The commission formed to combat the opioid epidemic will be announcing a number ofinitatives designed to push government action. StatNews claims to have obtained a copy of the draft report,expected to be released Wednesday, which includes 53recommendations.

Among the actions to be recommended by the commission is theformation of drug courts in every federal judicial district, notingthat as of 2015, fewer than a third of federal judicial districtsand only 44 percent of U.S. counties operated drug courts.

But drug courts, the unofficial report points out, “have beenshown to increase engagement in addiction treatment and reducerecidivism rates,” rather than the results produced by standardcourts, since they combine both criminal justice and addiction treatment sothat those with substance use disorder can avoid criminalsentencing—as long as they comply with a treatment course that caninclude counseling and medication-assisted treatment.

The commission also intends to recommend streamlining the systemfor distributing federal funding that expands and mirrors theprocess for obtaining block grants offered by the Substance Abuseand Mental Health Services Administration. It should require onlyone application and result in states receiving at least equivalentfunding while allowing them to redirect resources currently usedfor paperwork toward program implementation. Currently the systemis “fragmented.”

Federal addiction treatment providers also could come in for anincrease in reimbursement rates, as the commission wants theDepartment of Health and Human Services to more adequately measureand cover the “true costs” of treating substance use disorder,including use of inpatient psychiatric facilities.

In addition, the commission wants the Centers for Medicare andMedicaid Services to review policies that incentivize theprescription of opioids over more expensive non-opioid treatments;it also recommends lowering barriers to treatment, including thosethat impose limits on access to any of the three forms ofmedication-assisted treatment approved by the Food and DrugAdministration. It also wants access to recovery coachesimproved.

Some states restrict who among emergency responders canadminister naloxone, and the guidelines of the National HighwayTraffic Safety Administration (which oversees the federal Office ofEmergency Medical Services) guidelines currently recommend thatparamedics and advanced medical technicians be allowed by localcommunities to administer naloxone. The report also says theyshould be reviewed to allow emergency medical technicians to alsoadminister the medication, and in higher doses.

It will ask that the Drug Enforcement Administration requireprescribers renewing licenses to prescribe opioids prove thatthey’ve participated in an opioid prescription education program,as well as recommending that HHS develop a “national curriculum andstandard of care for opioid prescribers,” and that pharmacistsreceive training “on best practices to evaluate the legitimacy ofopioid prescriptions.”

The report also recommends that CMS remove questions about painlevels from patient satisfaction surveys to be sure that providersaren’t looking to boost patient approval by prescribingopioids.