By Lyle Dennis, Cavarocchi-Ruscio-Dennis Associates, Consultants to AASLD
The opioid crisis in the United States has reached critical levels, with deaths and hospitalizations skyrocketing. For hepatologists, one of the most concerning aspects of this situation is the increase in hepatitis C virus (HCV) infections. After a lot of talk – but not a lot of action – steps are beginning to be taken in the United States Congress to address this problem.
During the week of March 19, the House Energy and Commerce Committee’s Health Subcommittee is expected to hold two days of hearings addressing many aspects of the opioid crisis. It is expected that the issue of opioid-related infectious diseases will be addressed at this time.
Congressman Leonard Lance (R-NJ), who is a member of the subcommittee, has prepared a bill known as the “Eliminating Opioid Related Infectious Diseases Act of 2018.” The bill is expected to be introduced at the time of the hearing and will be assigned a bill number at that time.
The bill reauthorizes and expands Section 317N of the Public Health Service Act, which deals with “Surveillance and Education Regarding Infections Associated with Injection Drug Use.” The bill includes several major improvements to existing law.
It directs the Centers for Disease Control and Prevention (CDC), directly and through grants to public and nonprofit private entities, to provide the following:
- Cooperate with the states to implement a surveillance system to determine the incidence of infections associated with injection drug use and assist in determining the prevalence of chronic HCV and HIV cases.
- Identify, counsel and offer testing to at risk individuals as a result of injection drug use, receiving blood transfusions prior to July 1992, or other risk factors as determined.
- Provide appropriate referrals for counseling, testing and medical treatment for identified individuals and ensure, to the extent possible, appropriate follow up care is provided.
- Develop and disseminate public information and education programs and materials for the detection and control of such infections, with priority given to high risk individuals.
- Improve the education, training and skills of health professionals related to the detection and control of infections associated with injection drug use, with priority given to substance use disorder treatment providers, pediatricians, other primary care providers and obstetrician-gynecologists.
In addition, CDC may carry out programs to provide for the improvement of the quality of clinical laboratory procedures with regard to such infections.
To implement the legislation, the bill authorizes $40,000,000 for each of the fiscal years 2019 through 2023. It is important to note that this is an authorization bill and the actual funding would have to be appropriated through the regular appropriations process in order to become available to implement this program. Nevertheless, the legislation could be an important and welcome step forward in addressing the spike in HCV cases that has occurred as a result of the opioid epidemic.