Policy News Roundup: February 9, 2023

Key reads

Biden highlights mental health and addiction in State of the Union

In the State of the Union address, President Biden told the story of Doug, from Newton, New Hampshire, and his daughter Courtney. Courtney discovered pills in high school, then spiraled into addiction and died from a fentanyl overdose at 20. The family has been working since to end stigma and change laws. Biden called for launching a major surge to stop fentanyl production, sale and trafficking, with more drug detection machines to inspect cargo and stop pills and powder at the border, for working with couriers like FedEx to inspect more packages for drugs and for strong penalties to crack down on fentanyl trafficking. He called for doing more on mental health, especially for children, including greater access to mental health care at schools and holding social media companies accountable. Biden called for giving law enforcement training and for more first responders and professionals to address the growing mental health and addiction challenges. Biden also highlighted passage of the MAT Act and the historic investments in mental health in the Bipartisan Safer Communities Act, as well as seizure of over 23,000 pounds of fentanyl in just the last several months.

See the more detailed plans on mental health and addiction Biden outlined here: FACT SHEET: In State of the Union, President Biden to Outline Vision to Advance Progress on Unity Agenda in Year Ahead

Source: Full Transcript of Biden’s State of the Union Address (New York Times)

Congress considering marijuana's danger for kids

Policymakers overseeing marijuana legalization were flying blind about its effect on public health. Only recently has a steady flow of data emerged on health impacts. Lawmakers’ reaction to the data raises the prospect that the loosely regulated marijuana marketplace could come under pressure. Even some of those most supportive of legalization are calling for more regulation and better oversight. Rep. Blumenauer (D-Ore.), Capitol Hill’s unofficial cannabis czar, said that one of the reasons he has fought so hard to legalize and regulate marijuana is to keep it out of the hands of young people. He and Rep. Joyce (R-Ohio), co-chairs of the Congressional Cannabis Caucus, are now talking about standards on dosing, mandates for childproof containers for edibles and advertising restrictions aimed at protecting children. They are also concerned about high potency cannabis and its effects. Public health experts are supportive of such efforts but are frustrated that policymakers eager to get on with legalization missed the opportunity to mitigate the consequences in advance.

Source: Pot is making people sick. Congress is playing catch-up (Politico)

HHS highlights key 2022 actions

The Department of Health and Human Services released a snapshot of key accomplishments in 2022. Key areas of focus included reducing health care costs and expanding access to coverage and care, strengthening behavioral health care, strengthening supports for vulnerable children and families and advancing equity and increasing opportunities for communities. It highlights efforts to expand naloxone, increased funding, overdose prevention grants, setting a standard clinical definition for opioid withdrawal in infants, funding for support and training on substance use during pregnancy and postpartum, the harm reduction research network and the 988 transition. The snapshot also highlights the National Tour to Strengthen Mental Health; the surgeon general’s Framework on Workplace Mental Health and Well-Being and mindfulness tools; grants to meet behavioral needs of people with/at risk of HIV/AIDS; Bipartisan Safer Communities Act funds; proposed rules prohibiting menthol cigarettes and flavored cigars and plans for a proposed rule to reduce addictiveness of tobacco products; and investments in social determinants.

Source: Snapshot: How HHS is Building a Healthier America (Department of Health and Human Services)

Lawmakers call for restoring ONDCP director to Cabinet

Rep. Trone (D-MD) and Sen. Markey (D-MA), along with Reps. Fitzpatrick (R-PA) and Kuster (D-NH) and 51 other members of Congress, sent a letter to President Biden urging him to reinstate the Director of the Office of National Drug Control Policy to a Cabinet-level position. The position was a Cabinet position between 1993 and 2009. The lawmakers believe reinstating the director to the Cabinet is vital to curbing deaths, reducing synthetic opioids entering the country, building interagency collaboration and improving the effectiveness of drug control programs.

Source: Ahead of State of the Union, Trone Spearheads Bipartisan, Bicameral Letter Urging Biden to Reinstate Director of ONDCP to Cabinet-level Position (Congressman David Trone)

Congressional Research Service releases report on parity

The Congressional Research Service released a report explaining federal requirements related to mental health and substance use disorder benefits (such as Essential Health Benefits coverage mandates and requirements for preventive services coverage without cost sharing), as well as federal parity requirements, with respect to private health insurance. It provides a review of relevant legislative history and a discussion and examples of required federal agency activities (such as oversight and reporting).

Source: Mental Health Parity and Coverage in Private Health Insurance: Federal Requirements (Congressional Research Service)

California provides funding for workforce and treatment programs

The California Department of Health Care Services (DHCS) made $18 million in grants available to help students 18+ gain practical on-the-job experience in behavioral careers through the Mentored Internship Program. It allows provider organizations in underserved and diverse communities to develop, implement and maintain an in-house internship program that will create a sustainable addiction workforce. The program is funded by opioid settlement funds. DHCS also awarded more than $4 million to 54 DUI programs to support the creation of linkages to resources and referral options to treatment to reduce opioid overdoses and opioid-related traffic fatalities and to curb recidivism amongst DUI program participants with substance use disorder. The pilot is funded by State Opioid Response Grant funds.

