Kelly, Tillis Introduce Bipartisan Legislation to Increase Access to Non-Opioid Treatments

Today, Senators Mark Kelly (D-AZ) and Thom Tillis (R-NC) introduced the Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act, bipartisan legislation that would provide greater access to non-opioid treatments for pain management for seniors.  

The United States is facing a public health crisis caused by prescription drug addiction, and our country’s seniors are not immune to the worsening opioid epidemic. In 2021, 1.1 million seniors were diagnosed with an opioid use disorder, and 50,000 experienced an opioid overdose-from prescription opioids, illicit opioids, or both. Tragically, the number of Americans aged 65 and older who died as the result of a natural or semisynthetic opioid overdose increased 63 percent between 2012 and 2020. 

“Arizona seniors managing pain deserve real choices—not a system that steers them toward addictive opioids just because they’re the cheaper option,” said Kelly. “By expanding affordable access to safer, non-opioid treatments, we’re helping prevent addiction and giving seniors better options for attending their health.” 

“The opioid crisis continues to wreak havoc on families and communities across the country, including in North Carolina,” said Tillis. “This bipartisan, pragmatic legislation will help prevent opioid addiction before it starts by leveling the playing field for non-opioid alternatives, ensuring seniors have uninterrupted access to non-opioid, non-addictive alternatives.”   

“One way to prevent opioid addiction is by avoiding unnecessary exposure to prescription opioids,” said Chris Fox, Executive Director, Voices for Non-Opioid Choices. “To do so, providers and patients must have easy and equal access to non-opioid pain management options. Unfortunately, non-opioid approaches are all-too-often out of reach for many Americans due institutional preferences and economic incentives that lead to our reliance on opioids to treat pain. This results in millions of Americans developing a new, long-term opioid use pattern every year. The Alternatives to Prevent Addiction in the Nation (“Alternatives to PAIN”) Act would ensure that non-opioid approaches are just as easily accessible as other medications. The legislation will go a long way towards ensuring that all Americans in all settings can access such approaches. It is a much-needed step towards preventing opioid addiction in America and Voices for Non-Opioid Choices proudly supports and urges enactment of this critical legislation.” 

The Alternatives to PAIN Act is cosponsored by Senators Shelley Moore Capito (R-WV), Tim Kaine (D-VA), Katie Britt (R-AL), Jeanne Shaheen (D-NH), Ted Budd (R-NC), Chris Coons (D-DE), John Cornyn (R-TX), Cory Booker (D-NJ), Jerry Moran (R-KS), Michael Bennet (D-CO), Jim Banks (R-IN), Alex Padilla (D-CA), Steve Daines (R-MT), and Mark Warner (D-VA).   

Background:  

The opioid epidemic is estimated to cost U.S. taxpayers $1.5 trillion every year. Too often, cost considerations incentivize Medicare Part D sponsors to employ utilization management practices intended to steer patients towards lowest cost options, which typically end up being generic opioids. This has resulted in opioid prescribing in Medicare Part D increasing over the past decade. In fact, Medicare Part D’s share of overall opioid prescriptions dispensed in the United States has increased 75 percent just since 2011.  

Non-opioid treatments and therapies can be successful in replacing, delaying, or reducing the use of opioids. With several new opioid alternatives in the pipeline and others currently on the market, Congress must advance policies that give practitioners and patients more access to these non-addictive treatments. 

This bipartisan legislation would: 

• Limit patient cost-sharing for patients receiving non-opioid based pain relief under Medicare Part D plans. 
• Prohibit the utilization of step therapy and prior authorization for these drugs. 
• Encourage the continued dialogue between patients and their healthcare professionals about preferences in pain management choices.   

This legislation builds on the Non-Opioids Prevent Addiction in the Nation (NO PAIN) Act, signed into law in December 2022. The NO PAIN Act directed the Centers for Medicare & Medicaid Services (CMS) to provide separate Medicare reimbursement for non-opioid treatments used to manage pain in both the hospital outpatient department (HOPD) and the ambulatory surgery center (ASC) settings. Prior to the NO PAIN Act being signed into law, hospitals received the same payment from Medicare regardless of whether a physician prescribed an opioid or a non-opioid. As a result, hospitals relied on opioids, which are typically dispensed by a pharmacy after discharge at little or no cost to the hospital.   

The Alternatives to PAIN Act is supported by the following organizations: Voices for Non-Opioid Choices, Ambulatory Surgery Center Association, American Addiction Recovery Coalition, American Association of Oral and Maxillofacial Surgeons, American Psychological Association Services, Asheville Equine Therapy, A Better Life-Brianna’s Hope, A Voice in the Wilderness Empowerment Center, Blue Water Recovery & Outreach Center, CA Black Health Network, Center of Addiction & Faith, Chatham Drug Free, Clean Living Exceptional Alternative Recovery Residences (CLEARR), Danny’s Ride, Dove Recovery Center for Women, Elderly Advocates, Families of Addicts, Freedom Through Recovery, Georgia for Recovery, Hawaii Health and Harm Reduction Center, Healing On The Fly Inc, Hear Alex’s Story, Hep Free Hawaii, Hernando Community Coalition, Herren Project, Holistic Homes for Us, Hope Haven, Inclusive Recovery, InStep Indy, Iron Tribe Network, Jake’s Reach, Journey House Foundation, LITE Recovery Café, Lifeboat Addiction Services, Medicare Rights Center, Mental Health America, Mental Health America of Illinois, Metro Drug Coalition, Michigan Women Veterans Empowerment, National Association of Social Workers, National Certification Commission for Acupuncture and Oriental Medicine, National Hispanic Medical Association, National Rural Health Association, National Safety Council, National Transitions of Care Coalition, Operation First Response, Inc, Operation PAR, Overdose Lifeline, Parrott Creek Child and Family Services, Partnership for A Healthy Iowa, Partnership to End Addiction, Pennsylvania Mental Health Consumers Association, Pledge for Life Partnership, Positive Action Against Chemical Addiction, Inc. (PAACA), Prevention Action Alliance, Prevention Alliance of Tennessee, Psychophysiologic Disorders Association, PTSD Awareness Summit, REAL LIFE, Recovery Café- Ft. Wayne, Recovery Café- Muncie, Recovery Mobile Clinic, RetireSafe, Safe Haven Recovery Engagement Center, Salvage USA, Shatterproof, She Recovers Foundation, Sobar, Society for Opioid-Free Anesthesia, Society of Behavioral Medicine, South End – Roxbury Community Partnership, Stayin Alive 24 Coalition, Team Sharing, Inc., The Battle Within, U.S. VETS, VetPark’s A.T.V., Veterans National Recovery Center, Voices For Awareness, Warren Coalition, Warrior Path Home, West Warwick Prevention Coalition, Will Bright Foundation, Wyoming Valley Drug & Alcohol Services, and Young People in Recovery.  

Additional statements of support are available here. Full text of the legislation is available here.