[Congressional Record Volume 151, Number 104 (Wednesday, July 27, 2005)]
[House]
[Pages H6679-H6681]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
DRUG ADDICTION TREATMENT EXPANSION ACT
Mr. DEAL of Georgia. Mr. Speaker, I move to suspend the rules and
pass the Senate bill (S. 45) to amend the Controlled Substance Act to
lift the patient limitation on prescribing drug addiction treatments by
medical practitioners in group practices, and for other purposes.
The Clerk read as follows:
S. 45
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. MAINTENANCE OR DETOXIFICATION TREATMENT WITH
CERTAIN NARCOTIC DRUGS; ELIMINATION OF 30-
PATIENT LIMIT FOR GROUP PRACTICES.
(a) In General.--Section 303(g)(2)(B) of the Controlled
Substance Act (21 U.S.C. 823(g)(2)(B)) is amended by striking
clause (iv).
(b) Conforming Amendment.--Section 303(g)(2)(B) of the
Controlled Substance Act (21 U.S.C. 823(g)(2)(B)) is amended
in clause (iii) by striking ``In any case'' and all that
follows through ``the total'' and inserting ``The total''.
(c) Effective Date.--This section shall take effect on the
date of enactment of this Act.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Georgia (Mr. Deal) and the gentleman from Ohio (Mr. Brown) each will
control 20 minutes.
The Chair recognizes the gentleman from Georgia (Mr. Deal).
General Leave
Mr. DEAL of Georgia. Mr. Speaker, I ask unanimous consent that all
Members may have 5 legislative days within which to revise and extend
their remarks and include extraneous material in the consideration of
this Senate bill.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Georgia?
There was no objection.
Mr. DEAL of Georgia. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, I thank the Speaker for allowing us to consider the Drug
Addiction Treatment Expansion Act, S. 45.
In 2000, Congress passed the Drug Addiction Treatment Act which has
resulted in improved access to drug abuse treatment. This law has
allowed qualified practitioners to prescribed addiction treatment
medications from their office settings so long as the number of
patients to whom the practitioner provides such treatment does not
exceed 30 patients.
However, the Drug Addiction Treatment Act also limited the number of
patients a group practice could treat to 30 as well. This limitation
has created an unnecessary barrier to access to drug addiction therapy.
Under current law, a practice of 500 doctors would still be limited to
treating only 30 patients in the same way as a single physician. This
policy effectively limits the ability of patients to get access to
treatment for their drug addictions.
This legislation before us today would lift the 30-patient limit for
group practices, but would still keep in place the 30-patient limit for
individual physicians.
I thank the gentleman from Indiana (Mr. Souder) for his leadership on
this legislation that further expands access to needed addiction
therapy. The Committee on Energy and Commerce and the Committee on the
Judiciary have both favorably reported companion bills to S. 45, and I
urge my colleagues to support this legislation today.
Mr. Speaker, I reserve the balance of my time.
Mr. BROWN of Ohio. Mr. Speaker, I yield myself 2 minutes.
Drug addiction is a problem we must face both at the individual and
the systemic level. We bear the cost of addiction as a society. These
costs are measured in lives and unmet human potential; and, frankly, in
dollars.
A recent study by the National Institutes of Health found the
economic cost of drug abuse totaled some $100 billion a year, costs
borne by all members of society by increased demand on our health care
system and our criminal justice system.
H.R. 869, the Drug Addiction Treatment Expansion Act, addresses an
anomaly in the current law that limits access to an effective drug
addiction treatment.
To ensure proper oversight of drug addiction treatment, current law
limits the number of patients any one doctor can treat. However, this
restriction inadvertently limits group practices to the same 30-patient
limit. This legislation clarifies that each doctor in a group practice
is subject to the 30-patient limit, not the group practice as a whole.
This bill will expand access to effective addiction treatment. When
we come together to fight addiction, we must use every means available.
This bill gives doctors an improved and important tool. H.R. 869 has
the support of a range of organizations, including the American
Psychological Association and the Partnership for a Drug Free America.
I am pleased to support its passage.
Mr. Speaker, I reserve the balance of my time.
Mr. DEAL of Georgia. Mr. Speaker, I yield 5 minutes to the gentleman
from Indiana (Mr. Souder), who is the author of the House companion
legislation.
{time} 1245
Mr. SOUDER. I thank the gentleman from Georgia, and I appreciate his
leadership in moving this through his subcommittee. We served together
on the Drug Policy committee in Government Reform where he served ably
as vice chairman before moving up to this important subcommittee
chairmanship over in Energy and Commerce and understands directly the
need for drug treatment.
Mr. Speaker, we can work for interdiction. We can work for
eradication down in Colombia and Afghanistan. We can work to try to
seize it as it moves through the Caribbean and through the Pacific. We
can work to try to catch it at the borders. We can try to take down the
delivery people.
