Opioid crisis: Sen. Kaine co-sponsors legislation to expand non-opioid treatments for seniors

The Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act would help prevent substance use disorder in the United States by expanding access to non-opioid treatments for older Americans.

The bipartisan legislation, which Sen. Tim Kaine of Virginia, a member of the Senate Health, Education, Labor and Pensions (HELP) Committee, announced his co-sponsorship of yesterday, would make alternative pain management treatments more affordable under Medicare Part D.

“I’ve heard from communities across the Commonwealth about the challenges of overcoming substance use disorder,” Kaine said. “This commonsense, bipartisan legislation would help protect Virginians and Americans across the country from substance use disorder by making non-opioid pain relievers more affordable for older Americans.”

Current law requires older Americans on Medicare to be pushed into the cheapest pain management option, which is frequently an opioid prescription. Their risk for substance use disorder and overdose are increased. In 2021, more than 1.1 million Medicare beneficiaries were diagnosed with opioid use disorder, and more than 50,000 overdosed on opioids. Tragically, fewer than 20 percent who are diagnosed received medication to treat their substance use disorder.

The legislation would address the issues by:

• Limiting cost-sharing for patients receiving non-opioid based pain relief under Medicare Part D plans;

• Prohibiting the utilization of step therapy and prior authorization for these drugs; and
• Encouraging the continued dialogue between patients and their healthcare professionals about preferences in pain management choices. 

Kaine has long championed efforts to combat the opioid crisis and expand access to treatment. In 2023, President Biden signed into law the NOPAIN Act, legislation Kaine pushed for, that makes alternative pain management treatments more affordable under Medicare Part B. Also last year, significant portions of Kaine’s bipartisan Disrupt Fentanyl Trafficking Act were signed into law to direct increased federal attention to fentanyl trafficking, by utilizing Pentagon tools like counter-drug intelligence and involving Mexico as an active partner to combat the crisis and disrupt cartel activity in Mexico. This year’s national security package that was passed in April included the FEND Off Fentanyl Act, legislation Kaine advocated for, that strengthens current laws and will target and sanction transnational criminal organizations that traffic fentanyl to our communities.

 Three of Kaine’s bipartisan bills to address the substance use crisis—the Providing Empathetic and Effective Recovery (PEER) Support Act, the Strengthening Communities of Recovery Act, and the Advancing Research for Chronic Pain Act—were passed by the HELP Committee in 2023. The bills would codify the Office of Recovery at the Substance Abuse and Mental Health Services Administration (SAMHSA) and cut red tape for peer support specialists who serve individuals recovering from a mental health condition or substance use disorder; reauthorize and expand the Building Communities of Recovery grant program, which provides resources for community-based organizations to develop and improve recovery services, including peer support, advocacy, education, employment assistance, and outreach to families and communities impacted by substance use disorder; and advance research and help clinicians and scientists more effectively study chronic pain conditions, respectively.

Kaine has also cosponsored the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act, which would increase access to telehealth services for individuals with substance use disorder by permanently removing an in-person exam requirement for providers to prescribe substance use disorder treatments. Kaine’s bipartisan STOP TRANQ Act would require the State Department to provide detailed reporting on global xylazine trafficking networks. Xylazine, or “tranq” is powerful sedative that is increasingly used as an additive to fentanyl to devastating effect.

The legislation is led by Sens. Thom Tillis of North Carolina and Mark Kelly of Arizona.