WASHINGTON — Responding to a drug crisis that has contributed to more American deaths than car crashes, the Senate on Thursday overwhelmingly passed a broad drug treatment and prevention bill, the largest of its kind since a law in 2008 that mandated insurance coverage for addiction treatment.
"This is big and significant," said Marvin Ventrell, the executive director of the National Association of Addiction Treatment Providers. "It had legs and interest because of the opioid crisis that has hit Middle America."
The bill, which passed 94-1, is a boon for Republican senators in swing states, which have been hit particularly hard by the drug crisis. Republican Sens. Rob Portman of Ohio and Kelly Ayotte of New Hampshire spent weeks promoting the measure on the floor after seeing opioid-related crime and addiction soar in their states.
The measure authorizes money for various treatment and prevention programs for a broad spectrum of addicts, including those in jail. It strengthens prescription drug monitoring programs to help states and expands the availability of the drug naloxone, which helps reverse overdoses, to law enforcement agencies. It also increases disposal sites for prescription medications that are often abused by teenagers and others.
"This is a strong signal that the United States Congress now gets this issue," Portman said in a news conference after the vote.
The bill was threatened by Democrats who were angered that Republicans turned away an accompanying measure to provide $600 million in extra funding to pay for some of the programs that the bill authorizes.
"What good are additional programs if they aren't adequately funded?" asked Sen. Bob Casey, D-Pa. "We can't ask medical professionals to do more to treat addiction if they don't have the resources." (Portman and Ayotte were among five Republicans to vote for the extra funding measure.)
But in the end, the bill was considered too urgent to dismiss over a funding fight.
While meaningful bipartisan legislation in the Senate is rare these days, Republicans and Democrats have found common ground over the last year on criminal justice and mental health issues.
The epidemic "is probably one of the most pressing public health issues facing American families across the country," said Sen. Lisa Murkowski, R-Alaska, one of dozens of senators who came to the Senate floor to praise the bill, which was sponsored by Portman and Sen. Sheldon Whitehouse, D-R.I.
In contrast, Murkowski's bipartisan energy bill has been held up for weeks by Democrats over a similar funding fight — in that case for money to help the city of Flint, Michigan, recover from its tainted water crisis.
The drug emergency has become increasingly pervasive, and in places rarely associated with issues like opioid addiction. An epidemic of abuse of prescription painkillers and heroin — often abused when the prescription drugs run out — has swept the United States, with overdose deaths quadrupling since the late 1990s.
The fate of the legislation in the House is uncertain. A companion bill there does not have strong Republican support but several committees have been working on the issue.
Portman said Thursday he had left voice mail messages and texted a House colleague "with the initials Paul Ryan."
While Senate Republicans have come around to accept state and local drug treatment programs as acceptable terrain for federal support, far more conservative House factions may be harder to sway.
Many of their views may well have been captured by Sen. Ben Sasse, R-Neb., the only no vote on the Senate bill.
"I'm distressed by opioid abuse as a dad and citizen," he said. "Families, nonprofits and government at the state and local level can help. I'm not convinced fighting addiction, as opposed to stopping drug traffickers, is best addressed at the federal level."
The House is in recess this week.
"Speaker Ryan is encouraged by the Senate's effort to attack the alarming opioid epidemic sweeping the country," said AshLee Strong, a spokeswoman for Ryan. "Several House members have been working hard on their own efforts."
According to the Centers for Disease Control and Prevention, drug overdose was the leading cause of injury death in 2013 — the most recent data available — among Americans 25 to 64, surpassing deaths caused by motor vehicle crashes; 71 percent of the overdoses involved opioid painkillers.
Some public health experts have bemoaned the lack of federal response and have argued that the Food and Drug Administration has exacerbated the problem by continuing to approve new opioids in a market flooded with them.
The treatment and prevention action has largely been at the state level. Some states, like Florida, that have passed such laws have seen a decline in opiate-related deaths.
"We really haven't seen major legislation in this space for well over a decade," said Daniel Raymond, policy director of the Harm Reduction Coalition. "It's a big deal because it's bipartisan and because it symbolizes this broader shift we are seeing at community level in addressing addiction more as a health problem rather than just criminal justice problem."
The fragile bipartisan coalition was preserved by keeping the bill focused on programs that both sides could support, but the funding fight made for a few awkward moments at a bipartisan news conference following passage of the bill.
"I hope that the Republican leadership will honor their statements and commitments" toward fighting the epidemic, Whitehouse said.
Democrats vowed to keep fighting for more money, with encouragement from the White House.
The bill is "an important first step," said Sen. Chuck Schumer, D-N.Y. "But it's only the first step in a long race against this epidemic — by itself it won't get us over the finish line."