Lawmakers hear testimony urging state action to expand access to medications for opioid use disorder

The Joint Committee on Addiction and Community Safety Response heard extensive testimony March 19 in favor of House Bill 2506, a committee bill directing the Alcohol and Drug Policy Commission and Oregon Health Authority to develop policies and supports to increase access to medications for opioid use disorder (MOUD) in hospitals, emergency departments and other physical health-care settings, and to improve transitions to community-based treatment.

Annalise Stolf, ADPC director, told the committee the commission studied barriers after language in House Bill 4002 directed such work and that the ADPC prioritized emergency-department initiation of MOUD and warm handoffs to community care. Mitch Doig, senior policy analyst for ADPC, summarized the work group's findings: MOUD reduces cravings and withdrawal, increases treatment engagement and retention, and is associated with lower overdose and mortality — but access is inconsistent. The work group is preparing claims-analysis baseline data and has identified key elements for success: care coordination programs, payment models to support prescribers in community settings, training and technical assistance, and monitoring of incentive programs.

John McElveen, State Opioid Treatment Authority, emphasized evidence showing higher retention and better long-term outcomes when MOUD is initiated and bridged from acute-care settings. Anora Englander of OHSU described a hospital-based consult and linkage program (Impact) that her team developed after seeing patients repeatedly hospitalized for complications of injection drug use; she testified such services reduce mortality, improve patient and staff experience and lower costs.

Emergency and EMS physicians, hospital clinicians and providers from rural and community organizations described barriers to access in their regions. John Treanor, an emergency physician and EMS medical director, asked for care in how the bill uses the phrase “standards of care,” suggesting the committee consider alternatives such as guidelines or best practices to avoid regulatory or liability conflicts with clinicians’ professional obligations. Rural witnesses including Katie Joaquin (EOCCO region) and Allison Noyce (CODA) described long travel distances to opioid treatment programs and the need to expand MOUD availability in local physical-health settings.

Provider organizations and advocates including 4D Recovery, Oregon Recovers, CODA and others urged passage, and multiple witnesses recommended that the legislation include technical assistance, payment and workforce supports so hospitals and community providers can reliably initiate MOUD and connect patients to ongoing care.

No formal vote occurred during the hearing; committee members asked witnesses to provide additional written material and indicated a window for submitting supplemental testimony.