We will continue to do that. We will continue to work through our
national ad campaign, through school programs to try to prevent drug
use. But ultimately many people in America become addicted. The
question is, How can we treat them? As has already been explained, this
was an unintended consequence of the original act. I appreciate Senator
Levin's help on the Senate side in moving this bill that group
practices were capped at 30 patients as well.
Between 1997 and 2000, the number of treatment admissions for primary
heroin abuse increased 21 percent while treatment admissions for
primary abuse of narcotic painkillers increased at an unprecedented 186
percent. In view of the skyrocketing numbers of treatment admissions
for primary opiate addiction in recent years, it is imperative that
measures be taken at the Federal level to provide adequate treatment
options. Given this epidemic of drug abuse in America, drug addiction
treatment programs must effectively correspond to the widespread nature
of this problem. In order to expand drug treatment programs, please
support this bill, the Drug Addiction Treatment Expansion Act, which
will remove the 30-patient limit currently imposed on group practices.
According to the American Medical Association, the current 30-patient
cap has limited access to effective substance abuse treatment services.
There is a broad consensus according to AMA in the medical community
that buprenorphine is a major new tool to fight addiction and does not
have a high potential for misuse or fatal overdose. Lifting the cap
would enable group practices to treat more patients with this highly
effective drug.
There are 49 different, well-respected drug treatment organizations
that back this bill, including the American Medical Association, the
National Association of State Alcohol and Drug Abuse Directors, the
American Psychiatric Association, the American Psychological
Association, the Association of American Medical Colleges, the Alliance
of Community Health Plans, and the American Medical Group Association.
And then in addition to all these medical groups, are almost all the
major anti-drug groups in America, including the Partnership for a
Drug-Free America, the Community Anti-Drug Coalitions of America, Drug-
Free Schools Coalition, Drug Free America
[[Page H6680]]
Foundation, the Save Our Society From Drugs, Drug-Free Kids, America's
Challenge.
I include this list of 49 groups for the Record.
American Medical Association (AMA)
National Association of State Alcohol and Drug Abuse
Directors (NASADAD)
American Psychiatric Association (APA)
American Psychological Association (APA)
Association of American Medical Colleges (AAMC)
Alliance of Community Health Plans (ACHP)
American Osteopathic Academy of Addiction Medicine (AOAAM)
American Medical Group Association (AMGA)
American Academy of Addiction Psychiatry (AAAP)
Partnership for a Drug-Free America
Community Anti-Drug Coalitions of America (CADCA)
American Society of Addiction Medicine (ASAM)
American Association for the Treatment of Opioid Dependence
(AATOD)
Legal Action Center (LAC)
National Alliance of Methadone Advocates (NAMA)
National Association of Drug Court Professionals (NADCP)
National Council on Alcoholism and Drug Dependence (NCADD)
State Associations of Addiction Services (SAAS)
National Association of Counties (NACO)
Kaiser Permanente
National Association of County and City Health Officials
(NACCHO)
National Association of County Behavioral Health Directors
(NACBHD)
The College on Problem of Drug Dependence (CPDD)
The Friends of NIDA
Faces & Voices of Recovery
Association for Addiction Professionals of New York
Drug-Free Schools Coalition
Drug Free America Foundation, Inc. (DFAF)
Save Our Society From Drugs (SOS)
Drug-Free Kids: America's Challenge
Advocates for Recovery Through Medicine (ARM)
National Families in Action (NFIA)
National Association of Social Workers (NASW)
Man Alive, Inc.
Institute on Global Drug Policy (IDGP)
International Scientific and Medical Forum on Drug Abuse
Californians For Drug-Free Youth (CADFY)
National Alliance of Advocates for Buprenorphine Treatment,
Inc.
Christian Drug Education Center
New Jersey Federation for Drug Free Communities
Wisconsin Families in Action (WFIA)
New York Academy of Medicine (NYAM)
American Academy of Pediatrics (AAP)
Association for Medical Education and Research in Substance
Abuse (AMERSA)
Physicians and Lawyers for National Drug Policy (PLNDP)
Entertainment Industries Council, Inc. (EIC)
The City of New York, New York
Providence Breakthrough
International Study Group Investigating Drugs as
Reinforcers (ISGIDAR)
Housing Works
I think that we can unanimously support this bipartisan effort to
make sure that we have another tool in an adequate way with group
practices to make sure that we can treat the scourge of drug addiction
and help many family members get back into their families, whether it
be the mom, the dad, the kids; and this is the way we can in a
bipartisan way and with the other body show that we really are trying
to address these difficult questions of drug treatment.
Mr. BROWN of Ohio. Mr. Speaker, I yield 2 minutes to the gentleman
from Massachusetts (Mr. Capuano).
Mr. CAPUANO. Mr. Speaker, I rise to first of all thank the gentleman
from Indiana (Mr. Souder) for being so dogged on this issue. As we have
heard already, this is a relatively simple item. We have people who
need treatment. I thought we were here to try to help people seek
treatment and to provide it and we have an anomaly in the law that
prevents them from getting the treatment that they want and that we
want to provide them. This bill fixes that anomaly. It is very simple.
