December 7, 2017

VIDEO: Cassidy Urges NIH Director to Make Fighting the Opioid Epidemic a Priority

During today’s Senate Health, Education, Labor and Pensions (HELP) Committee hearing on the implementation of the 21st Century Cures Act, U.S. Senator Bill Cassidy, M.D. (R-LA) urged National Institutes of Health (NIH) Director Francis Collins, M.D., Ph.D. to make combating the opioid epidemic a priority by providing sufficient funding to the National Institute of Drug Abuse (NIDA).

Key excerpts of Cassidy’s comments are transcribed below.

During a HELP committee hearing on the opioid crisis last week, Cassidy questioned state officials on best practices for addressing addiction and identifying “pill-mill” doctors.

CASSIDY: Dr. Collins, again, great respect for you and for your institute. But as I have pointed out in the past, we don’t seem to have an NIH which targets funding relative to disease burden. So when I look at NIDA, their budget only went up 2 percent last year, and it still remains far smaller than other institutes in which there is far less morbidity and mortality flowing from those disease conditions.

So if we are going to address the issues of opioids or mental health, both of which are playing into this, it seems like there has to be a greater shift in where our funding is going at NIH towards these disease conditions.

Now in the past you’ve suggested that, ‘Well we’ll kind of organically grow, oh, this one’s stable, and allow this one to grow.’ But when I look at it, all the institutes seem to be growing at about the same pace.

So I guess my question for you is, it doesn’t seem as if NIH is making these a priority if you look over other conditions, if you look at the relative funding increase of those institutes. You’re a very thoughtful person, so please give me your thoughts on that.

COLLINS: Senator, you point to a very important issue about how do we make decisions. I have to point out however that it’s the Congress that assigns a budget, it’s a line item every year in the appropriations process, to each of those institutes. As the NIH director, I don’t get to set those numbers. And so we follow what the Congress tells us ought to be the appropriation for a given year. And then, we work with great flexibility to try to be sure that when there is a public health need, as there is now, for instance, with opioids, which I think you are referring to. Because of course we have a big opportunity there in terms of our understanding of how the brain works. The brain initiative is directly relevant here. The neurology institute has an enormous investment in understanding pain, as does the National Center for Complementary and Integrative Health. So one shouldn’t look at our organizational structure and say that the money actually fits precisely into those buckets. We have lots of ways that we can mix—

CASSIDY: I accept that, if I may, just because I have limited time. So you’re saying that if we want more money to go to the National Institute of Drug Addiction [sic], we need to line item it in our budget.

COLLINS: That’s the only way it happens.

CASSIDY: So that said, the flexibility does seem as if it should be flexing toward things like NIDA. Pain is important, but ultimately pain translates into addiction. That’s a final common pathway, and so it does seem as if we should be flexing towards them. Is that where the flexing is taking place?

COLLINS: I think that’s what we’re trying to do, is to shift the priority opportunities we have, more funds into that space, because we recognize this is a terrible public health emergency.