Policy News Roundup: January 20, 2022

Key reads

Study finds that providing buprenorphine in jail could help reduce recidivism

A study on providing buprenorphine to incarcerated adults with opioid use disorder compared Massachusetts’s Franklin County jail, which provided buprenorphine, and the Hampshire County jail, which did not. The study found that providing the medication reduces the odds of recidivism. Less than half of participants from the Franklin County jail re-offended, compared with 63% from the Hampshire County jail. New criminal charges were laid against 36% of participants from the Franklin County jail, compared to 47% of those from the Hampshire County jail. About 40% of those in the Hampshire County jail returned to jail, while only around 20% of those from the Franklin County group did. Overall, the Franklin County group had a 32% reduction in probation violations, re-incarceration or court charges when offered buprenorphine treatment.

Source: Opioid Addiction Treatment in Jail Could Change Lives (HealthDay)

White House summarizes actions taken in first year to address the overdose crisis

The White House released a list of actions taken by the administration to address addiction and the overdose crisis since they took office a year ago. These include efforts in the areas of prevention, harm reduction, treatment and recovery and supply reduction. Initiatives include a new Overdose Prevention Strategy, public education campaigns, research, model laws to expand naloxone and syringe services program access and ensure proper spending of opioid litigation funds, new buprenorphine prescribing guidance, regulations to allow mobile methadone programs, the extension of methadone take-home flexibilities, convenings on harm reduction and the opioid litigation, efforts to curb the supply of fentanyl and funding across all categories.

Source: White House Releases List of Actions Taken by the Biden-⁠Harris Administration Since January 2021 to Address Addiction and the Overdose Epidemic (Office of National Drug Control Policy)

Califf nomination moves to full Senate, where there is likely to be a close vote

The Senate Health, Education, Labor and Pensions Committee voted to advance Robert Califf’s nomination to head the Food and Drug Administration (FDA). Califf is facing a tight confirmation vote in the full Senate. Several Democrats have announced their opposition over concerns about Califf’s industry ties or the FDA’s record on opioids. Abortion politics and the opportunity to sink a Biden nominee are complicating efforts to make up for them with Republican votes. Sen. Hassan announced she would vote no, explaining that it is imperative to have a strong commissioner who recognizes the role the FDA’s decisions played in fueling the addiction crisis. She said it does not appear that things would be different under Califf. Sen. Markey similarly announced his opposition due to FDA’s failures to effectively regulate opioids. Sen. Manchin has also voiced opposition due to concerns around opioids, and Sens. Sanders and Blumenthal have also expressed opposition. So far, only Republicans Sens. Burr, Collins, Murkowski and Romney plan to vote yes.

Source: Senate Panel OKs Califf Nomination for F.D.A. Chief (New York Times); Biden’s FDA nominee faces uncertain Senate vote (Axios)

HHS holds roundtable on youth behavioral health

Department of Health and Human Services Secretary Becerra hosted a virtual roundtable discussion with organizations helping to tackle the youth behavioral health crisis. It addressed topics including access, capacity and equity to support services; health care coverage; workforce challenges; the 988 crisis line; Medicaid funding for services in schools; telehealth; and improved data collection. The top priority for the group is reducing the youth suicide rate. Participants included American Academy of Pediatrics, Children’s Hospital Association, American Academy of Child and Adolescent Psychiatry, National Association of School Psychologists, AASA (The School Superintendents Association), YWCA, YMCA, the National Alliance on Mental Illness, the National Federation of Families for Children’s Mental Health and the Trevor Project.

Source: Readout of the Youth Behavioral Health Roundtable (Department of Health and Human Services)

SAMHSA study finds rapid increase in telemedicine services in mental health and addiction treatment facilities during COVID

A Substance Abuse and Mental Health Services Administration report found an increase in the percentage of facilities providing telemedicine services between 2015-2020. The report used data from the National Survey of Substance Abuse Treatment Services and the National Mental Health Services Survey on telemedicine services in mental health and substance use disorder (MH/SUD) treatment facilities. In 2015, 25.7% of SUD treatment facilities indicated using telemedicine/telehealth, compared to 58.6% in 2020. For MH treatment facilities, provision of telemedicine services increased from 22.2% to 68.7%. COVID-19 resulted in more facilities adapting their services and increasing their use of technology. The number of facilities providing telemedicine sharply increased 2019-2020. The percentage of SUD facilities with telemedicine services more than doubled 2019-2020, from 27.5% to 58.6%. The percentage of MH facilities increased from 38% to 68.7%.

Source: Telemedicine Services in Substance Use and Mental Health Treatment Facilities (Substance Abuse and Mental Health Services Administration)

West Virginia county facing HIV outbreak amid syringe service program closures

Kanawha County, West Virginia, experienced an HIV outbreak during the COVID-19 pandemic among people who inject substances. The county has high rates of opioid use disorder and overdose deaths. It is located near Cabell County, which had an HIV outbreak in 2018-2019. After the suspension of syringe services programs (SSP) in March 2018 and April 2021, a state law and a Charleston City Council ordinance enacted stricter SSP requirements. COVID affected HIV response and services for people who inject substances. As of Oct. 27, 2021, 85 persons met the HIV outbreak case definition. Methamphetamine and heroin were the most frequently injected substances, and polysubstance use was common. People reported reusing or sharing syringes, mainly because access to sterile syringes was limited after SSP closures. People expressed medical mistrust because of stigma and discrimination in health care settings. HIV screenings were rarely performed at health encounters before diagnosis, and none of the patients had been prescribed pre-exposure prophylaxis (PrEP). Prescriptions for naloxone and medications for opioid use disorder were documented in fewer than a quarter of opioid-related health care encounters.

Source: Notes from the Field: HIV Outbreak During the COVID-19 Pandemic Among Persons Who Inject Drugs — Kanawha County, West Virginia, 2019–2021 (Centers for Disease Control and Prevention)

J&J reaches opioid settlement with New Mexico

Johnson & Johnson has agreed to pay $44 million to resolve claims that it fueled the opioid crisis in New Mexico, a state which originally opted against participating in the nationwide settlement with J&J. The $44 million is consistent with the terms of the nationwide J&J and distributor proposal.

Source: J&J reaches opioid settlement with holdout state New Mexico (Reuters)

Endo agrees to $65 million settlement in Florida

Endo agreed to pay up to $65 million to resolve claims by the state of Florida and local governments that the company helped fuel the opioid crisis. The settlement includes no admission of wrongdoing.

Source: Drugmaker Endo signs $65 mln opioid settlement with Florida (Reuters)

Additional action needed to address the overdose crisis

While the Biden administration has taken positive steps to address the opioid crisis so far, more is needed, as overdose deaths continue to rise to record levels and the COVID-19 pandemic has exacerbated the crisis. Policies have shifted to focus more on harm reduction and treatment, moving away from punitive policies. More funding and action will be required to address the spike in deaths, historic underfunding, long-standing barriers to medications for opioid use disorder and continued stigma. The article quotes experts including Andrew Kolodny, Sarah Wakeman and Leana Wen.

Source: Overdose deaths hit a historic high in 2020. Frustrated experts say these strategies could save lives (PBS)

Despite the record number of overdose deaths, most people with addiction do recover