Policy News Roundup: May 5, 2022

    Key reads

    Fentanyl test strips allowed by more states, though still limited

    States are increasingly allowing and providing fentanyl test strips. Georgia, Tennessee and Alabama recently passed bills that would decriminalize the use of fentanyl test strips, and New Mexico and Wisconsin enacted laws this year. Pennsylvania state law still prohibits test strips, but the Philadelphia and Pittsburgh mayors have ordered bans on prosecuting people possessing them, and the state attorney general said he will not charge people for possession. Alaska health officials distribute free test strips, and a vending machine in Ohio offers them alongside naloxone. South Carolina has made the strips available and sends a survey to anyone that receives them. The survey finds that people who use the strips report using fewer drugs, with some choosing not to use the drugs altogether, and that they feel safer in preventing overdoses. However, the Florida legislature balked this year at a bill that would decriminalize test strips, and fentanyl test devices remain illegal in about half of states.

    Source: More states allow fentanyl test strips as a tool to prevent overdoses (CNN)

    FDA issues proposed rules banning menthol cigarettes and flavored cigars

    The Food and Drug Administration (FDA) announced proposed product standards to prohibit menthol as a characterizing flavor in cigarettes and prohibit all characterizing flavors (other than tobacco) in cigars. This has the potential to reduce disease and death from tobacco use by reducing youth use and increasing the number of smokers who quit. In 2019, there were more than 18.5 million current menthol cigarette smokers, with particularly high rates of use by youth, young adults and African American and other racial/ethnic groups. More than half a million youth in the U.S. use flavored cigars. In recent years more young people tried a cigar every day than tried a cigarette. The FDA cannot and will not enforce against individual consumers for possession, but only against manufacturers, distributors, wholesalers, importers and retailers. Public comments will be open through July 5, and the FDA will hold public listening sessions on June 13 and 15.

    Source: FDA Proposes Rules Prohibiting Menthol Cigarettes and Flavored Cigars to Prevent Youth Initiation, Significantly Reduce Tobacco-Related Disease and Death (Food and Drug Administration)

    Federal news

    Substance use prevention is important and cost-effective

    National Institute on Drug Abuse Director Nora Volkow explains the importance and financial sense of prevention. Primary prevention is relatively inexpensive. The higher-risk behaviors it is designed to reduce are so costly to the health care system that it is wasteful not to make sure that screening and treatment referral are readily implemented and reimbursed by insurers and that interventions are convenient for parents and their children. Greater investment in youth prevention would yield savings not just in health care, but also in public safety and the criminal justice system, behavioral health, education, etc. Communities, schools and health care systems have scientifically well-supported tools to help prevent substance use and risk behaviors in adolescence, but they are seldom implemented.

    Source: Investing in Prevention Makes Good Financial Sense (National Institute on Drug Abuse)

    May is National Adolescent Health Month and Mental Health Awareness Month

    This month is the first-ever National Adolescent Health Month. It will focus on weekly themes: empower youth with sexual and reproductive health information and services, support mental health and wellbeing, encourage physical health and healthy decision-making, and sustain equitable, accessible and youth-friendly services. This month is also Mental Health Awareness Month. The Department of Health and Human Services released a fact sheet on its efforts over the past year, including in the areas of strengthening the behavioral health workforce, expanding crisis care and suicide prevention, enforcing parity, fostering behavioral and primary health care integration, addressing substance use disorder and overdose prevention, expanding tele-behavioral health services and addressing youth mental health.

    Source: Statements by HHS Secretary Xavier Becerra, Assistant Secretary for Health Admiral Rachel Levine, and Deputy Assistant Secretary for Population Affairs Jessica Marcella on the Inaugural National Adolescent Health Month (Department of Health and Human Services); Secretary Becerra and HHS Leaders Recognize Mental Health Awareness Month 2022 (Department of Health and Human Services)

    HRSA awards funding for school-based health services

    The Health Resources and Services Administration awarded nearly $25 million to improve and strengthen access to school-based health services. Awards will support local partnerships between schools and health centers to provide youth with comprehensive physical and mental health care. Health centers will use the funding to reduce disparities and improve access to care by increasing the number of young people receiving essential health care, including mental health services. They will also use the funds for community and patient outreach, health education and translation support.