Source: DHCS Invests In Opioid Prevention, Treatment, And Recovery Careers And Provides Services To DUI Program Participants With Substance Use Disorders (California Department of Health Care Services)

Chicago expands crisis response programs

Chicago expanded the Crisis Assistance Response and Engagement (CARE) program, which integrates behavioral health professionals into teams that respond to 911 calls when they have a behavioral health component. It launched the Opioid Response Team (ORT), the city’s first CARE team to focus on 911 calls for substance use or overdose emergencies; prior teams focused on mental health emergencies. A Chicago Fire Department Community Paramedic and Peer Recovery Specialist from the University of Illinois Chicago Community Outreach Intervention Projects will respond together to connect residents to ongoing substance use care, provide harm reduction resources and provide follow-up support in the days after overdose. In 2023, the city will expand 911 mental health teams into three more sets of neighborhoods with the highest volume of mental health-related 911 calls. The city will also expand the minimum age eligibility down to 12 (from 18) and the range of 911 calls to which CARE teams can respond (to include suicide threats and well-being checks, criminal trespass or suspicious person when they involve a mental health component).

Source: City of Chicago Announces Expansion of Alternative 911 Response Program (Chicago Department of Public Health)

Michigan launches Substance Use Vulnerability Index

The Michigan Department of Health and Human Services has launched the Michigan Substance Use Vulnerability Index (MI-SUVI), a tool to help stakeholders target efforts to address substance use issues specifically facing their communities. Previously, overdose mortality data alone was relied on to identify areas with higher substance use, which does not consider a community’s access to resources, the impact of nonfatal overdoses or social determinants of health. MI-SUVI uses data on access to services, social vulnerability and substance use burden, which together create a county-level vulnerability score or index that shows areas more vulnerable to adverse substance use outcomes.

Source: MDHHS launches county-level substance use vulnerability index (Michigan Department of Health and Human Services)

Study finds majority support for prohibiting the sale of tobacco products

A study assessing support for commercial tobacco retail policies among adults found that 62.3% of adults supported a policy prohibiting the sale of menthol cigarettes, with significant differences by sex, educational attainment, annual household income and tobacco product-use variables (current cigarette, menthol cigarette, noncigarette tobacco product use). Approximately two-thirds of respondents who did not currently use tobacco products and more than one-third of those who did supported this policy. No differences were observed by age, race/ethnicity or region, highlighting broad support. The study found 57.3% supported a policy prohibiting the sale of all tobacco products, with significant differences by sex, age, race/ethnicity, educational attainment, region and tobacco product use. More than 61% of those who did not use tobacco and about 25% of those who did support this policy. Findings can help inform federal, state and local efforts to prohibit the sale of tobacco products, including menthol cigarettes.

Source: Support for Policies to Prohibit the Sale of Menthol Cigarettes and All Tobacco Products Among Adults, 2021 (Centers for Disease Control and Prevention)

There is a bipartisan approach to addressing the overdose crisis

Regina LaBelle, director of the Addiction and Public Policy Initiative at Georgetown University Law Center’s O’Neill Institute, outlines a bipartisan approach to address the overdose crisis with three prongs – expand quality treatment, invest in mental health care and disrupt international criminal networks. She suggests that Congress can take additional steps following the changes made in the omnibus bill to expand access to treatment, including amending the inmate exclusion that limits the use of federal Medicaid funds during incarceration. She calls for looking after youth to make sure the early signs of mental health concerns are recognized and to get the support they need. This will take federal funding, as well as parents, schools and communities working together to identify mental health concerns, monitor social media and prioritize the mental health of young people. Lastly, steps to disrupt drug trafficking networks should include taking steps to reduce money laundering and illicit finance practices by freezing assets and other enforcement actions.

Source: 3 actionable bipartisan solutions to address the overdose crisis (The Hill)

Communities are collecting and sharing data to address overdoses

Authorities are hoping to made a dent in the overdose crisis by sharing information in near-real time to predict where the next cluster of overdose deaths may be and prevent at least some of them. When New York City’s overdose prevention center detects an unusually potent bag of illicit fentanyl, for example, it quickly sends out a “bad batch alert” to warn other people who use substances. Staffers walk encampments to spread the word, word goes out on social media, and the city’s health department and other organizations are notified. Cities around the country are examining their wastewater for opioids and other substances, academic researchers are sifting drug-related chatter on Reddit and others are combing dispatches of first responders. In addition to funding many of the experiments, the federal government launched a program to track and share information on nonfatal overdoses. Many of these projects are new and most have time lags, lack of information or information gaps, but researchers believe some combination may help curb the crisis.

Source: To curb drug deaths, communities turn to Reddit, texts and wastewater (The Washington Post)