Positioning and Advancing Clinical Pharmacists Practicing in Substance Use Disorder Treatment

One of ACCP’s top legislative priorities – as approved by the ACCP Board of Regents in the College’s Advocacy Platform – involves increasing patient access to comprehensive clinical pharmacy services for managing mental health and addiction. ACCP is currently exploring opportunities on Capitol Hill and across different regulatory agencies to increase access to team-based clinical pharmacy services for patients receiving substance use disorder (SUD) treatment.

SUPPORT Act on Capitol Hill

Working with its partners at the American Society of Addiction Medicine (ASAM), ACCP recently participated in a stakeholder initiative to advance H.R.4531, the Support for Patients and Communities Reauthorization (SUPPORT) Act of 2023.

The SUPPORT Act builds on landmark 2018 legislation that contained important funding for community-based treatment and recovery programs, including a requirement that state Medicaid programs cover all three FDA-approved medications for opioid use disorder (MOUD) – buprenorphine, methadone, and naltrexone.

A Senate companion bill to the SUPPORT Act is currently under consideration by the Senate Committee on Health, Education, Labor and Pensions (HELP). ACCP will continue to work with its stakeholder partners throughout the remainder of the 118th Congress to ensure the bill’s passage into law.

Reauthorization of the SUPPORT Act includes important new provisions aimed at addressing challenges that have emerged since passage of the original legislation. The new provisions would:

• Permanently place xylazine in Schedule III of the Controlled Substances Act while maintaining access for veterinarians and ranchers to use in animals
• Provide resources for training and education related to fentanyl and other illicit substances for first responders, particularly in rural areas
• Renew support for individuals in SUD treatment and recovery to live independently and participate in the workforce
• Protect mothers and infants by reauthorizing resources for residential SUD treatment for pregnant and postpartum women
• Ensure Medicaid beneficiaries have access to MOUD

Click here to review a section-by-section summary of H.R.4531 from the House Committee on Energy and Commerce.

Click here to read the text of the bill.

Click here for a summary of the Energy and Commerce Health Subcommittee field hearing on the SUPPORT Act in Gettysburg, Pennsylvania.

Addiction Recovery Medical Home Alternative Payment Model (ARMH-APM)

ACCP is also working closely with its partners at the Alliance for Addiction Payment Reform. The Alliance is a national multisector alliance of health care industry leaders – including payers, health systems, and subject matter experts – dedicated to aligning incentives and establishing a structure that promotes the type of integration and patient care capable of producing improved outcomes for patients, payers, and health systems.

The Alliance has developed the Addiction Recovery Medical Home (ARMH) model, an alternative payment model (APM) engineered to provide patients with a long-term, comprehensive, and integrated pathway to treatment and recovery. Of importance, the APM specifically includes clinical pharmacists in its model care recovery team.

Thanks to this ongoing partnership, the Alliance has also published an Issue Brief: Coordinated and Comprehensive Medication Management in Substance Use Disorder Treatment and Recovery. The publication states that clinical pharmacists are responsible for comprehensive medication management (CMM) in team-based patient care environments and that medication plans for CMM that are led by a clinical pharmacist as part of an interdisciplinary team must include clear and measurable goals of therapy with specific follow-up time intervals to ensure optimal medication use and outcomes.

ACCP Task Force on Opioid Use Disorder

Within ACCP, the Task Force on Opioid Use Disorder – led by Paul Stranges, Pharm.D., FCCP, BCACP (chair), and Kathleen Adams, Pharm.D., BCPS (vice chair) – is currently developing an important new ACCP commentary that examines clinical pharmacists’ contributions to the management of OUD. This highly anticipated paper will be an important advocacy tool in ACCP’s communications on Capitol Hill and with other key stakeholders.