WASHINGTON (AP) – Alarmed by a deadly new turnaround in the nation's drug addiction crisis, the government will allow states to use federal money earmarked for the opioid epidemic to help an increasing number of people struggling with methamphetamine and cocaine.
The little-noticed change is buried in a huge spending law passed by Congress at the end of last year. Under pressure from voters and state officials, lawmakers on both sides and the Trump administration agreed to broaden the scope of a $ 1.5 billion subsidy program, previously restricted to the opioid crisis. Beginning this year, states can also use these federal dollars to combat addiction to "stimulants," a term the government uses for meth and cocaine.
"Methamphetamine and cocaine are coming back and are more potent than they were during the last wave," said Mark Stringer, director of the Missouri Department of Mental Health. He oversees the state's efforts to prevent addiction, get drug addicts to treatment and support them in their recovery. "Where meth is much more prevalent than opioids, it will change the game."
About 68,000 people died of a drug overdose in the U.S. in 2018, with opioids involved in about two-thirds of cases. Opioids are a class of drugs that include fentanyl, heroin, certain prescription painkillers and various chemical combinations prepared for street sales. But national figures also hide dramatic differences in the country's most lethal drugs.
In most states west of Mississippi, methamphetamine is the biggest killer, according to 2017 government data. Meanwhile, the highly lethal fentanyl opioid maintains its hold on the East and Midwest. Cocaine ranks third overall in drug deaths.
Senator Jeanne Shaheen of New York, whose state was hit hard by the opioid epidemic, said she was hearing from all quarters last year that the scourge of drug addiction is gradually changing.
"They were seeing a lot more impact from methamphetamine and cocaine, substances they were unable to treat because of a specific language of the law," said Shaheen, referring to previous restrictions in the federal subsidy program targeted at opioids.
As a member of the Senate Appropriations Committee, which writes the spending, Shaheen said he worked with Republican and Democratic leaders to add "stimulants" – not just opioids – to the language of the 2020 bill.
White House anti-drug secretary James W. Carroll said the Trump administration was also hearing requests for more flexibility from state officials and supported the move.
"I know that the term 'opioid crisis' is used a lot and is not my favorite way of describing what we're up against," said Carroll. "I say that we really have a crisis of addiction."
Other senators who were pushing to expand the grant program included Republicans Rob Portman of Ohio and Shelley Moore Capito of West Virginia, also a member of the Appropriations Committee. Their states were devastated by opioids.
Federal lawmakers don't want to be caught if another drug crisis starts in an election year. The country is starting to see progress on opioids, with deaths decreasing slightly.
Last week, the Chamber's Energy and Commerce Committee sent letters to federal agencies requesting detailed information on evolving patterns of cocaine and methamphetamine use.
"We are concerned that while the country rightly dedicates so much attention and resources to the opioid epidemic, another epidemic – this involving cocaine and methamphetamine – is on the rise," wrote committee chairman Frank Pallone, DN. .J. and Republican ranking Greg Walden of Oregon.
Methamphetamine, which was once cooked in makeshift labs in the U.S., is now produced by Mexican cartels and smuggled across the border. The price of the drug fell even when its purity increased.
The increase in the prevalence of cocaine is being driven by greater supply, as cultivation of the coca plant has become more widespread in Colombia. Cocaine can also be mixed with fentanyl, contributing to overdose deaths. As with methamphetamine, government data show that the price of cocaine has fallen while its purity has increased.
Treating people addicted to meth or cocaine is different from treating opioid addiction. There are FDA-approved drugs for opioid addiction, but not for cocaine and methamphetamine.
Instead, treatment relies on counseling and support to try to help people overcome their drug habit. It is a labor-intensive effort that presents a significant risk of failure. Access to more federal dollars will help pay for treatment, especially in states that have accepted the expansion of Medicaid under the Affordable Assistance Act. Expanded Medicaid for low-income adults is one of the pillars of treatment in the states that have adopted it.
The Federal Administration for Mental Health Services and Substance Abuse is preparing to notify states of the new concession flexibility available.
Finally, state officials want Congress to consider doubling opioid money into a larger block grant program run by the same agency, creating a large stockpile of federal money to treat addiction, with fewer restrictions on its use.
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