Policy News Roundup: March 17, 2022

    Key reads

    2022 spending bill signed into law

    President Biden signed into law the Consolidated Appropriations Act, 2022 this week. The $1.5 trillion spending package includes billions of dollars to address mental health and addiction, including for prevention, treatment, research, bolstering the workforce and supply reduction. One provision gives the Food and Drug Administration authority over synthetic nicotine to help curtail youth vaping. Others extend the scheduling of fentanyl analogues and some telehealth flexibilities provided during the pandemic. It largely maintains the status quo on marijuana enforcement, preventing D.C. from establishing a regulated market and continuing to protect medical marijuana markets legal at the state level. See our summary for more detail on what is in the law.

    Source: What’s in the government spending law (CNN)

    Individuals impacted by the opioid crisis testify in front of the Sacklers

    More than two dozen Americans whose lives were upended by the opioid crisis gave statements in U.S. Bankruptcy Court in front of members of the Sackler family in a three-hour virtual hearing, as was recommended by the mediator in the Purdue case in the most recent settlement agreement. Richard, Theresa and David Sackler attended. People spoke about the pain of losing children after years of trying to get them adequate treatment, their own journeys through addiction and caring for babies born into withdrawal. Under court rules, the Sacklers were not allowed to respond to the victims, who were selected by lawyers for creditors in the case. Several speakers noted the lack of an apology from the Sacklers. Some called for prosecutors to pursue criminal investigations.

    Source: ‘Scum of the earth’: Drug victims face Purdue Pharma owners (Associated Press)

    Federal news

    Biden signs STANDUP Act and Methamphetamine Response Act into law

    President Biden signed into law the Suicide Training and Awareness Nationally Delivered for Universal Prevention (STANDUP) Act of 2021. The measure requires state, tribal and local education agencies that receive certain grants to establish and implement evidence-based suicide awareness and prevention training policies. It requires the federal government to provide best practices for these trainings. Biden also signed the Methamphetamine Response Act of 2021, which designates methamphetamine as an emerging threat. The bill requires the Office of National Drug Control Policy to develop, implement and make public a national response plan specific to methamphetamine.

    Source: Bills Signed: S. 1543, S. 1662, S. 3706; Bills Signed: H.R. 3665 and S. 854 (White House)

    Lawmakers introduce bill to end parity opt-out for state and local government health plans

    Sens. Murphy and Stabenow and Reps. Porter and Dingell introduced the Closing Health Coverage Gaps for Public Servants Act. This measure would sunset the ability for self-funded, non-federal government health care plans that cover firefighters, police, public school teachers and city and state workers to opt out of federal parity requirements. According to the Centers for Medicare & Medicaid Services, 180 out of 181 of these plans that have an opt-out do not have parity protections. Partnership to End Addiction, along with over 20 other organizations, have endorsed this bill to close a loophole that prevents many individuals from having necessary insurance protections.

    Source: Murphy, Stabenow, Porter, Dingell Introduce Legislation to Close Health Coverage Gaps for Public Servants, Expand Compliance with Mental Health Parity Laws (Chris Murphy)

    HHS OIG issues opinion in support of contingency management

    The Department of Health and Human Services Office of the Inspector General (OIG) issued an advisory opinion on digital contingency management and related tools to treat substance use disorder and whether such a program constitutes grounds for the imposition of sanctions. The opinion concluded that an app-based contingency management program developed by DynamiCare Health Inc., a digital therapeutics and telehealth company focused on addiction, will not incur a risk of sanctions under the Anti-Kickback Statute and Beneficiary Inducement Prohibition. This is the first time OIG has issued such an opinion for a nationally accessible contingency management program that offers patients the full-value, direct monetary rewards that research has shown to be effective. DynamiCare’s protocol allows up to $599 in monetary incentives per patient, despite a federal ceiling of $75 per patient per year.

    Source: HHS-OIG Issues Favorable Advisory Opinion on App-based Motivational Incentives for Substance Use Disorders (National Council for Mental Wellbeing)

    2.55 million youth reported using tobacco products in 2021

    The 2021 National Youth Tobacco Survey found that 2.55 million middle and high school students reported current use of a tobacco product. Among students who currently used tobacco products, about 1 in 3 used at least one type of combustible tobacco product, and about 3 in 10 used two or more tobacco products. E-cigarettes were the most common tobacco product currently used (2.06 million), followed by cigarettes (410,000). Current use was higher among students who identified as lesbian, gay, bisexual or transgender, those with symptoms of psychological distress and non-Hispanic Black students. Most reported using flavored products and exposure to tobacco product marketing/content through traditional and social media. Among those who used e-cigarettes, peer use and curiosity were the most cited reasons for first trying them. The most cited reasons for current use were feelings of anxiety, stress, or depression and the “high or buzz.” Most students currently using tobacco products reported seriously thinking about quitting.

