From the Desk of Teresa Cobleigh, Herren Project Strategy & Communications Director
Herren Project applauds efforts to elevate the overdose issue as one of legislative urgency worthy of bipartisan support at federal and state levels. If there is ever an issue that requires bipartisanship, this is it. We all bleed red and grieve blue when we lose our sons and daughters. Republicans and Democrats need to come together to solve this crisis.
Some US legislators are working across the aisle to sponsor legislation that addresses the crisis. For example, Rep. Joe Neguse (D-CO), along with a bipartisan coalition of House lawmakers including Rep. Madeline Dean (D-PA), Rep. Don Bacon (R-NE), Rep. David Trone (D-MD), Rep. Mike Lawler (R-NY) and Rep. Juan Ciscomani (R-AZ) are co-sponsoring the bill Innovate to Save Lives Act of 2023 which promises a 10% Research & Development (R&D) tax credit to small businesses. If tax incentives from Innovate to Save Lives can be used to expedite the delivery of medications and vaccines, it CAN truly save lives.
At a recent conference hosted by the non-profit Cure Addiction Now (CAN), scientists from universities across the country echoed the call for research funding and drug development to fill a critical gap where there is a current disconnection. CAN founder Nancy Davis, a bereaved parent, wants to memorialize her son Jason with a cure. Jason, like so many others, went through treatment but struggled to stay sober. CAN is dedicated to filling a critical funding gap in research because people in recovery need and deserve better prospects.
CAN scientists highlighted the disconnection between drug development and their utilization in treatment, stating that medications for opioid use disorder (MOUD) are underutilized. Dr. Sandy Comer of Columbia University Irving Medical Center, claims that even with MOUD, about half do not sustain treatment after six months. She is researching vaccines that could boost their efficacy and hopefully prevent substance use disorder (SUD) in high-risk individuals. Other scientists bemoaned that approvals for projects can take years, the FDA is notoriously slow, and clinical trials are expensive. Dr. Kelly Dunn from Johns Hopkins compared the four medications for SUD to the 90 drugs developed during the same time for other conditions. Despite being the top killer for people under 35, addiction takes a small piece of the R&D pie.
Dr. Kurt Rasmussen, lead CAN scientific advisor, notes the promise in repurposing and changing drugs or botanicals that currently exist, such as GLP-1s and suvorexant. Dr. Kristen Smith of Johns Hopkins advocated for further study of Kratom, a botanical with stimulant benefits, and Dr. David Olson of UC Davis is researching how the botanical Ibogane might be modified to become safer and non-hallucinogenic. Dr. Ed Nunes, Addiction Psychiatrist at Columbia University who runs large clinical trials as part of a NIDA/NIH network, advocates for continued federal funding and a greater role for the FDA to get industry behind the effort. Dr. Paul Kenny from Mt. Sinai School of Medicine says there is a disconnect, especially for drugs that regulate motivation.
Tax credits from Innovate to Save Lives could be the buy-in needed to invest in clinical trials and bring promising medications to market.
Legislators in the Bipartisan Fentanyl Prevention Caucus must weigh the merits of various approaches. They might consider amending existing laws that have had unintended consequences. Should addiction to fentanyl be considered a disability under the Americans with Disability Act (ADA)? Dr. Sharon Walsh from the University of Kentucky thought that moderate to severe cases were indeed debilitating and would fit the diagnosing criteria of impairment with daily living. Currently, addiction to alcohol and addiction to drugs are treated differently under the ADA. Those with alcohol use disorder are protected regardless of whether they are sober. For illegal drug use, the law drops protections. This means those in the early and vulnerable stages of recovery lose protective status if they relapse, despite relapse being a manifestation of their chronic disease. If we afford ADA protections to people in early recovery, would practitioners in the industry provide better fiduciary care? Maybe then people struggling with their sobriety might have better prospects.
And what about The Health Insurance Portability and Accountability Act of 1996 (HIPPA)? Privacy rights seem to preempt other aspects of fiduciary care, thwarting efforts to coordinate and communicate with outside providers and family members for the benefit of the patient. Should we look at that?
What is the impact of declaring Fentanyl a Weapon of Mass Destruction? Would it have a negative impact on therapeutic research? Would criminalizing possession of any amount also thwart necessary research?
Until lawmakers work collaboratively to consider the issues and bring change, nonprofits like CAN will work on vital research to bring hope to millions, while others like Herren Project will provide the recovery support so urgently needed for those in the vulnerable stages of early recovery. Collaboration and legislative leadership will be critical if we are to move forward.
What you can do: Urge your representatives to elevate the crisis as a legislative priority and put Americans before partisanship. Let’s all work collaboratively for change.
