America's Opioid Crisis

Our comprehensive public policy priorities

Educate & Prevent
Training for dentists, doctors and pharmacists.  We support the aggressive expansion of education and training for health care providers about the dangers of overprescribing opioids, screening for and recognizing the signs of addiction to alcohol and other drugs, appropriately intervening when addiction is suspected and referring to specialty care when needed. This is especially relevant in the area of opioids, where education is desperately needed on the dangers of overprescribing and alternatives for addressing pain.

Public education. We support national education and prevention campaigns that target youth and their parents, older adults and the general population to dispel myths, provide facts and resources, and reduce stigma. One specific idea we support is educational literature for consumers, provided with their opioid prescriptions. Another might be to add a “penny a pill” or similar surtax to opioids, with the proceeds to fund public education campaigns.

Promotion of non-medication pain management therapies. We encourage public and private organizations to follow the lead of groups like Minnesota’s Veterans Administration in embracing healthy approaches to pain management that do not rely so heavily on pain medications. We also urge state medical boards to include diverse pain management guidelines in their policies. A survey we commissioned in October 2014 supports this priority, finding that 80 percent of respondents are willing to reduce or eliminate their current chronic pain medications and try alternatives instead. We are especially grateful for the new opioid prescribing guidelines recently issued by the Centers for Disease Control and Prevention (CDC).

Limits on medications. We support legislation like that recently signed into law in Massachusetts that forbids doctors from writing opioid prescriptions for more than a seven-day supply. Lawmakers in Vermont and Maine were considering similar laws, which would go a long way toward reducing excess supply in medicine cabinets and limiting the expectation on length of use.

A ban on direct marketing of opioids. The Food and Drug Administration (FDA) should forbid the makers of opioids from marketing them to doctors and the public.

Responsible medication approvals and labeling. 
  • We urge the U.S. Food and Drug Administration (FDA) to refrain from approving new high dosage opioid painkillers, especially those easily crushed and therefore more prone to misuse and diversion, unless they are clearly safer than existing products. 
  • We also encourage medication labels that appropriately limit approved uses.
  • In addition, we encourage a strong FDA warning on all opioid labels. Such warnings would help ensure that patients are aware of the dangers and the availability of alternatives. These are deadly drugs that in essence represent “heroin in the medicine cabinet.”
  • We also believe natural painkillers like "kratom" should be investigated for possible inclusion on the DEA's controlled drug schedule. Kratom, derived from a plant, has properties of amphetamine and opioids and is marketed as a “natural painkiller.” It doesn't show up on drug screens, which means people with opioid use disorders can use it without being detected. Those selling it are doing so publicly without consequences, as it remains legal in spite of its addictive qualities. The FDA did in 2014 ban the import of kratom under its authority to keep out substances strongly suspected to be harmful. The Drug Enforcement Administration (DEA) has also listed kratom as a “drug of concern” but not a controlled substance. Indiana, Tennessee, Vermont and Wyoming have banned it on their own, and the Army has forbidden its use by soldiers.


Effective Prescription Drug Monitoring Programs (PDMP). We support establishing a national PDMP and mandating its use by all prescribers. PDMPs help prescribers see what prescriptions their patients may be getting from other prescribers, identifying problematic drug-seeking early on. State-level PDMPs are often voluntary, and the information is usually not shared across state lines. Short of a national system, we encourage more efforts to strengthen state PDMPs, including mandated utilization, appropriate funding and coordination of PDMPs across state lines. Utilization is especially key, since studies show that in states where it is not mandatory, the PDMP is used only a third of the time. Grants to state substance abuse agencies, including the Substance Abuse Prevention and Treatment Block Grant, could require coordination across state lines and mandatory PDMP utilization, for example.

The addition of naloxone revivals as an item tracked by PDMPs. We also think prescribers need to know if their patients have ever had to be revived from an overdose. A recent study in the Annals of Internal Medicine found that too many folks who are revived are then prescribed opioids again.

Effective law enforcement. We support strong sentences for criminal overprescribing of opioids as well as enterprising diversion schemes intended to supply the illegal drug market.

Disposal of unused, unneeded medications. We support the U.S. Drug Enforcement Administration’s regulations governing the safe and secure disposal of prescription medications at authorized collection locations. We also support the DEA's National Prescription Drug Take-Back Day and urge communities to vigorously promote their authorized collection locations with other community-wide Prescription Drug Take-Back Days. Such efforts facilitate continued public education about the dangers of keeping excess medications in the home or workplace.
Revive & Treat


Availability of overdose “rescue drugs.”  We encourage expanded access to the opioid antidote "naloxone," and we support “Good Samaritan” laws which encourage people to call 911 for help when they witness an overdose without fear of being arrested themselves for drug possession or being under the influence. States such as New York have trained thousands of first responders and lay individuals to recognize and respond to opioid overdoses using naloxone, and many have companion “Good Samaritan” laws. We encourage similar policy nationwide.

