Commission on Combating Synthetic Opioid Trafficking releases final report
The U.S. Commission on Combating Synthetic Opioid Trafficking, a bipartisan congressional commission, released its final report. The report estimates that fatal overdoses cost the U.S. at least $1 trillion annually. It outlines a strategy to address the crisis that includes law enforcement and diplomacy to shut down sources of chemicals used to make synthetic opioids, treatment and support for those with addiction and investment in research to better understand addiction and develop treatments. The report recommends five “pillars” for government action – elevating the Office of National Drug Control Policy and restoring Cabinet rank to its director; disrupting the supply of substances through better coordinated law enforcement; reducing demand through evidence-based treatment and harm reduction; using diplomacy to enlist help from other governments in cutting off supplies of chemicals used to manufacture fentanyl; and developing surveillance and data analysis to spot new trends in illicit substance use.
Source: Opioid fight needs new strategy, Cabinet leadership: report (Associated Press)
The Lancet Commission releases recommendations for addressing the opioid crisis
The Stanford-Lancet Commission issued recommendations for responding to the opioid crisis. It analyzed the state of the opioid crisis in North America and detailed a strategy for policymakers to de-escalate the crisis. Since 1999, there have been more than 600,000 opioid overdose deaths in North America. Modeling found that by the end of this decade, an additional 1.2 million people are predicted to die from opioid overdose without substantial reform. The Commission calls for a shift in opioid use disorder treatment by characterizing addiction as a chronic condition and providing consistent funding for regional specialty addiction centers with localized services for addiction treatment. It calls on the Biden Administration to reinvigorate the National Pain Strategy. Deceptive marketing and prescribing practices and international funding for subsidized generic morphine in low-income countries must be reined in to prevent future opioid crises.
Source: Managing the opioid crisis in North America and beyond (The Lancet)
Congress planning action on behavioral health
Several Congressional committees are holding hearings and outlining plans for legislative packages addressing behavioral health. However, crafting bipartisan legislation on Capitol Hill is no small feat, and doing so in an election year is even harder. There is little information yet on how the packages would shape up, if they will come to a vote and whether they would have a large impact. However, the Senate Finance Committee held a hearing this week and plans to put together legislation this summer addressing behavioral health. The Senate Health, Education, Labor and Pensions Committee held a related hearing last week and said it intends to write bipartisan legislation to strengthen behavioral health programs. The House Energy and Commerce Committee is holding a hearing on COVID and mental health next week, and the House Ways and Means Committee also held a hearing last week and will be working on legislation this year.
Source: Health 202: Congress is turning attention to mental health (Washington Post)
Justice Department signals it may be open to safe injection sites
The Justice Department is signaling it might be open to allowing safe injection sites. In response to questions from the Associated Press, it said it is “evaluating” such facilities and talking to regulators about “appropriate guardrails.” The position is a drastic change from the department’s stance in the Trump administration, when prosecutors fought vigorously against a plan to open a site in Philadelphia. For months after Biden took office, the department had refused to take a public stance on the sites, but officials now say they are weighing their use. In December, Office of National Drug Control Policy Director Rahul Gupta also said that he is “interested in looking at the science and data behind all of the emerging harm reduction practices,” and the National Institutes of Health issued a call for harm reduction research that mentioned safe consumption sites.
Source: Justice Dept. signals it may allow safe injection sites (Associated Press)
HHS announces reports and grants to help pregnant women and children affected by substance use
A new series of reports from the Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation on substance-exposed pregnancies highlights how pregnant and postpartum women who use substances and their children can benefit from evidence-based prevention and treatment. The reports identify strategies that can reduce the negative impacts of substance use on families. They are being released as the Substance Abuse and Mental Health Services Administration begins accepting applications for the Services Grant Program for Residential Treatment for Pregnant and Postpartum Women. This is a $10 million grant program that will provide pregnant and postpartum women and their children with comprehensive substance use treatment and recovery support services across residential and outpatient settings. For the first time this year, the program will extend services to fathers, partners and other family members.
Source: HHS Announces New Reports and Grant Program Addressing the Health Needs of Pregnant Women and Children Affected by Substance Use (Substance Abuse and Mental Health Services Administration)
State and local news
Mallinckrodt bankruptcy reorganization approved
Pharmaceutical maker Mallinckrodt won court approval of its reorganization, which includes a $1.7 billion settlement of opioid-related litigation, bringing its 16-month bankruptcy close to an end. U.S. Bankruptcy Judge John Dorsey signed off on the plan. In addition to settling thousands of lawsuits accusing it of deceptively marketing its opioids, the plan allows Mallinckrodt to reduce its debt and hands control to creditors. Mallinckrodt filed for bankruptcy in October 2020 to resolve more than 3,000 opioid lawsuits. In September, the company won the support of committees representing junior creditors and opioid claimants, which had long been opposed to the plan, and nearly all U.S. states back the plan. Dorsey overruled objections raised by Rhode Island, Sanofi, certain insurers and shareholders. Rhode Island had argued that Mallinckrodt could not use its bankruptcy to give Chief Executive Officer Mark Trudeau legal protections, a dispute that mirrors the one in Purdue’s case.
Source: Mallinckrodt wins approval of restructuring plan, opioid deal (Reuters)
Teva reaches opioid settlement with Texas
Teva reached a $225 million settlement with Texas to resolve claims that the company fueled the opioid crisis in the state. Teva agreed to pay $150 million over 15 years and provide $75 million worth of naloxone. The deal is the largest Teva has struck in the more than 3,500 opioid lawsuits it faces. It did not admit wrongdoing as part of the settlement. The company previously settled with Oklahoma and Louisiana. A jury in New York found Teva liable in December, and a California judge concluded that Teva could not be held responsible the month before.
Source: Teva, Texas strike opioid settlement worth $225 million (Reuters)
New York to provide $100 million for behavioral health crisis stabilization centers
New York Governor Kathy Hochul announced more than $100 million in funding over five years for 12 new Intensive Crisis Stabilization Centers across the state that will provide immediate care to people experiencing behavioral health crises. The Centers will be open 24/7, and recipients may receive services for up to 24 hours. Walk-in care will be available to all individuals, including adults, children, adolescents and families. The Centers will provide care, observation and urgent treatment to those experiencing behavioral health crises. They will provide care in the community and divert individuals from unnecessary emergency department visits. They will offer peer and recovery-oriented support services, in addition to referral and follow-up services.
Source: Governor Hochul Announces $100 Million for Behavioral Health Crisis Stabilization Centers (Governor Kathy Hochul)
Other news in addiction policy
Recovery community organizations need increased, stable funding
Ryan Hampton and William Stauffer (Pennsylvania Recovery Organizations Alliance) explain the importance of recovery community organizations (RCOs) and the need for federal and state support. The Substance Abuse Prevention and Treatment Block Grant program is the funding foundation of states’ addiction prevention and treatment systems, but the grants shut out RCOs. Recovery supports receive only a small fraction of state mental health funding, and leaders are often more willing to invest in ineffective criminal justice responses. Funding for RCOs is patchwork, with some funded through time-limited grants, some through block grants to states and some through grassroots funding drives. Instead of competing for grants or spending resources on fundraising, RCOs should be supported by permanent, guaranteed funding, such as by Congress mandating that 10% of block grants be reserved for RCOs. Better data collection and analysis are needed to determine effectiveness of money spent and improve outcomes.