Policy News Roundup: June 8, 2023

Key reads

SAMHSA published National Model Standards for Peer Support Certification

The Substance Abuse and Mental Health Services Administration (SAMHSA) published National Model Standards for Peer Support Certification for substance use, mental health and family peer workers. The model standards were created to accelerate universal adoption, recognition and integration of the peer workforce across all elements of the health care system. SAMHSA collaborated with federal, state, tribal, territorial and local partners including peer specialists, and requested and incorporated public comments. The standards are not intended as a substitute for any state certifications but instead as guidance for states, territories, tribes and others to promote quality and encourage alignment and reciprocity across often disparate state peer support certifications. Standards address authenticity and lived experience; training; examinations; formal education; supervised work experience; background checks; recovery; diversity, equity, inclusion and accessibility; ethics; costs and fees; and peer supervision.

Source: HHS Publishes National Model Standards for Substance Use, Mental Health, and Family Peer Worker Certifications (Substance Abuse and Mental Health Services Administration)

Supporting Families Through Addiction Act reintroduced in Congress

Reps. Trone and Meuser and Sens. Capito and Gillibrand reintroduced the Supporting Families Through Addiction Act (one-pager). The bill would create a $25 million grant program over five years to help national and local nonprofit organizations provide support services to families of those with substance use disorder. Organizations around the country help millions of families affected by addiction, offering services to families that are often not provided by treatment facilities nor covered by insurance. Most of these organizations receive little or no government support. The bill would help close that gap. Evidence shows that when families are involved in their loved one’s treatment and recovery, outcomes improve. The bill was passed by the House last Congress.

Source: Trone, Capito, Gillibrand, Meuser Reintroduce the Supporting Families Through Addiction Act (Congressman David Trone)

Lawmakers introduce resolution recognizing Naloxone Awareness Day

Sens. Markey and Rick Scott and Reps. Trone, Fitzpatrick, McClain and Kuster introduced a resolution recognizing June 6 as Naloxone Awareness Day. The resolution promotes awareness of naloxone and aims to educate members of the public about the importance of recognizing the signs of overdose and equipping themselves with naloxone.

Source: Markey, Scott Lead Bipartisan, Bicameral Resolution Designating June 6th Naloxone Awareness Day (Ed Markey)

FDA issues warning letters to vape retailers

The Food and Drug Administration issued warning letters to 30 retailers, including one distributor, for illegally selling unauthorized tobacco products. The unauthorized products were various types of Puff and Hyde brand disposable e-cigarettes, which are two of the most commonly reported brands used by youth. The warning letters are the result of a nationwide blitz to crack down on the sale of unauthorized e-cigarettes that are popular with youth, which included investigations of hundreds of retailers and distributors across the country. All products cited in the warning letters are disposable e-cigarettes.

Source: FDA Conducts Retailer Inspection Blitz, Cracks Down on Illegal Sales of Popular Disposable E-cigarettes (Food and Drug Administration)

Biden administration promoting smoking cessation

The Biden administration plans to launch a government-wide framework for smoking-cessation help. It aims to harmonize smoking cessation resources available across agencies. It would focus on marginalized communities, as well as on preventing minors from using e-cigarettes. The Food and Drug Administration and National Institutes of Health awarded funding for a Center for Rapid Surveillance of Tobacco, which will help collect and analyze data faster on types of tobacco products used nationwide. The National Institute on Drug Abuse (NIDA) is funding development of new smoking cessation treatment approaches, including monoclonal antibodies, noninvasive brain stimulation, ketamine, psilocybin, etc. It is funding studies to identify individuals who would benefit from targeted prevention interventions, identify the role of vaping in combustible tobacco initiation and assess how social determinants influence risk for smoking behaviors and nicotine addiction. NIDA is prioritizing research addressing health disparities and ways to promote quitting in diverse populations, as well as to develop behavioral smoking interventions for adolescents. Agencies are also researching e-cigarettes, including effectiveness as harm reduction and effects of exposure to vapor.

Source: HHS on Smoking Cessation (Politico); NIDA supports research on novel approaches for smoking cessation (National Institute on Drug Abuse)

Schools expand naloxone access amid rise of fentanyl

Schools are increasingly working to expand access to naloxone. Partnership to End Addiction’s Vice President of Health Law and Policy, Lindsey Vuolo, explains that with the proliferation of fentanyl, it is important to have naloxone everywhere, and that there have been efforts to get it into schools, restaurants, bars, libraries, vending machines, etc. Questions are being raised on the message expanded naloxone sends to youth, but research shows that it does not enable or encourage substance use. The article links to Partnership’s article “Does Having Naloxone in My House Enable My Child to Use Opioids?,” and Vuolo explains that there is still stigma in schools. The National Association of School Nurses has endorsed naloxone in the school setting as part of emergency preparedness and response plans, and many schools are training school nurses, other staff and students.