Immediate intervention for people revived from an opioid overdose. We believe health care providers should adopt a “standard of care,” or recommended protocol, for helping people after they have been revived from an opioid overdose with naloxone. Such a standard or protocol would help ensure that overdose survivors are thoroughly evaluated, educated and referred to addiction treatment and/or community-based support resources. Too often today, people revived are sent home without further care. They are at extreme risk to “use” and possibly overdose again.


Accessible evidence-based treatment for opioid use disorder.
  • Longer-term care. Research, as well as the experience of our Comprehensive Opioid Response with Twelve Steps (COR-12) program for treating opioid addiction, shows that engaging patients longer improves their chances for sustained recovery. While we believe the level of care (i.e. residential, intensive outpatient, etc.) is best determined by clinicians using American Society of Addiction Medicine (ASAM) criteria, we support an emphasis on longer-term care.
  • Enforce insurance “parity” to guarantee that insurance companies are not arbitrarily discontinuing coverage for treatment at a certain time. Our organization was at the forefront in supporting the 2008 parity law. We still see “fail-first” violations, though, whereby patients are forced to fail at lower levels of care before receiving the appropriate level of care. The parity provisions also are inconsistently adhered to by insurance companies, something our staff contends with daily. We firmly believe that insurers and other payers should be required to disclose their medical management criteria and how they employ them.
  • Safe, responsible use of medication to assist addiction treatment when appropriate. We support the use of certain medications if used adjunctively with therapy and recovery supports to minimize risks and maximize the benefits of treatment. Our COR-12 program is a model. To that end, we believe primary care doctors who prescribe medications for opioid addiction need to also "prescribe" therapy, regular drug screens and recovery support resources as well. Current regulations make these suggestions, but do not require anything. At minimum, we’d like to see weekly drug screens and at least one hour of counseling a week required for patients receiving medications for opioid addiction.

    In addition, we encourage doctors to consider naltrexone or its extended-release version – Vivitrol – as a viable alternative to Suboxone in some cases, and to consider both of those options as the safest alternatives. To ensure thorough consultations are possible between primary care doctors and their patients with opioid addiction, we also urge that existing limits be maintained on the number of patients to whom a doctor can prescribe Suboxone; at the same time, we would like to see more doctors certified to prescribe the medication.
  • Abstinence as long-term goal. We know from years of experience that abstinence is a realistic goal for people with opioid addiction, and we urge all professional caregivers to pursue that goal.
Criminal justice reform. We strongly support the expansion of Drug Courts and similar corrections alternatives that are more rehabilitative than punitive and that have proven to reduce crime, save money, ensure compliance and restore families. We also believe legislative efforts like The Second Chance Act can help those who were convicted of drug offenses get back on their feet through treatment, re-entry programs and employment training. We further support efforts to reform draconian mandatory sentencing laws, restore the voting rights of recovering drug offenders and provide them with more and better sober housing options.

Expanded infrastructure for community-based recovery. Addiction is a chronic illness, and we need to think of recovery from addiction as we do cancer remission – something that needs close attention and support for up to five years. That doesn’t mean we need five-year-long treatment programs, but rather support mechanisms that help connect recovering people so they can support one another in the community context and be a magnet for others in their community who might seek recovery as well. While recovery often begins with treatment, it is sustained in the community, and people with addiction benefit substantially from long-term recovery engagement. We support grants and targeted efforts to establish recovery community organizations (RCOs); expand and improve recovery housing; and promote collegiate recovery programs and recovery high schools.

Loan forgiveness for licensed addiction counselors who practice in high need areas. There is a huge need for addiction counselors right now, with a projected 31 percent employment growth rate by 2022 for these jobs. In fact, more than 21,000 new counselors will be needed to fill the need, according to the Bureau of Labor and Statistics. We can encourage prospective counselors to go into the field, and fill a need in the country, by offering targeted loan forgiveness for those who commit to practicing in certain high need areas, for a specified period of time, similar to what’s been implemented for doctors in rural areas, for example.  

Telehealth and other remote supports. We urge federal and state legislation that would make it more feasible for organizations like ours to provide care remotely using telehealth technologies. The greatest challenges are obtaining provider licenses across multiple state lines and accessing insurance reimbursements for care delivered in this manner. This is relevant because patients on medication assistance for opioid addiction require continuing care services that support their long-term journey to abstinence, and it is difficult to engage them long term without doing so remotely. Telehealth technologies also could help bring therapy resources to locations where primary care doctors are able to prescribe Suboxone but unequipped to provide addiction counseling. That is a clear need expressed by participants at our Addiction Medicine for the Primary Care Provider Conferences. American Indians, military veterans, and residents of rural areas, for example, would benefit greatly from greater access to care.

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