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    Policy News Roundup: March 21, 2024

    Key reads

    OTPs are increasingly backed by private equity and opposing expansion of methadone

    Private equity firms have acquired stakes in nearly one-third of all methadone clinics in recent years, gaining outsize control of the U.S. addiction treatment industry. While 20 years ago, most opioid treatment programs (OTPs) were run by state and tribal governments or local nonprofits, now, 65% are operated by for-profit companies. The addiction crisis has also sparked a private-equity gold rush. There are increasing calls from lawmakers, patients and experts to expand methadone availability beyond OTPs. In the past two years, large clinic chains backed by private equity firms have launched a lobbying blitz aimed at preserving their exclusive right to dispense methadone. OTPs backed by private equity maintain that the investments have filled a major shortfall in government funding and that their opposition to expanding methadone availability is based on safety concerns. But the shift toward private-equity-backed-treatment raises questions about whether OTPs’ advocacy is geared more toward protecting profits or improving public health.

    Source: The methadone clinic monopoly: Opioid treatment chains backed by private equity are fighting calls for reform (STAT)

    Federal news

    VP Harris hosts marijuana reform roundtable

    Vice President Harris convened a roundtable on marijuana reform with rapper Fat Joe, Kentucky Gov. Beshear and individuals who received pardons for marijuana convictions. Harris said, “nobody should have to go to jail for smoking weed” and that “far too many people have been sent to jail for simple marijuana possession.” Harris called on the Department of Health and Human Services and Department of Justice to hasten the reclassification of marijuana. She said, “Marijuana is considered as dangerous as heroin and more dangerous than fentanyl, which is absurd, not to mention patently unfair.” Harris highlighted the administration’s pardoning of federal marijuana possession charges and call for rescheduling, as well as other criminal justice and reentry reforms, efforts around clemency and efforts to shorten some of the excessive crack cocaine sentences.

    Source: Harris to host marijuana reform roundtable with Kentucky governor, rapper Fat Joe (The Hill); No one should go to jail for ‘smoking weed,’ VP Harris says at White House (Reuters); Remarks by Vice President Harris in a Roundtable Conversation about Marijuana Reform (White House)

    Biden signs END FENTANYL Act into law

    President Biden signed into law the Eradicating Narcotic Drugs and Formulating Effective New Tools to Address National Yearly Losses of life (END FENTANYL) Act. The measure requires U.S. Customs and Border Protection to review and update manuals and policies related to inspections at ports of entry to ensure the effective detection of illegal smuggling of substances and humans along the border.

    Source: Press Release: Bills Signed: S. 206, S. 1858 (White House)

    State and local news

    Even without a drug-induced homicide law, California prosecutors are increasingly filing murder charges in fentanyl deaths

    Few places are as aggressive as Riverside County, California, in prosecuting people who supply fatal doses of fentanyl. Since late 2021, the County district attorney has charged 34 suspected fentanyl suppliers with murder and is said to be the first prosecutor in California to achieve a guilty verdict from a jury in a fentanyl-related homicide trial. Riverside leans conservative, tending to favor more punitive approaches to crime. But even in liberal San Francisco, the district attorney’s office has been preparing to investigate fentanyl deaths as possible homicides. Prosecutors have been working around the fact that, unlike many other states, California does not have a law that specifically allows fentanyl deaths to be charged as murders. Prosecutors have borrowed from a legal theory used to prosecute drunk drivers. Of the 34 cases where murder charges have been filed in connection with fentanyl deaths in Riverside, only one has resulted in a murder conviction by a jury; another resulted in an involuntary manslaughter conviction, and six others resulted in plea deals reducing the charges to voluntary manslaughter.

    Source: California Prosecutors Filing Murder Charges in More Fentanyl Deaths (The New York Times)

    Huntington and Cabell County public nuisance opioid case to be reviewed by WV state Supreme Court

    A U.S. appeals court sent Huntington and Cabell County, West Virginia’s bid to revive their $2.5 billion lawsuit against opioid distributors to the state’s highest court. Huntington and Cabell County had urged the appeals court to overturn a lower court’s ruling rejecting their case. The panel ruled that the West Virginia Supreme Court must first decide whether the distributors can be liable under the state’s law for creating a “public nuisance” by flooding the region with pills. The lower court judge had ruled in 2022 that the state’s public nuisance law covered only conduct that directly damages public property or resources, not harm caused by drug sales. The appeals court said that whether the case can be revived depends on interpreting state law, and therefore, the question of whether the public nuisance law covers harm from opioid sales must go to the state Supreme Court.

