WASHINGTON — North Carolina and other states need sustained, flexible federal funding to support programs working to reduce deaths and addiction from opioids and other drugs, state health officials told Congress today.
Public health officials asked lawmakers for continued commitment to Medicaid and programs that help states address drug addiction problems. A panel of the U.S. House Energy and Commerce Committee held a hearing on the issue.
“Moving an entire system of care is a monumental task. We’re working diligently and we’ve made staggering progress, but please don’t give up,” Jennifer Smith, secretary for the Pennsylvania Department of Drug and Alcohol Programs, told lawmakers. “It depends on sustained funding and support.”
States, particularly North Carolina, have been trying to respond to a growing problem of addiction and overdose to opioids and other drugs. From 1999 to 2017, nearly 400,000 people across the United States died from opioid overdoses, according to the Centers for Disease Control and Prevention.
Federal lawmakers passed a collection of bipartisan bills in 2018 aimed at fighting the crisis. The legislation provided states billions of dollars in federal funding to assist with response, treatment and recovery.
State public health officials from Pennsylvania, Massachusetts, Rhode Island and West Virginia also credited Medicaid expansion in their states for giving them the ability to pay to treat many of those who face addiction.
Rep. Diane DeGette (D-Colo.), who chaired the hearing, said states are now facing a “fourth wave” of the opioid crisis: a large increase in methamphetamine use.
“In 2018, there were more than twice as many deaths involving meth as 2015, and meth is increasingly turning up in overdose deaths and drug busts across the country,” DeGette said.
“Given the complexity of the epidemic and its ability to evolve, states, federal government agencies and Congress must remain vigilant.”
“This is not a crisis that we can resolve overnight, and it requires ongoing federal and state attention,” said Energy and Commerce Committee Chairman Frank Pallone (D-N.J.). “States are on the front lines of this national emergency, providing much of the support for those in need. They are our eyes and ears on what is occurring on the ground, and that’s why this hearing is so important.”
Over the past two decades, North Carolina has had 12,000 deaths due to opioid overdose, according to the North Carolina Department of Health and Human Services (DHHS). In 2016, North Carolina was in the top eight states for fentanyl overdose deaths alone.
“North Carolina was hard hit by the opioid crisis. The consequences have been large, and far reaching,” said Kody Kinsley, a DHHS deputy secretary.
In 2016, 1,407 people died in North Carolina due to unintended overdoses. For each death, there were six more hospitalizations, Kinsley said. But in 2018, North Carolina saw its first decline in deaths in five years.
“The most significant thing you can do would be to give us more time. Sustaining funding over longer windows of time or permanently would allow states to be ready for the next wave of the epidemic,” Kinsley said.
Kinsley asked for lawmakers to increase the substance abuse and treatment block grants, which have stayed constant for North Carolina even though the population is growing.
Kinsley said an even bigger boost would be for North Carolina lawmakers to expand Medicaid. More than half of the people who come to North Carolina hospitals with an overdose are uninsured, so much of the extra federal funding for opioids in North Carolina goes directly to their treatment. North Carolina provided treatment to 12,000 uninsured persons with the federal programs.
But that also means that money is not available to start new programs like other states that rely on Medicaid to treat their patients, like Pennsylvania and Rhode Island.
“At present, more than two-thirds of our federal opioid response grants are just going for treatment and expanding care for those that are uninsured,” Kinsley said. “So we do not have those dollars available to expand workforce and treatment.”