    Source: Approximately 2.55 Million Students Reported Currently Using a Tobacco Product in 2021 (Centers for Disease Control and Prevention)

    State and local news

    First New York marijuana retail licenses will go to those convicted of a marijuana-related offense and their families

    New York announced that the first licensed marijuana retailers will be those who have been convicted of a marijuana-related offense or their family. The policy is part of an effort to ensure that early business owners in the industry will be members of the communities affected by the war on drugs. The state is trying to avoid pitfalls encountered in other states, which have seen “social equity” applicants and other mom-and-pop businesses struggle with lack of capital and competition from deep-pocketed corporate operations. Gov. Hochul has proposed $200 million in this year’s budget to support the businesses. Cannabis regulators advanced the first set of draft rules for the adult-use market, which will be open for public comment for 60 days before a final vote later this spring. The rules also lay the foundation for the Seeding Opportunity Initiative, which will include three programs that prioritize farmers and equity entrepreneurs.

    Source: New Yorkers With Marijuana Convictions Will Get First Retail Licenses (New York Times); Cannabis Board advances first adult-use regulations and aim for New York sales this year (Politico)

    Delaware launches program to educate restaurant industry staff about overdoses and addiction

    The Delaware Division of Public Health’s Office of Health Crisis Response launched a Restaurant Accolade Program to train and educate restaurant industry staff on how to reverse an opioid overdose and support coworkers with addiction. There are three levels of hands-on training to receive certification and recognition – bronze (key staff are trained to recognize signs of overdose, administer Narcan and connect with emergency medical services for additional assistance; all trained staff receive a personal Opioid Rescue Kit), silver (one or two individuals are trained to be peer supporters for their coworkers), and gold (general managers and human resources personnel receive training and support in developing policies and procedures to create an accepting environment for individuals in recovery, combat the stigma of addiction and promote a substance-free workplace).

    Source: DPH Announces Launch Of Restaurant Accolade Program To Address Substance Abuse Prevention, Opioid Overdose (Delaware News)

    North Carolina starting its first addiction psychiatry training program

    The Mountain Area Health Education Center (MAHEC) is starting an addiction psychiatry training program. It will train up to two psychiatrists in a yearslong fellowship. They will learn trauma-informed practices for managing addiction, as well as skills for identifying and effectively treating people with co-occurring mental health and substance use disorders. There are only about 50 other addiction psychiatry fellowships nationwide, and just two others located in rural regions. The fellows will train and work alongside people in MAHEC’s more generalized addiction medicine program, which trains family medicine doctors and others how to manage the physical issues that often accompany substance use disorder, such as treating infections and withdrawal symptoms.

    Source: NC will soon have its first addiction psychiatry training program (North Carolina Health News)

    Other news in addiction policy

    Misleading news coverage of research findings poses threat to youth wellbeing

    In a commentary, Partnership to End Addiction’s Robyn Oster (Senior Research Associate, Health Law and Policy) and Linda Richter (Vice President, Prevention Research and Analysis) outline the threat to youth health and wellbeing posed by misleading news coverage of research on youth mental health and addiction. Summaries of research findings that minimize a real and ongoing problem, exaggerate the severity of a problem or distort the cause of a problem can lead scarce attention and resources to be diverted away from pressing issues and their solutions.

    Source: Misleading News Coverage of Research Findings Poses a Risk to Youth Mental Health and Safety (Journal of Adolescent Health)

    Telehealth plays a large role in mental health and addiction care during the pandemic

    An analysis of outpatient visits during five six-month periods between March 2019 and August 2021 found that mental health and substance use disorder (MH/SUD) services via telehealth have remained elevated (36% of outpatient visits) during the pandemic, while other outpatient care by telehealth has declined (5% of outpatient visits). The analysis used a data set of more than 126 million patients from over 156 Epic organizations, including 889 hospitals and 19,420 clinics across all 50 states. Telehealth use for MH/SUD continues to grow as a share of all telehealth visits (from 11% to 39%) due to the increase in need as a result of the pandemic and the return to in-person visits for other outpatient care. Rural residents are more likely to use telehealth for MH/SUD visits, and non-elderly adults consistently used telehealth to access MH/SUD services. Telehealth use is significant across major MH/SUD conditions. See also this policy brief, which summarizes statutes/regulations governing telehealth for addiction and COVID federal regulatory flexibilities.

    Source: Telehealth Has Played an Outsized Role Meeting Mental Health Needs During the COVID-19 Pandemic (Kaiser Family Foundation)

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    March 2022