    Source: 4th Circuit sends West Virginia city’s opioid case to state’s top court (Reuters)

    NY governor orders review of state's marijuana licensing amid frustrations with rollout

    New York Governor Hochul told New York officials to come up with a fix for the way the state licenses cannabis businesses amid widespread frustration over the slow rollout and explosion of unlicensed dispensaries. The governor ordered a top-to-bottom review of the state’s licensing bureaucracy. The main goal of the review, to be conducted by the commissioner of the Office of General Services, is to shorten the time it takes to process applications and get businesses open. The Office of Cannabis Management, which recommends applicants to the board for final approval, received 7,000 applications for licenses last year, but regulators have awarded just 109 so far this year. The agency has just 32 people assigned to evaluate the applications.

    Source: New York Must Figure Out How to Fix Cannabis Mess, Hochul Orders (The New York Times)

    Massachusetts governor proposes pardon of marijuana possession misdemeanors

    Massachusetts Governor Healey proposed a blanket pardon of misdemeanor marijuana possession convictions in the state. The pardons will be mostly automatic and could potentially clear the charge from hundreds of thousands of people’s records. The proposal still needs approval from the Governor’s Council, which is comprised of all Democrats and has a record of backing Healey’s past requests for clemency for certain individuals. Four of the seven current members have already expressed support for the marijuana pardons. Biden granted a pardon to all people convicted of simple marijuana possession under federal law in 2022 and urged governors to take similar action for state offenses.

    Source: Massachusetts governor proposes sweeping marijuana pardons (Politico)

    Pennsylvania health department offering new virtual trainings on the overdose crisis

    The Pennsylvania Department of Health announced several new virtual training opportunities to help prevent unintentional overdoses. The online modules are free and include continuing education credits for health care providers that may meet various licensing requirements. The programs are tailored to different audiences and include offerings such as the Pennsylvania Substance Use Navigation programs’ newest additions to aid health care providers and care teams in emergency departments in increasing knowledge on topics such as harm reduction, buprenorphine initiation, linkage to care and stigma; strategies for improving maternal and infant health related to opioid use for health care providers who treat pregnant and postpartum women; the care team’s role in providing evidence-based care to people with opioid use disorder; evidence-based opioid prescribing in dentistry; and addiction and connection to treatment resources for child welfare professionals.

    Source: Department Of Health Offers New Training To Fight The Overdose Crisis (Pennsylvania Pressroom)

    Other news in addiction policy

    Positive childhood experiences can have an important protective effect

    Just as adverse childhood experiences (ACEs) can have a detrimental impact on a child’s long-term health, positive childhood experiences (PCEs) that cultivate a sense of stability, safety and connectedness have a protective effect and can neutralize some of the damage caused by toxic stress. However, ACEs get far more attention than PCEs, which may give adults the false impression that prevention is the only way to mitigate health consequences of ACEs. Studies have found that the more positive experiences a person has to counterbalance trauma and adversity, the better the outcomes. PCEs include the ability to talk with family about feelings, feeling supported by family in difficult times, joyfully participating in community traditions, having a sense of belonging in high school and feeling supported by friends, having at least two non-parent adults who care and feeling safe and protected by an adult at home. It is important for physicians to understand the power of PCEs and begin discussing them with patients.

    Source: The harms of adverse childhood experiences are well-known. But positive experiences can affect future health, too (STAT)

    Endo wins approval for bankruptcy plan, including opioid settlements

    Endo won court approval on a Chapter 11 exit plan that cuts debts, settles government claims and resolves thousands of lawsuits accusing the company of helping fuel the U.S. opioid crisis. Court approval of Endo’s plan comes weeks after the company agreed to pay the U.S. government as much as $465 million over the next decade to settle criminal and civil claims over its sales and marketing of Opana ER. Endo is expected to pay individual opioid victims between $89.7 million and $119.7 million, as well as $273 million to more than 40 states. A committee representing opioid victims said that before Endo filed bankruptcy, the company also paid about $240 million to states, public entities and an opioid victim with neonatal abstinence syndrome.

    Source: Bankrupt Drugmaker Endo Wins Approval on Opioid Settlements, Restructuring (Bloomberg)


    March 2024