Policy News Roundup: July 29, 2021

Key reads

WHO warns about youth e-cigarette use

The head of the World Health Organization (WHO) noted that while many countries have made progress in the fight against the tobacco epidemic, the marketing of e-cigarettes to youth could have harmful health outcomes going forward. The warning came with the release of the WHO report on the global tobacco epidemic in 2021, the eighth study from the WHO measuring progress on efforts to curb the sale of tobacco and nicotine products worldwide. More than four times as many people are covered under WHO-recommended tobacco control measures as in 2007, but children who use e-cigarettes are up to three times more likely to use tobacco products in the future. The WHO urged governments to adopt policies to protect their populations from the harms of e-cigarettes and to prevent youth uptake. Eighty-four countries currently lack safeguards to protect unregulated proliferation of ENDS, but 32 nations have completely banned the sale of e-cigarettes, and an additional 79 have implemented measures to limit sale in public places, prohibit advertising, or require that they display health warnings.

Source: WHO leader issues warning on ‘harmful’ e-cigarettes (The Hill)

Coalition releases recommendations for mental health and substance use infrastructure investments

The Coalition for Whole Health released “Building for Health,” a set of recommendations for investing in infrastructure to deliver mental health and substance use disorder care. It provides recommendations for Congress and the Administration to strengthen and expand the mental health and substance use treatment workforce, invest in its digital infrastructure, build capacity to expand access to comprehensive care and expand affordable stable housing opportunities.

Source: Coalition of 150+ Organizations Releases Recommendations for Infrastructure Investments in Mental Health and Substance Use Disorder Care in the Wake of COVID-19 (Legal Action Center); Congress must invest in mental health and substance use care infrastructure (The Hill)

SAMHSA investing $100 million for COVID-19 mitigation for people with mental health and substance use disorder

The United States Department of Health and Human Services (HHS) will invest more than $1.6 billion from the American Rescue Plan to support COVID-19 testing and mitigation measures in high-risk congregate settings. This includes $100 million through SAMHSA to expand testing and mitigation resources for people with mental health and substance use disorder, thus providing supplemental funding to the Substance Abuse Prevention and Treatment and the Community Mental Health Services block grant grantees for rapid onsite testing and for facilitating access to testing. Funds are available to provide behavioral health services to staff working as contact tracers and other members of the COVID-19 workforce, training and technical assistance on implementing rapid onsite testing, and facilitating access to behavioral health services, including the development of onsite testing confidentiality policies, PPE, supporting mobile health units in underserved areas, and expanding local and tribal programs to implement COVID-19 response services for those connected to the behavioral health system. It also includes funding for shelters for people experiencing homelessness, group homes, and other congregate settings; federal, state, and local prison populations; and local domestic violence shelters and tribal shelters supportive services for survivors of domestic and dating violence.

Source: Biden Administration to Invest More Than $1.6 Billion to Support COVID-19 Testing and Mitigation in Vulnerable Communities (Department of Health and Human Services)

Bill introduced to hold e-cigarette companies accountable and increase enforcement and prevention

Senators Durbin, Shaheen, Murkowski, Collins, Baldwin and Romney and Represetatives Bustos and Fitzpatrick introduced the Resources to Prevent Youth Vaping Act to protect children from the dangers of e-cigarettes. It would require e-cigarette manufacturers to pay user fees to the FDA to provide the agency with additional resources to conduct stronger oversight of the e-cigarette industry and increase awareness of the danger of e-cigarettes. It would increase the total amount that would be collected in tobacco user fees by $100 million in fiscal year 2022 and index that amount to inflation for future years. It would authorize the FDA to collect user fees from all manufacturers of tobacco products, including e-cigarettes. Currently, manufacturers of traditional combustible tobacco products pay user fees, but e-cigarette companies are exempt. FDA could use the revenue to conduct safety reviews of vaping products, prevent sales to minors, support efforts to educate youth on the dangers of e-cigarettes, and increase oversight and enforcement.

Source: Durbin, Colleagues Introduce Bipartisan, Bicameral Legislation to Hold E-Cigarette Companies Accountable For The Youth Vaping Crisis (United States Senator Dick Durbin)

Legislation introduced to improve prescriber education on opioids and SUD

Senators Markey and Braun reintroduced the Safer Prescribing of Controlled Substances Act, which would require prescribers of opioid medications to complete additional training on responsible prescribing practices and substance use disorder treatment. The mandatory education would focus on best practices for pain management and alternative non-opioid therapies for pain, methods for diagnosing and treating SUD, linking patients to evidence-based treatment for SUD, and tools to manage adherence and diversion of controlled substances, including PDMPs. The bill would also require HHS to evaluate how implementing this new education requirement impacts prescribing patterns.

