ONDCP leading with a harm reduction approach
The Department of Justice is expected to soon decide whether the Safehouse supervised consumption site it blocked three years ago can operate. Support for supervised consumption from the Biden administration would be a major turning point. Although the Trump administration sued to stop the Safehouse site, the Biden administration has not intervened regarding the two sites that opened last year in New York. Office of National Drug Control Policy (ONDCP) Director Rahul Gupta is already overseeing the most progressive federal drug strategy since ONDCP’s inception. The strategy largely focuses on harm reduction, and Biden is the first president to support the approach. Some see Gupta as an unlikely flagbearer for harm reduction after he was blamed for the demise of harm reduction programs four years ago in West Virginia. Gupta is the first medical doctor to occupy his role. He says the administration has adopted a consider-everything attitude.
Source: Biden’s Drug Czar Is Leading the Charge for a ‘Harm Reduction’ Approach (New York Times)
Overdose cluster highlights new trends
In February, eight people died of overdoses within a block of each other in St. Louis. All were Black, mostly men, ages 36 to 66. At least some thought they had purchased crack cocaine, but the substances contained fentanyl. The cluster captures how the overdose crisis has morphed. Synthetic opioids are increasingly tainting other substances, and overdoses are claiming the lives of Black and American Indian/Alaska Native people at record rates. More residents died in 2020 from overdoses than COVID-19, but the overdose crisis is not receiving the same urgent response. The historic lack of investment in predominantly Black neighborhoods and higher rates of incarceration and houselessness that leave people more vulnerable to overdose are colliding with an increasingly dangerous drug supply. Black people have less access to treatment and overdose prevention tools, and resources have not been effectively targeted to reach Black residents. State laws limit syringe and fentanyl test strips distribution and use.
Cannabis Administration and Opportunity Act introduced in Senate
Senators Cory Booker, Chuck Schumer and Ron Wyden introduced the Cannabis Administration and Opportunity Act. The measure would end the federal prohibition on cannabis by removing cannabis from the federal list of controlled substances and empowering states to implement their own laws. It would establish a federal regulatory framework to protect public health and safety, prioritize restorative and economic justice, end discrimination in the provision of federal benefits on the basis of cannabis use, provide major investments for cannabis research and strengthen worker protections.
Source: Booker, Schumer, Wyden Introduce Cannabis Administration and Opportunity Act (Cory Booker)
Bill introduced to allow TV and radio ads for cannabis products
Senator Ben Ray Luján introduced the Secure and Fair Enforcement (SAFE) Advertising Act, which would permit radio and television stations to accept advertising for state-legal cannabis products. Radio and TV stations need a Federal Communications Commission license to operate, and broadcast stations cannot accept ads for cannabis products due to the continued federal prohibition. The bill would remove the risk that stations could lose their license if they accept ads for cannabis. For stations in states that have not legalized cannabis advertising, the legislation would leave the law as is and would not interfere with state regulation. Any ads would be required to meet Food and Drug Administration packaging and labeling requirements or include “This product has not been evaluated by the Food and Drug Administration. There may be health risks associated with consumption of this product.” Broadcasters airing cannabis ads would have to prove that at least 70% of their audience is at least 21 years old.
HUD public housing policies create barriers for people with addiction
Department of Housing and Urban Development (HUD) eligibility criteria make it difficult for people with substance use disorder (SUD) to qualify for public housing. Local public housing authorities (PHA) that manage public housing and rental subsidy programs must deny an applicant who has been evicted from public housing in the last three years for drug-related criminal activity or who is using a controlled substance or alcohol that the PHA deems a risk to “the health, safety, or right to peaceful enjoyment of the premises by other residents.” Most PHAs enforce these rules beyond what HUD requires. HUD explicitly excludes SUD from its definition of disability, misaligned with the Rehabilitation Act, Americans with Disabilities Act and Affordable Care Act. The policies have contributed to disproportionate houselesness rates for Black people in particular. Housing-first programs have been shown to lead to better SUD and housing outcomes. HUD needs to enact SUD-inclusive criteria.
Source: By Perpetuating Substance Use Disorder Stigma, Public Housing Policy Causes Harm (Health Affairs)
State and local news
Teva reaches $4.25 billion opioid settlement
Teva announced a settlement in principle with some 2,500 local governments, states and tribes over its role in the opioid crisis. The deal is worth up to $4.25 billion. Teva would make payments over 13 years. The $4.25 billion includes the nearly $550 million in settlements the company has already struck as trials got underway in San Francisco, Florida, West Virginia, Texas, Louisiana and Rhode Island. States and communities can choose to accept a portion of their payouts in overdose reversal medications rather than cash. In 2016, Teva acquired Actavis, a generics unit of Allergan. For the deal to be finalized, Allergan also has to reach a settlement with the plaintiffs. That announcement is expected soon. The deal is also contingent on an overwhelming majority of state, local and tribal governments voting in favor.
Source: Teva Reaches Tentative $4.25 Billion Settlement Over Opioids (New York Times)
National Association of Counties launches guide on spending settlement funds
The National Association of Counties (NACo) launched its Opioid Solutions Center, which will help guide counties in evaluating their needs and how to spend opioid settlement funds. It includes a guide on approved uses of the funds and case studies, as well as a free helpline for technical assistance for counties. NACo will also convene a national leadership network of 20 to 25 counties that are committed to addressing substance use disorder.
Source: Counties plan funding as opioid settlement payout nears (National Association of Counties)
National Governors Association "Strengthening Youth Mental Health" initiative announced
New Jersey Governor Phil Murphy announced his new “Strengthening Youth Mental Health” initiative at the National Governors Association (NGA) Summer Meeting, which marked the beginning of his term as NGA Chairman. The initiative’s four core pillars include prevention and resilience building, increasing awareness and reducing stigma, access and affordability of quality treatment and care and caregiver and educator training and support. The initiative will support success in and outside the classroom by acknowledging the relationship between mental health and academic growth, promoting the academic recovery of youth impacted by COVID-19.
Source: Governor Murphy Unveils “Strengthening Youth Mental Health” Initiative as National Governors Association Chairman (State of New Jersey Governor Phil Murphy)
Other news in addiction policy
ACA preventive care mandate being challenged in court
The Affordable Care Act’s (ACA) requirement that insurers cover preventive services is being challenged in court. The case is before Judge Reed O’Connor, the author of several anti-ACA rulings. It could determine whether insurance companies are allowed to deny coverage or charge high copays for preventive care. The challenge argues that the ACA’s preventive care mandates violate the Religious Freedom Restoration Act and that forcing people to pay for plans that cover STD screenings and HIV prevention drugs will “facilitate and encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use.” The suits says the government cannot show that forcing insurers to “provide PrEP drugs, the HPV vaccine, and screenings and behavioral counseling for STDs and substance use free of charge is a policy of such overriding importance that it can trump religious-freedom objections.” The Biden administration is arguing that the case should be thrown out because the plaintiffs do not have legal standing because they are not being harmed by their insurance covering preventive services.
Source: Obamacare back in court as Texans challenge coverage for STDs and HIV care (Politico)