Policy News Roundup: January 26, 2023

    Key reads

    Advocates express concern about flavored marijuana products targeting kids

    Health advocates have long chided the tobacco industry for marketing harmful nicotine products to children, resulting in many cities/states outlawing flavored tobacco products. Now, the same concerns are growing over the packaging and marketing of flavored marijuana. New York forbids marijuana product marketing that is designed to appeal to children, but the Office of Cannabis Management has yet to adopt rules on labeling, packaging and advertising. Products that look like candy are regularly sold out of illegal dispensaries that operate out in the open. Even once packaging/marketing standards are set, they will likely not comply. Linda Richter, Partnership to End Addiction’s Vice President, Prevention Research and Analysis, suggests that state/local laws banning flavored tobacco products should be broadened to include marijuana. She notes that there is more scrutiny on the tobacco than cannabis industry and that because marijuana remains illegal at the federal level, there are no federal packaging/marketing standards to set parameters to avoid appealing marketing to young people.

    Source: Flavored cannabis marketing is criticized for targeting kids (Associated Press)

    Buprenorphine deaths did not increase amid COVID flexibilities

    A study found that despite buprenorphine’s wider availability due to emergency flexibilities during COVID, deaths involving buprenorphine still constitute a small fraction of substance use mortality. The flexibilities allowed doctors to issue new buprenorphine prescriptions via telemedicine. While deaths involving buprenorphine ticked upward in the months following the policy changes, they increased at a significantly lower rate than overall deaths involving substance use. Between July 2019 and June 2021, the share of opioid-related deaths involving buprenorphine fell from 3.6% to 2.1%. Nearly 93% of deaths involving buprenorphine also involved other substances, meaning that fewer than 1 in 600 opioid-related deaths is attributable to buprenorphine alone. The findings suggest that concerns about unintended risks of easing buprenorphine prescribing were largely unfounded.

    Source: Buprenorphine deaths did not increase despite wider access during pandemic, study shows (STAT)

    Federal news

    White House highlights elimination of the buprenorphine waiver

    The White House held an event on the removal of the buprenorphine waiver requirement in the omnibus bill. Speakers included Office of National Drug Control Policy Director Rahul Gupta, Assistant Secretary for Mental Health and Substance Use Miriam Delphin-Rittmon, Drug Enforcement Administration Administrator Anne Milgram, Senator Maggie Hassan and Representative Paul Tonko (sponsors of the MAT Act), Dr. Alister Martin (emergency medicine physician at Massachusetts General Hospital) and Shannon Hicks (person in recovery). ONDCP Director Gupta discussed his experience treating patients with addiction and getting a buprenorphine waiver. The elimination of the waiver requirement in the omnibus will increase access to treatment and reduce stigma. He thanked Congress, advocates and federal agencies and called on medical providers to screen and treat patients for addiction, on Americans with opioid use disorder to seek treatment, and on pharmaceutical companies, suppliers and pharmacies to make sure treatment is available, accessible and affordable.

    Source: Removing Barriers to Addiction Treatment Event (White House); Opioid addiction is a disease. We cut red tape so doctors can finally treat it effectively. (USA Today)

    FDA denies marketing of two menthol e-cigarettes

    The Food and Drug Administration (FDA) issued marketing denial orders for two menthol e-cigarette products from R.J. Reynolds. The company must not market or distribute the Vuse Vibe Tank Menthol 3.0% or Vuse Ciro Cartridge Menthol 1.5% in the U.S. or they risk FDA enforcement action. The FDA pointed to evidence that non-tobacco-flavored e-cigarettes, including menthol, have a known and substantial risk with regard to youth appeal, uptake and use. According to the 2022 National Youth Tobacco Survey, Vuse was the second most common brand used by youth who reported usual e-cigarette use.

    Source: FDA Denies Marketing of Two Vuse Menthol E-Cigarette Products Following Determination They Do Not Meet Public Health Standard (Food and Drug Administration)

    DOJ reaches first ADA settlement resolving claims of employment discrimination based on OUD

    The Department of Justice (DOJ) filed a complaint and proposed consent decree to resolve allegations that Cumberland County, Tennessee, violated the Americans with Disabilities Act (ADA), which prohibits employers from discriminating based on disability. The law requires employers to make reasonable accommodations to qualified employees with disabilities. The lawsuit alleges that the County Sheriff’s Department discriminated against a correctional officer on the basis of his disability, opioid use disorder (OUD), by failing to make reasonable accommodations to permit his continued employment while taking medications for OUD. The Sheriff’s Department also constructively discharged him by forcing him to resign. The lawsuit alleges that the department violated the ADA by preventing employees who are taking legally prescribed medications from having them present in their system while at work. This is DOJ’s first ADA settlement resolving claims of employment discrimination based on OUD.