I will fully admit that I did not find this on my own. I found this
because a doctor in my own district called me, Dr. Schmitt from Mass
General Hospital, who works out of the Charlestown Community Health
Center. He treats these people. He wants to be able to treat more.
Unfortunately, he works in a group practice and is limited to 30. He
will be able to help more people in his own community, which will help
the community at large.
This bill is a modest piece of legislation. It simply allows more
people to be treated. It is not a panacea, it is not going to fix our
drug problem, but it is going to increase access to these treatments I
believe that all Americans want us to do for their sons and daughters
who have fallen victim to the terrible sins of drug abuse.
Mr. Speaker, I urge the passage of this bill. Again, to repeat, I
want to thank the gentleman from Indiana for his tenacious push of this
bill.
Mr. DEAL of Georgia. Mr. Speaker, I reserve the balance of my time.
Mr. BROWN of Ohio. Mr. Speaker, I yield 4 minutes to the gentleman
from Maryland (Mr. Cummings).
Mr. CUMMINGS. I thank the gentleman for yielding time.
Mr. Speaker, I rise today in support of S. 45, which amends the
Controlled Substances Act to lift the patient limitation on prescribing
drug addiction treatments by medical practitioners in group practices.
This bill is the companion legislation to H.R. 869, which I have
cosponsored. On that subject, let me acknowledge the sponsorship of
H.R. 869 by the distinguished gentleman from Indiana (Mr. Souder). As
Chair and myself as ranking member of the House Government Reform
Subcommittee on Criminal Justice, Drug Policy and Human Resources, we
have worked tirelessly on the issue and are pleased to have it
considered on the floor today.
In 2000, Congress passed the Drug Addiction Treatment Act, otherwise
known as DATA, to expand treatment options for patients addicted to
opiates. To address concerns about potential abuse or diversion of the
treatment medications, DATA limited the prescription of this drug to 30
patients per physician. Unfortunately, DATA also contained language
that imposed a 30-patient cap on group practices in addition to the
limit per physician. This resulted in an unintended effect of limiting
large group practices such as that of Johns Hopkins Medical Center in
my district from meeting the high demand for drug treatment. However,
S. 45 would eliminate this disparity by removing the 30-patient limit
imposed on group practices, thereby expanding access to treatment for
all patients regardless of where they receive their medical care.
S. 45 is especially important for my district which includes
Baltimore City. According to the latest data available, Baltimore has
the third highest rate per 100,000 people of heroin-related addictions
among the 21 metropolitan areas reporting this information. Further,
Baltimore's heroin use ranked at 195, which is much higher than the
national rate of 37. Heroin abuse counted for the most drug treatment
admissions to publicly funded facilities in the city from July 1, 2001,
through June 30, 2002. In addition, mortality data indicate that there
were 349 heroin/morphine-related deaths in the Baltimore metropolitan
area in 2001, more than for any other illicit drug.
I must also note that heroin abuse via injection has contributed
significantly to the number of HIV cases in the Baltimore area. S. 45
would greatly reduce these numbers by increasing the availability of
treatment medications such as buprenorphine or ``bupe'' in institutions
such as teaching hospitals and community health clinics. Treatment
medications such as buprenorphine will allow more people to remain
productive while trying to overcome their drug addiction. Experts say
that buprenorphine leaves patients more clearheaded than methadone and
produces less intense withdrawal symptoms. They point out that in the
brain, buprenorphine behaves like heroin but works more slowly and less
efficiently than other opiates. In other words, this specific treatment
reduces or eliminates withdrawal symptoms without producing euphoria.
When we passed the law in 2000, our legislation limited bupe's
availability because we wanted to avoid the creation of prescription-
writing mills. It is important to note that this bill will not open
prescription-writing mills. Rather, it would expand access so that more
physicians in large group practices would be able to prescribe the
drug.
I urge my colleagues to support S. 45. This is an important piece of
legislation.
Mr. BROWN of Ohio. Mr. Speaker, I yield back the balance of my time.
[[Page H6681]]
Mr. DEAL of Georgia. Mr. Speaker, I would simply urge my colleagues
to support this legislation.
Mr. Speaker, I yield back the balance of my time.
The SPEAKER pro tempore (Mr. Culberson). The question is on the
motion offered by the gentleman from Georgia (Mr. Deal) that the House
suspend the rules and pass the Senate bill, S. 45.
The question was taken.
The SPEAKER pro tempore. In the opinion of the Chair, two-thirds of
those present have voted in the affirmative.
Mr. DEAL of Georgia. Mr. Speaker, on that I demand the yeas and nays.
The yeas and nays were ordered.
The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the
Chair's prior announcement, further proceedings on this motion will be
postponed.
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