March 5, 2024
The Honorable Chuck Schumer
Majority Leader
U.S. Senate
U.S. Capitol Building
Washington, DC 20515

The Honorable Mitch McConnell
Minority Leader
U.S. Senate
U.S. Capitol Building
Washington, DC 20515

The Honorable Mike Johnson
Speaker
U.S. House of Representatives
U.S. Capitol Building
Washington, DC 20515

The Honorable Hakeem Jeffries
Minority Leader
U.S. House of Representatives
U.S. Capitol Building
Washington, DC 20515

Dear Majority Leader Schumer, Minority Leader McConnell, Speaker Johnson and Minority
Leader Jeffries:
On behalf of the patients, providers, families, and health professionals our 51 organizations
represent, we urge you to pass the Alternatives to Prevent Addiction in the Nation (Alternativesto PAIN) Act (H.R. 7142/S. 3832) to prevent unnecessary exposure to opioids and ensure accessto the wide array of FDA-approved, safe, and effective non-opioid pain management approaches
for America’s seniors.
The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, passed by Congress andsigned into law by President Biden in 2022, will ensure that many surgery patients have access tonon-opioid treatments beginning in 2025. The legislation covers outpatient surgical procedures
covered by Medicare Part B and, as a result, would do little to prevent health insurance plansfrom steering seniors with a Medicare Part D plan towards lowest cost care options, which areoften generic prescription opioids.
Our country’s seniors are not immune to the worsening opioid epidemic, with overdose deaths
among seniors soaring by more than 60 percent in the last decade. i In 2021, more than 1 million

seniors were diagnosed with an opioid use disorder, ii and more than 50,000 seniors suffered anopioid overdose from prescription opioids, illicit opioids, or both. iii
We urge Congress to ensure that non-opioid therapies are just as accessible to seniors as opioidbased medications. The Alternatives to PAIN Act would do this by establishing patient costsharing no greater than generic tier for Medicare Part D beneficiaries receiving non-opioid pain
relief. The legislation would also prohibit utilizing step therapy and prior authorization for nonopioid pain management drugs for Medicare Part D beneficiaries.
Further, the opioid epidemic is estimated to cost U.S. taxpayers $1.5 trillion annually. iv Congresscan cut that cost and save lives by updating Medicare Part D and passing the Alternatives toPAIN Act, which will prevent addiction by increasing access to non-addictive pain management
approaches.
With opioid overdose death rates continuing to climb, Congress must remain vigilant in fighting
this crisis. Seniors deserve choices when managing their pain or recovering from surgery. Inorder to prevent addiction and save lives, we urge Congress to pass the Alternatives to PAINAct.
Together, we can prevent opioid addiction before it starts and, in the process, save lives. We lookforward to working with you to enact this important legislation.
Sincerely,
Voices for Non-Opioid Choices
Ambulatory Surgery Center Association
American Association of Oral and Maxillofacial Surgeons
American Psychological Association Services
Asheville Equine Therapy
A Voice in the Wilderness Empowerment Center
CA Black Health Network
Center of Addiction & Faith
Chatham Drug Free
Clean Living Exceptional Alternative Recovery Residences (CLEARR)
Hawaii Health and Harm Reduction Center
Healing On The Fly Inc
Hep Free Hawaii
Herren Project
Journey House FoundationMedicare Rights CenterMental Health America of Illinois
Michigan Women Veterans Empowerment
National Association of Social Workers
National Certification Commission for Acupuncture and Oriental Medicine
National Hispanic Medical Association
National Rural Health Association
National Safety Council
National Transitions of Care Coalition
Partnership for A Healthy Iowa
Partnership to End Addiction
Pledge for Life Partnership
Prevention Action Alliance
PTSD Awareness Summit
Operation First Response, Inc
Overdose Lifeline
Real Life Program
RetireSafe
Salvage USA
Shatterproof
She Recovers Foundation
Society for Opioid-Free Anesthesia
Society of Behavioral Medicine
South End - Roxbury Community Partnership
Team Sharing, Inc.
The Battle Within
The Zellner Foundation for Military Vets
U.S.VETS
VetPark’s A.T.V.
Veterans National Recovery Center
Voices For AwarenessWarren Coalition
Warrior Path HomeWest Warwick Prevention Coalition
Will Bright Foundation
Young People in Recovery
Humphreys, Keith; Shover, Chelsea. “Twenty-Year Trends in Drug Overdose Fatalities Among Older Adults in theUS.” JAMA Psychiatry. March 29, 2023. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2802945
ii
Kwong, Jason; Himmelright, Margaret. “Opioid Overdoses and the Limited Treatment of Opioid Use Disorder
Continue To Be Concerns for Medicare Beneficiaries.” U.S. Department of Health and Human Services Office ofInspector General. September 2022. https://oig.hhs.gov/oei/reports/OEI-02-22-00390.pdf
iKwong, Jason; Himmelright, Margaret. “Opioid Overdoses and the Limited Treatment of Opioid Use Disorder
Continue To Be Concerns for Medicare Beneficiaries.” U.S. Department of Health and Human Services Office ofInspector General. September 2022. https://oig.hhs.gov/oei/reports/OEI-02-22-00390.pdf
iv“The Economic Toll of the Opioid Crisis Reached Nearly $1.5 Trillion in 2020.” The Joint Economic Committee.
Sep 28, 2022. https://www.jec.senate.gov/public/_cache/files/67bced7f-4232-40ea-9263-f033d280c567/jec-cost-ofopioids-issue-brief.pdf
iii