January 30, 2024

Cárdenas, Miller-Meeks Introduce Alternatives to PAIN Act

WASHINGTON, D.C.U.S. Representatives Tony Cárdenas (CA-29) and Mariannette Miller-Meeks (IA-01) introduced the “Alternatives to Prevent Addiction in the Nation (Alternatives to PAIN) Act,” legislation that would provide greater access to non-opioid treatments for pain management for seniors.

“It’s time we put our words into action and address the fatal opioid crisis head on,” said Congressman Cárdenas. “The Alternatives to PAIN Act is a bipartisan and common-sense solution, that will allow our seniors to have greater access to non-addictive, affordable alternatives to opioids when it is medically appropriate. I firmly believe this bill will ultimately help to prevent addiction and save more lives.”

“It is critical that we turn the tide on the opioid addiction and opioid overdose crisis in this country,” said Congresswoman Miller-Meeks. “I am proud to introduce the ‘Alternatives to PAIN Act’ to ensure that new opioid alternatives and others currently on the market, are made available for Medicare Part D beneficiaries. We encourage all prescribers to seek non-opioid medication or non-medication treatments or alternatives (if medically warranted) to reduce pain, including before and after surgery.”

“220. That’s how many Americans we lost every day last year to an opioid-related drug overdose,” said Chris Fox, Executive Director of Voices for Non-Opioid Choices. “Despite well-intentioned federal efforts to combat the opioid addiction crisis, the crisis persists. The Alternatives to PAIN Act is a critical piece of federal legislation that will prevent opioid addiction by ensuring that Americans can access the full suite of non-opioid pain management approaches, including at the pharmacy counter.


As too many of our constituents are painfully aware, the United States is facing a public health crisis caused by prescription drug addiction. Unfortunately, our country’s seniors are not immune to the worsening opioid epidemic. In 2021, 1.1 million seniors were diagnosed with an opioid use disorder, and 50,400 seniors experienced an opioid overdose-from prescription opioids, illicit opioids, or both. Tragically, the number of Americans aged 65 and older who died as the result of a natural or semisynthetic opioid overdose increased 63 percent between 2012 and 2020.

Now, more than ever, we must prevent unnecessary opioids from becoming prevalent in medicine cabinets, homes, and communities. We can do this by increasing the use of non-opioids for pain management. Non-opioid treatments and therapies can be successful in replacing, delaying, or reducing the use of opioids which is why we believe it is necessary for Congress to advance policies that give practitioners and patients more access to these non-addictive treatments.

The opioid epidemic is estimated to cost U.S. taxpayers $1.5 trillion every year. Unfortunately, all-too-often cost considerations incentivize health insurers – including Medicare Part D sponsors – to employ utilization management practices intended to steer patients towards lowest cost options, which typically end up being generic opioids. We must change this practice to ensure that these plans make non-opioid therapies just as accessible to patients as opioid-based pain approaches.

Unfortunately, this has resulted in opioid prescribing in Medicare Part D increasing over the past decade. In fact, Medicare Part D’s share of overall opioid prescriptions dispensed in the United States has increased 75 percent just since 2011.

With several new opioid alternatives in the pipeline and others currently on the market, it is essential we encourage robust access to these therapies for Medicare Part D beneficiaries. That is why we’ve introduced the Alternatives to PAIN Act. This bipartisan piece of legislation would:

  • Limit patient cost-sharing for patients receiving non-opioid based pain relief under Medicare Part D plans;
  • Prohibit the utilization of step therapy and prior authorization for these drugs; and
  • Encourage the continued dialogue between patients and their healthcare professionals about preferences in pain management choices.

Read the text of the bill here.