    Source: Cumberland County, Tennessee Agrees to End Discrimination Based on Opioid Use Disorder (Department of Justice)

    State and local news

    Oregon releases audit on Measure 110 implementation

    The Oregon Secretary of State and Oregon Audits Division released a report that details how the Oregon Health Authority (OHA) struggled with implementing Ballot Measure 110 (M110), passed in 2020 to decriminalize substance use and create a new course focused on treatment instead of punishment. The report outlines recommendations for OHA on how to improve M110. It is too early to tell whether M110 will be successful. Auditors recommended four course adjustments for OHA – address fragmentation, ensure that success can be measured, create the foundation for a successful grants program and seek opportunities to expand collaboration with other stakeholders. Auditors also make several recommendations to the state legislature to address potential risk areas in law.

    Source: Secretary of State Shemia Fagan Releases Real-Time Audit Report of Ballot Measure 110 Implementation (State of Oregon Newsroom)

    Kentucky opens applications for Recovery Ready Community certification

    Kentucky Governor Andy Beshear announced that applications are open for Kentucky communities to apply for Recovery Ready certification. In June 2022, Beshear announced the creation of the Recovery Ready Communities program. Since then, the Office of Drug Control Policy, the Advisory Council for Recovery Ready Communities and Volunteers of America Mid-States have created a certification program for communities. Communities are eligible to apply for the certification, which measures their services to residents who are seeking help for addiction in three categories – prevention, treatment and recovery support.

    Source: Gov. Beshear Encourages Kentucky Communities To Strengthen Fight Against Drug Epidemic (Kentucky.gov)

    Judge grants preliminary approval to Juul settlement

    Juul secured preliminary court approval of a $255 million settlement resolving claims by consumers that it deceptively marketed e-cigarettes. The judge said the proposed class action settlement resolving claims by consumers who said they overpaid for Juul’s vaping products was “fair, reasonable and adequate.” The settlement is part of a larger, global agreement by Juul to resolve thousands of lawsuits by school districts, local governments and individuals accusing it of contributing to a youth vaping crisis. The class action settlement resolves claims by people who say they would have paid less, or not bought e-cigarettes at all, if Juul had not downplayed the products’ addictiveness and appealed to teens through social media campaigns and other means.

    Source: U.S. judge grants preliminary approval to Juul consumer settlement (Reuters)

    West Virginia and Walgreens reach $83 million opioid settlement

    Walgreens has agreed to pay West Virginia $83 million to settle the state’s opioid lawsuit. The deal is not part of a $5.7 billion nationwide settlement Walgreens reached with state and local governments last year. West Virginia, which previously opted out of nationwide settlements with drugmakers and distributors, has now secured more than $900 million from manufacturers, distributors and pharmacies, a larger amount per capita than any other state. Of the companies West Virginia sued, only Kroger has not settled and is set to go to trial in June.

    Source: Walgreens to pay $83 mln to settle West Virginia’s opioid claims (Reuters)

    Other news in addiction policy

    Parents' top concern about their kids is mental health

    A survey found that 4 in 10 parents with children under 18 say they are extremely or very worried that their children might struggle with anxiety or depression at some point, topping the list of parent worries. Mental health concerns are followed by concerns about their children being bullied (35% extremely or very worried), being kidnapped or abducted (28%), getting beaten up or attacked (25%), having problems with drugs or alcohol (23%), getting shot (22%), getting pregnant/getting someone pregnant as a teen (16%) and getting in trouble with the police (14%). Mothers are more likely than fathers to worry about most of these things. There are differences by income and race/ethnicity, with lower-income and Hispanic parents generally more likely than others to worry about their children’s physical safety, teen pregnancy and problems with drugs and alcohol. Black and Hispanic parents are more likely to be worried about their children getting shot or in trouble with the police.

    Source: Parenting in America Today (Pew Research Center)

    OTC naloxone has the potential to help address the overdose crisis

    In response to over-the-counter (OTC) naloxone applications, harm reductionists, including some of the staunchest proponents of this shift, are raising concerns that the effort will not be enough to improve access for the people most vulnerable to overdose. Granting OTC status to intranasal naloxone is, on its own, inadequate, but it can be an important step toward curbing overdose deaths. Critics worry that shifting nasal spray formulations to OTC will endanger insurance coverage, which could significantly increase out-of-pocket costs to consumers. Many note that people who use substances are the most likely to witness and reverse an overdose, but nasal sprays represent a small proportion of the naloxone distributed to them. The federal government should use the approach of emergency orders that have made COVID tests widely available through insurance reimbursement. Seeing naloxone on pharmacy shelves can help normalize naloxone and reduce stigma. OTC status would reduce concerns about privacy, as consumers would no longer need to provide identification or personal details.

    Source: Making naloxone available over the counter won’t solve the overdose crisis — but it will help (STAT)

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    January 2023