Policy News Roundup: May 6, 2021

Key reads

GAO report explores barriers to behavioral health treatment and the effects of COVID-19

The Government Accountability Office examined the need for and availability of behavioral health services and how these have changed during the pandemic, as well as issues regarding the payment of claims for behavioral health services. GAO found longstanding concerns about the availability of treatment, particularly for low-income individuals. Potential barriers to treatment include shortages of qualified professionals, particularly in rural areas, provider reimbursement rates and health system capacity. Further, behavioral health conditions have increased during COVID-19, while access to services has decreased. Provider organizations reported that denials and delays were more common for behavioral health than for medical and surgical services, but data on this is lacking because of challenges consumers and providers face in identifying and reporting parity violations. GAO previously recommended that federal agencies evaluate the effectiveness of their parity oversight, but the agencies have not done so.

Source: Behavioral Health: Patient Access, Provider Claims Payment, and the Effects of the COVID-19 Pandemic (Government Accountability Office); Mental Health Services Wane as Insurers Appear to Skirt Parity Rules During Pandemic (Kaiser Health News)

Coordinated effort like Operation Warp Speed is needed to address addiction

A coordinated effort between government, private business, and citizen mobilization, similar to Operation Warp Speed for COVID, is needed to address the overdose crisis, experts say. According to Thomas McLellan of the Treatment Research Institute and Jacob Crothers of Groups Recover Together, industry leaders and legislators should use the lessons learned from the public-private coalitions forged in Operation Warp Speed to solve the overdose crisis. Several actions that mirror steps taken during the pandemic could significantly improve the country’s overdose response, including steps that help eliminate barriers to treatment and expand insurance coverage and address social determinants.

Source: Needed: an Operation Warp Speed for the opioid epidemic (STAT)

FDA approves higher naloxone dose

The FDA approved a higher dose of naloxone nasal spray to treat opioid overdose. The newly approved product delivers eight milligrams of naloxone. The FDA had previously approved two milligrams and four milligrams. The new dose may play an important role as overdoses increasingly involve fentanyl and other potent synthetic opioids.

Source: FDA Approves Higher Dosage of Naloxone Nasal Spray to Treat Opioid Overdose (Food and Drug Administration)

Class-wide scheduling of fentanyl analogues extended

On Tuesday, President Biden signed H.R. 2630, the Extending Temporary Scheduling of Fentanyl Analogues Act, which will extend the Drug Enforcement Administration’s temporary scheduling of fentanyl analogues to Schedule I through October 22. Congress and the administration will now work to create a more permanent solution that addresses research and sentencing concerns related to scheduling.

Source: Bill Signing: H.R. 2630 (White House)

SAMHSA highlights strategies to position youth for behavioral health careers and diversify the workforce

SAMHSA published a blog on strategies for growing a more diverse and culturally competent behavioral health workforce, starting with youth. Minorities may not choose careers in behavioral health due to stigma, financial disadvantages, limited access to mentors in the field and limited opportunities to explore such careers. Strategies proposed include boosting high school graduation rates among minority populations; increasing awareness of and interest in pursuing behavioral health careers through radio, social media, PSAs and career fairs; providing access to diverse mentors in the profession; implementing behavioral health career and technical education training programs in high schools and community colleges; providing information on financial resources to apply to behavioral health programs and taking minority students to visit colleges; and working on career plans with high school students.

Source: National Minority Health Month Spotlight: Strategies to Position Youth for Potential Behavioral Health Careers (Substance Abuse and Mental Health Services Administration)

Federal government supports harm reduction to save lives

Office of National Drug Control Policy Director Regina LaBelle, Acting Assistant Secretary of Mental Health and Substance Use Tom Coderre, and Centers for Disease Control and Prevention Director Rochelle Walensky wrote an article on increasing access to fentanyl test strips to save lives, foster engagement and build trust with underserved and at-risk populations. Fentanyl test strips have the potential to reduce overdoses, and the process of obtaining them can bring individuals with addiction in contact with a community organization or other harm reduction supports and can lead to reduced risk for drug-related harms and improved health outcomes. Federal funding focused on the opioid crisis could not be used to purchase fentanyl test strips, but last month, the administration removed those restrictions. Supporters say that while fentanyl test strips alone will not bridge the treatment gap or turn the tide of overdoses, they are an important part of the all-of-the-above approach that is needed.

Source: Unlocking federal funding for fentanyl test strips will save lives (STAT)

States pushing to block Sackler immunity in Purdue settlement

A growing group of public officials and activists is mounting a last-ditch effort to derail the Purdue settlement plan, describing it as an unethical, and possibly unlawful, use of the bankruptcy court’s power. Last week, the attorneys general for 24 states and Washington, D.C., filed a brief describing the proposed settlement as “unprecedented,” “unjust” and “unconfirmable as a matter of law.” They suggest that the bankruptcy system should not be allowed to shield non-bankrupt billionaires and that allowing the Sacklers to use bankruptcy to escape consequences would be terrible precedent. In recent weeks, attorneys representing local and state governments, tribes and activists have also filed briefs raising concerns about the plan, as has a division of the Department of Justice that oversees bankruptcy cases.

Source: 24 States Mount Legal Fight To Block Sackler Bid for Opioid Immunity (NPR)

Bellwether opioid trial begins in West Virginia

The trial for the case Huntington and Cabell County, WV, have brought against AmerisourceBergen, McKesson and Cardinal Health began on Monday. The suit claims the distributors ignored red flags that opioids were being diverted to illegal channels, flooding the state with hundreds of millions of highly addictive pills. Huntington and Cabell County are expected to seek more than $1 billion. The distributors have said they cannot be held liable for filling orders for drugs prescribed by doctors and argue that the plaintiffs’ legal theory of public nuisance does not apply. A verdict could help lay the groundwork for settlements in the thousands of other cases in the national multi-district litigation.

Source: West Virginia City Takes Big Three Drug Distributors to Court Over Opioids (Reuters)

Ohio is ending eased access to opioid addiction treatment provided during the pandemic

In March 2020, federal officials relaxed methadone dosing restrictions to allow expanded take-home doses during the pandemic, and Ohio was among the first states to come up with a plan to provide this service. Last month, the Department of Health and Human Services renewed the pandemic public health emergency declaration, allowing the flexibility to continue. Despite this, Ohio is ending the expanded methadone take-home doses on May 9. Addiction specialists and treatment advocates wonder why the old rules would return, especially during an ongoing opioid crisis. Methadone regulations are archaic and create barriers to care, they argue, especially for low-income people, who may find it particularly difficult to visit a clinic every day due to employment, child care needs and transportation challenges.

Source: COVID-19 brought easier access to methadone but Ohio’s ending it. Expert is asking ‘why?’ (Cincinnati Enquirer)

People can and do recover from addiction