Source: As overdoses climb, schools decide policies on Naloxone use (ABC Action News)

States reach settlement with Indivior

State attorneys general reached a $102.5 million multi-state settlement with Indivior, the maker of Suboxone, over its alleged monopolistic tactics. In 2016, a bipartisan group of 42 attorneys general filed a complaint alleging Indivior tried to preserve its monopoly by illegally switching the Suboxone market from tablets to film and attempting to destroy the market for tablets. Trial had been set for September 2023. The agreement will now be submitted to the court in the Eastern District of Pennsylvania for approval. In addition to the payment, Indivior is also required to comply with negotiated injunctive terms that include disclosing to the states all of the citizen petitions to the Food and Drug Administration, introduction of new products or if there is a change in corporate control. This information will help the attorneys general ensure that Indivior does not engage in the same alleged unlawful conduct again.

Source: Attorney General Josh Stein Announces $102.5 Million Settlement with Opioid Treatment Drugmaker (Attorney General Josh Stein)

Mayors highlight increased need for mental health services and toll of substance use

A U.S. Conference of Mayors survey of 117 cities found that 97% said requests for mental health services increased in their city over the last two years. 88% said they do not have adequate access to mental health resources to address the crisis. Substance misuse was identified most frequently as the main cause of the increased need for services, followed by COVID, homelessness, economic concerns and/or uncertainty and shortage of affordable housing. The top behavioral health problems were substance use disorder, homelessness stemming from mental illness, behavioral health workforce shortages and lack of access to behavioral health services. 82% reported developing new initiatives and/or increasing funding to established programs to address growing needs for mental health services within specific groups. At its annual conference, the U.S. Conference of Mayors adopted several resolutions, including ones on increased enforcement and public health interventions to address the fentanyl crisis, protecting youth from flavored tobacco products, addressing the national mental health crisis, supporting community crisis response programs, protecting the mental health of children on social media and prioritizing mental health services.

Source: SURVEY OF MAYORS: U.S. Conference of Mayors Releases New Data on Mental Health Crisis and City Responses (United States Conference of Mayors); 2023 Adopted Resolutions (United States Conference of Mayors)

Most people who inject drugs in NYC use fentanyl, but few report doing so intentionally

A study found that fentanyl was the most commonly used drug among people who inject drugs in New York City, with 83% of participants testing positive for it. However, only 18% reported recently using fentanyl intentionally. Most reported using heroin instead. Nearly one-quarter had overdosed at least once in the previous six months, with 36% of those who intentionally used fentanyl experiencing a recent overdose, compared to 21% of those who reported no recent fentanyl use but tested positive for it and 19% of those who reported no recent fentanyl use and tested negative for it. People who intentionally used fentanyl were more likely to be younger, white, use drugs more often and test positive for stimulants. Nearly all participants used strategies to prevent overdose, including keeping naloxone nearby, using smaller amounts of drugs, using drugs around others and having a trusted dealer. Increased access to naloxone and medications for opioid use disorder is needed, as well as increased support for and research on overdose prevention centers and other forms of opioid maintenance treatments.

Source: More Than 80% of People Who Inject Drugs Test Positive for Fentanyl—But Only 18% Intend to Take It (New York University)

Proposed methadone regulations need accompanying payment and financing reform to be effective

Proposed rules that would allow more flexibility at opioid treatment programs (OTPs) (e.g., increased take-home doses, relaxed entry requirements, expanded use of telehealth and mobile components) must be complemented by efforts to align payment with delivery system changes. Ways in which the current payment system for OTPs may not be aligned with the goals of the proposed rules include that payer reimbursement is not aligned with flexible take-home dosing; coverage policies are not aligned across payers; and Medicaid acceptance at OTPs and reimbursement policies are not aligned across states. Policymakers and payers could develop payment models that are aligned with the proposed regulations; address low Medicaid reimbursement rates for OTP services and low Medicaid acceptance at OTPs in some states by requiring a generous minimum level of reimbursement; reduce barriers to care by influencing private health plans to include in the benefit package methadone treatment at OTPs with minimal cost sharing and no prior authorization requirements; and map financing arrangements by payer types.

Source: New Methadone Treatment Regulations Should Be Complemented By Payment And Financing Reform (Health Affairs)

Ad Council study identifies barriers and facilitators to addiction treatment

An Ad Council Research Institute study identifies how to reach, encourage and support individuals open to treatment for substance use disorder (SUD). The results serve as the cornerstone for a new Ad Council campaign. Trauma was the most prevalent factor respondents pointed to as a reason they started and continue to use substances. 38% of respondents with a current SUD and 34% of those at risk do not think they can afford treatment or that their insurance would not cover it, making it the top reason respondents delay their decision to seek treatment, followed by not wanting to be a burden to friends/family and feeling they can cut back or handle things themselves. The top motivator was being present and healthy for their children, followed by to feel better and be healthier. Respondents open to treatment are most likely to consider mental health therapy/treatment or a support group if they decide to seek treatment, followed by detoxification/stabilization, medications for addiction treatment, outpatient and 12-step programs.

Source: Substance Use Disorders: New Research by the Ad Council Research Institute Outlines How Best to Reach, Encourage and Support those Open to Treatment (Ad Council)