a few days’ supply.

Missing from the final bill is a contentious provision that had nothing to do with opioids but that the pharmaceutical industry had pushed hard for. It would have softened a requirement that drug manufacturers start providing larger discounts next year to Medicare beneficiaries whose spending on prescription drugs falls in a coverage gap called the “doughnut hole.” The measure, which would have cost the federal government $4 billion, met with fierce opposition from consumer advocates and some members of Congress.

Also missing, according to many addiction treatment providers and researchers, is the vastly larger investment needed to truly stem the tide of overdose deaths and provide effective treatment on demand. As a model, they point to the Ryan White Care Act, a bipartisan bill that Congress passed in 1990, which has allowed for billions of dollars in treatment and other support for people with H.I.V. and AIDS, including antiretroviral drugs for anyone without insurance.

Senator Elizabeth Warren of Massachusetts and Representative Elijah Cummings of Maryland, both Democrats, have proposed legislation modeled on the Ryan White Act that would provide $100 billion over 10 years for addiction treatment and other supports. But the proposal has gone nowhere.

“Compared to how we responded to AIDS, it’s a failure,” said Keith Humphreys, a Stanford professor who advised both the Senate and House on their earlier bills, of the new version. “The Republicans didn’t want to spend, so they agreed on every second-tier issue they could.”

Still, he added, “If you look at it in terms of the incredible dysfunction of Congress on everything, it’s actually one of the few things they’ve been able to do together as parties.”



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