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What is the 21st Century Cures Act?

In our current political climate, it’s rare to see any bill pass through Congress with bipartisan support.

Enter the 21st Century Cures Act.

The 21st Century Cures Act—which passed with a vote of 94-5 in the Senate and 392-26 in the House in December—is a 996 page bill that takes steps to bring mental health and addiction treatment into the modern era.

The major provisions include: $4.8 billion to the National Institute of Health for cancer research, Alzheimer’s research, and other initiatives; $1 billion to help states fight opioid abuse; $500 million for the FDA to speed the approval of drugs and medical devices; $14 million to adjust health care coverage services by state; $12.5 million for states to maintain mental health facility databases with electronic health records; and $10 million to attract students into the mental health care field.

Let us take a moment to consider what it means to earmark $1 billion in grants over the next two years to specifically help states deal with the opioid crisis.

At the very least, it means increased funding for opioid treatment. This funding comes on top of the Comprehensive Addiction and Recovery Act from earlier in 2016. CARA established support for a variety of preventative, on-the-ground measures like expanding the availability of overdose-reversing naloxone to first responders, and expanding disposal sites for unwanted medications.

But in order to fully address addiction issues in US cities, policymakers recognize the need for policy-level preventative measures in addition to the increase in treatment funding.

There is no “typical” heroin user, which makes high-level prevention challenging. College students, in fact, are quickly becoming the new generation of heroin users. 19% of college students said that heroin use was a typical part of campus life. They start with prescription drugs like vicodin and oxycontin, then turn to heroin as a cheaper, more accessible alternative.

In order to reach people in all walks of life, the 21st Century Cures Act outlines a new entity called The National Mental Health and Substance Use Policy Laboratory. Or, for short, The Laboratory.

The Laboratory will be responsible for advocating awareness and implementation of mental health and substance abuse programs on a policy-level. They’ll be the ones charged with identifying, coordinating, and facilitating relevant policy changes, sharing accurate information about mental health and addiction, and reviewing existing programs. The hope is that by revamping the upper echelons of the health system to include mental health and substance abuse awareness, no individuals will be overlooked or denied access to preventative and rehabilitative care.

In order to treat people who are dealing with mental health and substance abuse issues, policy is only one piece of the puzzle. The work set-up by CARA must be continued; there must be a strong workforce to help patients on a day-to-day basis.

In order to achieve this, the 21st Century bill also sets out provisions to attract the next generation of students to pursue careers in mental health related fields. Even at the initial levels of coursework, a student in this field can help their peers see the dangers of substance abuse and start them on the path to making more informed decisions. They can help their friends recognize that being dependent on prescription medications is an addiction to be taken seriously, and that it’s important to get help.

The more trained counselors there are in the workforce, the better their ability to specialize and address a wide variety of mental health and addiction concerns. A well-trained counselor can support anyone from a veteran dealing with PTSD, to a mother battling cancer, to a family affected by addiction-related suicide. Agencies that serve those communities make up some of the top nonprofits presently influencing the mental health sphere. Not only the job prospects of a counselor far-reaching, but the work of helping people regain control of their lives is some of the most rewarding and beneficial work around. It’s about time the Federal Government draw some attention to it.

That’s only the beginning of the 21st Century Cures Act. No bill is perfect, and this one has its detractors, just as any fully-deliberated bill should. Those who did not vote for the bill—notably Elizabeth Warren and Bernie Sanders—did not seem to take issue with the mental health and substance abuse funding aspects, but with other provisions outlined in the bill.

It’s said that the bill forges an unhealthy relationship with big pharma, giving the drug companies the ability to market drugs for unapproved uses and exempting companies from disclosing fees given to doctors.

That’s the problem with behemoth bills. Even the worthiest of provisions come accompanied by potentially dangerous counterparts.

One can only hope that the rise in mental health education and trained mental health professionals will help maintain a balance against the big pharmaceutical companies. Perhaps it’s optimistic, but it’s better than taking the funding away from those in need.

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