Source: As Opioid Crisis Accelerates, Senators Markey And Braun Reintroduce Bipartisan Legislation To Improve Prescriber Education, Require Warning Label On Addictive Opioid Medications (United States Senator Ed Markey)

Endo and Tennessee reach $35 million settlement agreement

Endo has reached a $35 million agreement with Tennessee to settle a lawsuit by nine counties, 18 cities and towns, and “Baby Doe,” over the company’s role in the opioid crisis. A judge already ruled that Endo was liable in April without holding a civil trial over its role in the crisis, but a trial had been set to start this week to determine how much to award the plaintiffs. The settlement still requires some of the plaintiffs to approve it, and trial proceedings are adjourned until August 2 amid that process. The settlement will include no admission of wrongdoing or liability. Endo was the last defendant remaining in the 2017 lawsuit after Mallinckrodt and Purdue filed for bankruptcy. The lawsuit argued that Endo is liable under the state’s Drug Dealer Liability Act. The plaintiffs sued for $2.4 billion.

Source: $35M settlement reach in Tennessee opioid lawsuit (Associated Press)

Purdue's creditors largely approving the bankruptcy plan

A huge majority of more than 120,000 creditors of Purdue have voted to approve the company’s bankruptcy plan. Preliminary tabulation of voting by cities, states, tribes, insurers, families and caregivers of babies born with symptoms of withdrawal shows that 95% favor the plan. For the plan to take effect, the bankruptcy judge must sign off, a move long expected and now made even more likely by the full-throated results of the creditor vote. Purdue said it would release final voting tallies August 2, a week before a court hearing at which final objections will be aired, but the results are not expected to change materially. The judge is expected to rule shortly after. Although a handful of states filed objections to the plan, as did the Department of Justice, those efforts seem unlikely to derail proceedings.

Source: Purdue Pharma’s Creditors Overwhelmingly Endorse Bankruptcy Plan (New York Times)

Industry and states struggling with approach to delta-8 THC

Delta-8 THC has rocketed to popularity over the last year, and the cannabis industry and state governments are scrambling to reckon with it amid debate over whether it is legal. Delta-8 THC is billed as producing a milder higher than delta-9 and is often marketed as being legal due to the fact that most is synthesized from legal CBD. The law that permitted hemp products said they could not be more than 0.3% delta-9, but it said nothing about delta-8. Some interpret that as a green light for delta-8, but the DEA has said that “synthetically derived” THC and delta-8 specifically are top-level controlled substances, effectively illegal except for strictly limited research. There is little research on delta-8, but some state officials worry that converting CBD to delta-8 could produce harmful byproducts. Lawmakers in more than a dozen states have made or considered some move on delta-8 this year. Some sought to effectively ban it, while others aimed to allow it but regulate it like their legal marijuana markets, concerned that it was being sold at gas stations and convenience stores that do not have the same standards and limits that apply to dispensaries.

Source: High profile: Cannabis chemical delta-8 gains fans, scrutiny (Associated Press)

We have solutions to address the opioid crisis

There are policy approaches with strong evidence behind them to address the opioid crisis, including restricting drug supply (e.g., reductions in opioid prescriptions, law enforcement efforts to break up and take down drug markets, trade policy, border control measures, international cooperation); more and better addiction treatment (e.g., more spending on treatment to build it up where it is unavailable, insurance coverage, regulatory standards for treatment); harm reduction (e.g., needle exchanges, naloxone distribution, supervised consumption sites, giving heroin to treatment-resistant patients); and addressing root causes (e.g., any approach that lifts up the poor and disadvantaged). Most of these ideas are covered in President Biden’s plan to end the opioid crisis, but Biden and Congress will have to prioritize the plan.

Source: The opioid epidemic isn’t unsolvable (Vox)

Local governments should embrace harm reduction

Local governments often do not heed the advice of harm reduction advocates, even though many are people who use substances or their loved ones and know first-hand the benefits of sterile syringes, naloxone and drug-testing strips. Local governments have often acted ineffectively, sometimes in direct contradiction to experts’ recommendations, often pushing pack against harm reduction efforts that research shows save lives and prevent disease. State and local governments are passing laws to shut down syringe service programs, complicating grassroots harm reduction efforts and sometimes making their work illegal. People need more fentanyl test strips, safe consumption spaces and access to regulated medication. Allowing harm reduction programs to use federal dollars to purchase syringes would be an important policy change. Funding to fight the opioid crisis and from opioid litigation needs to reach grassroots programs to help them become sustainable. More official harm reduction work should move out of health departments and into the streets.

Source: What Those in Power Are Missing About the Opioid Epidemic (The Atlantic)