Opioid prescriptions decline amid prescribing guidelines
Opioid prescribing has fallen amid guidelines over the past decade from governments, health systems and insurers aimed at reducing opioid prescriptions. Patients receiving cancer treatments, however, are excluded from these limits. A new study examined prescribing rates among both cancer patients and those with other chronic pain, finding that overall prescribing rates still dropped between 2012 and 2019. The percentage of people prescribed an opioid, among the sample of private insurance claims, dropped from 86% to 78.7% for those with cancer pain and from 48.7% to 30.5% among those with other pain. Rates of non-opioid pain medications were steady for people with non-cancer pain but increased for cancer patients. For those who still received opioids, fewer received high doses or more than a one-week supply. The findings highlight the need to better understand how prescribing declines are influencing pain management, especially as the Centers for Disease Control and Prevention are updating opioid prescribing guidelines for chronic pain.
Source: U.S. Opioid Prescriptions Are Declining (HealthDay)
New York issues statewide naloxone standing order
New York State Health Commissioner Dr. Mary Bassett announced a statewide pharmacy standing order for naloxone beginning August 15. Since 2015, there has been a patchwork of naloxone standing orders in New York, including those issued by New York City and Erie County health departments. Some pharmacy chains have provided their own standing orders, and the State Health Department has had a mechanism for pharmacies seeking standing orders to obtain one. Those standing orders combined covered more than 2,600 pharmacies. The new standing order applies to all pharmacies in New York.
Source: State Health Commissioner Issues Statewide Pharmacy Standing Order for Naloxone to Reduce Opioid Overdoses and Save Lives (New York State Department of Health)
Sen. Scott introduces bill to address the opioid crisis
Senator Rick Scott (R-Fla.) introduced the Streamlining Text for Official Policy by Formulating Effective Needed Tools to Address Narcotics, Yearly Loss of Life and Protect Americans from Chemical Killers and Against Gangs Effectively (STOP FENTANYL PACKAGE) Act. The bill includes professional and civil liability protections for naloxone administration; overdose data collection; and grants for local law enforcement agencies to provide training on identifying overdoses, upgrade systems for drug tracing and forensic labs, and provide training to better trace criminals through the darknet. It would elevate the Office of National Drug Control Policy director to a Cabinet-level position, codify the Interagency Coordination Council and apply the Congressional Review Act to final rules inconsistent with the National Drug Control Policy; and provide funding for the Fentanyl Profiling Program for Drug Enforcement Administration data collection. The measure would also direct the Substance Abuse and Mental Health Services Administration to include an assessment of challenges faced by State Opioid Response Grant recipients in their annual report and provide best practices.
State and local news
Judge rules that Walgreens contributed to San Francisco's opioid crisis
A federal judge in San Francisco ruled that Walgreens contributed to the opioid crisis in the city through its sale of prescription drugs. The judge said Walgreens failed to properly investigate suspicious opioid orders for nearly 15 years. The amount Walgreens must pay will be determined in a later trial. San Francisco in 2018 sued Walgreens, as well as several manufacturers and distributors, claiming they created a public nuisance by flooding the city with opioids and failing to prevent diversion. A trial began in April, and all of the defendants except Walgreens reached settlements with the city before the court ruled. Walgreens intends to appeal.
Source: Walgreens prescriptions added to San Francisco’s opioid epidemic – judge (Reuters)
West Virginia settles with Rite Aid
West Virginia reached a settlement with Rite Aid that may total up to $30 million in a lawsuit alleging oversupply of opioids at pharmacies in the state. The lawsuit alleged that Rite Aid failed to monitor and report suspicious orders of prescription painkillers. The lawsuit against the remaining pharmacy defendants continues, with a trial date in September.
Source: WVa AG reaches settlement with Rite Aid over opioid supply (Associated Press)
National Governors Association releases resources for states to support harm reduction and equity in crisis care
The National Governors Association (NGA) released a resource to support states/territories in developing strategies to promote health equity and improve public health capacity to provide harm reduction services. It addresses three phases of establishing, sustaining and enhancing syringe service programs (SSPs) and other harm reduction strategies. It includes recommendations and state examples related to legal components, financing, needs assessments, engaging people with lived experience, creating clear-cut access to sterile syringes, establishing partnerships, and law enforcement. The NGA also released a brief on strategies to enhance cultural responsiveness and promote equity in behavioral health services across the crisis continuum to engage affected communities, incorporate the voice of people with lived experience and establish processes for accountability. It outlines and provides state examples of levers to advance culturally responsive care, including in existing services, creating opportunities for non-traditional partnerships and establishing governance structures that include persons with lived experience. It also outlines levers to create data-driven strategy and data transparency.
Source: Supporting And Sustaining Access To Harm Reduction Services For People Who Use Drugs (National Governors Association); Behavioral Health Equity For All Communities: Policy Solutions To Advance Equity Across The Crisis Continuum (National Governors Association)
Resource outlines state funding options to address addiction
The National Academy for State Health Policy released a resource outlining funding options for states for substance use disorder-related activities. It outlines details about funds from Medicaid, the Substance Abuse Prevention and Treatment Block Grants, the State Opioid Response Grants and legal settlements, including the administrator of the funds, required or recommended uses of funds, prohibited uses of funds, coordination with Medicaid and funding totals.
Source: Funding Options for States (National Academy for State Health Policy)
Other news in addiction policy
Gaps in treatment press need for harm reduction services
Beth Macy, author of Dopesick, has a forthcoming book “Raising Lazarus: Hope, Justice, and the Future of America’s Overdose Crisis.” In an article adapted from the book, she explains how underfinanced, ultra-motivated volunteers and workers are filling treatment gaps by using innovative strategies in select cities and rural areas across the country. Some must skirt law enforcement to bring lifesaving medications and harm reduction supplies to the most marginalized in their communities. Harm reduction services look vastly different in rural areas than in New York City, for example, which authorized the nation’s first supervised consumption sites. Many rural areas have a hodgepodge treatment landscape that relies entirely on the efforts of individuals. Harm reduction has been proven to work, and the federal government must pursue it to curb overdose deaths.
Source: Successful Addiction Treatment Looks Like This (New York Times)
Report outlines strategies for addressing addiction in the criminal legal system
AIR Center for Addiction Research and Effective Solutions issued a report on addressing addiction in the criminal legal system. A new approach to drug policy must include a reduction of new entrants through policies that divert people from the criminal legal system entirely and improvement of services for those currently in the system. Strategies to reduce new entrants include removal of upstream structural conditions, decriminalizing the personal possession of drugs, buprenorphine decriminalization, syringe service programs, comprehensive Good Samaritan and naloxone access laws and deflection programs. Strategies to improve services for those who are justice-involved include suspending (not terminating) Medicaid, Medicaid funding within correctional settings and peer support.
People are using social media to spread harm reduction messages
Harm reduction “influencers” on TikTok and Instagram are harnessing new interest in the topic as overdoses rise to educate and inform viewers. They are posting videos showing how to use naloxone, posts about testing drugs, and infographics about substance use. Using TikTok and Instagram is an effective way to reach younger audiences, among whom overdose death rates are highest. The nonprofit End Overdose’s popular TikTok videos, for example, aim to mix scientific information with whatever is trending at the moment. Individuals are also spreading information on harm reduction and drug safety on their personal pages. The platforms’ short posts hold people’s attention and are able to reach a broad audience. Social media also allows those who practice harm reduction to connect with peers.
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