New VA Bill Mandates Non-Opioid Pain Treatments in Formulary: 18-Month Deadline for New Drugs

The new Non-Opioids Prevent Addiction in the Nation for Veterans Act, or the NOPAIN for Veterans Act, is a straightforward piece of legislation aimed squarely at changing how the VA tackles pain management. Essentially, it forces the Department of Veterans Affairs (VA) to make sure specific non-opioid pain treatments are readily available to veterans.

The Mandate: Non-Opioids Get Priority

This bill requires the VA Secretary to include a defined “non-opioid pain management drug or biological product” in the VA’s national formulary. The formulary is basically the list of medications the VA covers, so getting on it is the key to access. What qualifies? Any drug or biological product that the FDA has approved to reduce acute or postoperative pain—the catch is that it cannot act on the body’s opioid receptors. This is a direct effort to increase the tools available for managing pain without relying on highly addictive opioids.

The bill sets strict deadlines for the VA to act. Once a qualifying non-opioid product gets FDA approval, the VA has a maximum of 18 months to add it to the formulary. If the product becomes eligible for certain temporary Medicare payment rules first, the deadline shortens to one year from that eligibility date. This speed limit is important because it means veterans won't have to wait years for new, potentially safer pain treatments to become routine. The VA must implement these changes within 90 days of the bill becoming law.

What This Means for Veterans

For a veteran facing surgery or dealing with acute pain, this bill is about choice and safety. It means that when a doctor is planning a procedure, they will have a guaranteed, covered option for pain control that doesn't involve starting down the path of opioid dependence. For instance, if a new injectable medication comes out that blocks pain signals for days without touching opioid receptors, the VA is required to make sure that drug is on the shelf and covered quickly. This is a big win for access, especially for those veterans who are already at risk or recovering from substance use disorders.

The Funding Catch

While the goal is fantastic, there is one key detail in the funding section that’s worth noting. The bill explicitly prohibits the use of any funds from the Cost of War Toxic Exposures Fund (established under the PACT Act) to pay for these new requirements. The Toxic Exposures Fund is intended to cover care for veterans exposed to burn pits and other toxins. By walling off that money, the bill ensures that the mandate for new pain drugs doesn’t siphon resources away from toxic exposure care. However, this means the VA must find the budget for these new drugs elsewhere, likely from its general medical services budget. While this doesn't stop the bill from working, it simply shifts the financial burden, requiring the VA to prioritize and allocate existing or new funds to meet the 18-month deadline.