    Source: HHS Awards Nearly $25 Million to Expand Access to School-Based Health Services (Department of Health and Human Services)

    ONDCP announces new funding for HIDTA program

    The Office of National Drug Control Policy announced $275 million for the High Intensity Drug Trafficking Area (HIDTA) Program. The funds will provide additional resources to 33 regional HIDTAs working to reduce violence associated with drug trafficking, improve interdiction efforts through enhanced data sharing and targeting, and dismantle illicit finance operations. The funding will also support public health and safety partnerships like the Overdose Detection Mapping Application Program (ODMAP), an overdose surveillance tool, and the Overdose Response Strategy, a partnership between HIDTA and the Centers for Disease Control and Prevention that works to reduce overdoses.

    Source: To Support New Strategy, ONDCP Announces $275 Million to Disrupt Drug Trafficking, and Illicit Finance (Office of National Drug Control Policy)

    Major food brands ask Congress to address marijuana-infused products mimicking their brands

    A dozen major food and beverage companies, including Pepsi, General Mills and Kellogg, called on Congress to do more to prevent the proliferation of marijuana-infused copycat products that mimic their brands. They want to broaden an existing law, the Shop Safe Act, so that THC-laced products that simulate the “famous marks” of known brands would be considered counterfeit. The change would make it clear that products that loosely spoof well-known products are prohibited for sale online under the law if they “implicate health and safety.” Look-alike packaging is often sold online, making the products harder to regulate or stamp out. In many cases, there are new companies whose sole mission is to make spoof packaging. Cannabis producers buy the empty bags online and fill them with drug-infused product. Many of the copycat packages list no manufacturer, so tracing them is hard.

    Source: Major food brands seek crackdown on marijuana-infused copycats (Washington Post)

    State and local news

    Amid rise in high-potency marijuana products, states reconsider warnings and potency caps

    New high-potency marijuana products (marijuana concentrates) can have levels of THC as high as 85-90%, while marijuana in a typical joint 20 years ago was closer to 5%. States like Washington and Colorado that legalized marijuana 10 years ago are now considering product warnings or potency caps to limit access. Some public health experts have complained that industry backers of legalization focus on the cannabis plant and fail to mention that legalization will be accompanied by a flood of cannabis concentrates. The new high-THC products are not legal for those under 21 in states with recreational marijuana, but teens say they are easily accessible. Vermont is the only state with legal recreational marijuana that has a potency cap. Efforts in South Dakota and Massachusetts to impose them have failed.

    Source: States that legalized marijuana now researching mental health risks of high-potency cannabis (NBC)

    Three state opioid settlements raise concerns about naloxone shortages

    Recent opioid settlement agreements Teva struck with three states (Texas, Florida and Rhode Island) could create shortages of treatment and opioid reversal drugs elsewhere. As part of the settlements, Teva agreed to give the states more than $220 million-worth of naloxone and other opioids treatments in lieu of monetary compensation. Reps. Marcy Kaptur of Ohio and Andy Harris of Maryland sent a letter asking Attorney General Garland whether such agreements could squelch competition in the treatment market and how they square with the Department of Justice’s antitrust enforcement efforts. The lawmakers are concerned that the settlements, which span 10 or 15 years, will stifle innovation in the space.

    Source: Settlements could lead to naloxone shortages (Axios)

    Washington reaches settlement with opioid distributors

    Washington reached a $518 million settlement with McKesson, AmerisourceBergen and Cardinal Health. McKesson will pay $197 million, and AmerisourceBergen and Cardinal will each contribute $160.5 million. Washington had opted out of the $26 billion nationwide settlement, through which it would have received $417.9 million. The settlement will become final if all localities agree to participate before a September deadline. If finalized, payments would be spread over 17 years. The state is expected to go to trial against Johnson & Johnson in September.

    Source: Opioid distributors reach $518 mln settlement with Washington state (Reuters)

    Other news in addiction policy

    Integrating behavioral and physical health would be beneficial to insurers

    A Moody’s report found that mental and behavioral health conditions account for a growing segment of health care costs, and insurers have a significant opportunity to address these expenses and drive down costs. Health care costs for people with behavioral health conditions are 3.5 times higher than for those without. Annual health care costs for patients with behavioral health needs are $12,272, with just 7.9% specifically for behavioral health. Insurers that move more quickly to integrate behavioral health into physical health programs will have an opportunity for a competitive advantage in the long term. Several insurers have made acquisitions of behavioral health companies. Getting better at identifying behavioral health needs is a key priority for many health plans. Other strategies involve enhancing virtual care options and including behavioral health conditions in value-based care models.

    Source: Moody’s: Why focusing on behavioral health could give insurers a leg up on the competition (Fierce Healthcare)

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    May 2022