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Attorney General Josh Stein Leads 39 State Coalition in Urging Congress to Remove Federal Barriers to Treat Opioid Use Disorder

Release date: 8/5/2019

(RALEIGH) Attorney General Josh Stein, along with Oklahoma Attorney General Mike Hunter, has sent a letter urging leaders in the United States House and Senate to remove federal barriers that are currently preventing health care providers from offering treatment for opioid use disorder. 
“The opioid epidemic is tearing families apart all over our state and nation,” said Attorney General Josh Stein. “Opioid addiction, like all chronic illnesses, requires treatment for people to get healthy. We must remove all unnecessary barriers between people with opioid use disorder and the treatment they need. I urge Congress to take these needed steps.”
“States are on the front lines and are combining all of the resources at our disposal to stop the current crisis,” Attorney General Mike Hunter said. “Although we have been successful in many ways, there is more that can be done by the federal government. By eliminating the barriers outlined in our letter, Congress can take meaningful, productive steps that will benefit those currently struggling with addiction before it’s too late. I appreciate my attorneys general colleagues, including North Carolina Attorney General Josh Stein, who acknowledge that addiction is a brain disease, not a moral failing, and the more help we can provide for those struggling the better.”
Opioid use disorder is the physical and psychological reliance on opioids. Symptoms of opioid addiction include uncontrollable cravings for the drugs and the inability to control opioid use despite its negative impacts. It’s estimated that 2 million Americans struggle with opioid use disorder.
The letter outlines three areas that need to be addressed:

  • Replace the cumbersome, out-of-date, privacy rules contained in 42 CFR Part 2 with the effective and more familiar privacy rules contained in the Health Insurance Portability and Accountability Act (HIPAA);


  • Pass HR 2482, the Mainstreaming Addiction Treatment Act, which would eliminate unnecessary burdens on buprenorphine prescribing imposed by the Drug Addiction Treatment Act of 2000. Buprenorphine is one of three drugs used as part of Medication Assisted Treatment, the most effective treatment for opioid use disorder. Outdated and unnecessary federal requirements are discouraging doctors from prescribing this lifesaving drug to patients who need it; and 


  • Fully repeal the Medicaid Institutions for Mental Diseases (IMD) exclusion. The IMD exclusion generally prohibits state Medicaid programs from receiving federal reimbursement for adults aged between 21 and 65 receiving mental health or substance use disorder treatment in a residential treatment facility with more than 16 beds.

Oklahoma and North Carolina are joined on the letter by attorneys general from Alaska, Arkansas, California, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Hawaii, Idaho, Illinois, Iowa, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakoda, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin.
For more information about Attorney General Josh Stein’s work to confront the opioid epidemic, visit

A copy of the letter is available here.

Laura Brewer (919) 716-6484

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