Policy News Roundup: October 21, 2021

    Key reads

    More than 96,000 people died of an overdose in a 12-month period, a new record

    More than 96,000 individuals died from an overdose in the 12-month period ending March 2021, a new high. In that time, the period when the COVID-19 pandemic took hold, the U.S. saw a nearly 30% increase in overdose deaths over the prior 12 months. These numbers from the Centers for Disease Control and Prevention (CDC) are provisional, and the CDC estimates that there will be over 99,000 deaths for the period once delayed reporting is accounted for. Overdose deaths increased in every state except for New Hampshire, New Jersey and South Dakota. Vermont had the largest increase in overdose deaths. Opioids, and particularly synthetic opioids, accounted for the highest number of overdose deaths.

    Source: US reaches record high of more than 96,000 drug overdose deaths in a 12-month period, CDC data show (CNN)

    Racial inequities persist in addiction treatment

    In a paper published in a recent American Academy of Addiction Psychiatry newsletter, Fabiola Arbelo Cruz, M.D., writes how racism has led minoritized groups to be historically and systematically excluded from access to addiction treatment. Black people are less likely to receive addiction treatment and are more likely to be arrested for drug possession. Racism in punitive drug policies has created stigma and criminalization of addiction and addiction treatment. Partnerships with local organizations and leaders are critical to increase trust and decrease stigma against treatment. Cruz writes that community engagement and partnership can help develop treatment that is culturally responsive. Individuals should receive treatment that is responsive to cultural, psycho-behavioral and social needs to minimize lapses in treatment and ensure retention. At the institutional and organizational level, we must increase the number of specialists trained to provide marginalized and minoritized populations with culturally responsive care.

    Source: Racial Inequities in Treatments of Addictive Disorders (Yale School of Medicine)

    Federal news

    Biden administration working to improve care for youth mental health and substance use

    The Biden-Harris administration has undertaken several initiatives since taking office to improve access to care for youth mental health and substance use. It is working on several programs that aim to ensure access to quality, affordable health care; invest in community-based youth mental health and substance use care; increase school-based behavioral health supports; lay the groundwork for future improvements in youth mental health and substance use prevention and treatment; enhance coordination across the Department of Health and Human Services; and highlight the pandemic’s impact on youth mental health.

    Source: Fact Sheet: Improving Access and Care for Youth Mental Health and Substance Use Conditions (White House)

    FDA approves new naloxone product

    The Food and Drug Administration (FDA) approved ZIMHI, a naloxone injection, as an additional option to treat opioid overdose. It is administered using a single-dose, prefilled syringe that delivers 5 mg of naloxone hydrochloride solution through intramuscular or subcutaneous injection. The FDA has previously approved injectable naloxone products in 0. 4mg and 2 mg doses under the brand name Narcan.

    Source: FDA approves naloxone injection to counteract opioid overdoses (Food and Drug Administration)

    FDA gives marketing authorization to oral tobacco products no longer sold

    The Food and Drug Administration (FDA) gave marketing authorization orders for four smokeless tobacco gums and chews after determining that they are appropriate for the protection of public health. Verve, the Altria company that makes the products, hasn’t sold them since early 2019. Altria said it applied the learnings from the application to its other oral nicotine pouch submissions, which remain under FDA review.

    Source: FDA Permits Marketing of New Oral Tobacco Products through Premarket Tobacco Product Application Pathway (Food and Drug Administration); FDA clears tobacco product…that no longer exists (Politico)

    Supreme Court declines to hear safe injection site case

    The United States Supreme Court decided it will not review Safehouse’s effort to open a supervised injection site in Philadelphia, a setback for the two dozen states and cities that supported the petition. A divided U.S. appeals court had rejected the Safehouse plan in January. Safehouse says the fight is not over and hopes to prevail on religious grounds by arguing that their faith compels them to try to save lives.

    Source: US Supreme Court won’t hear dispute over injection sites (Associated Press)

    State and local news

    Judges keep Purdue bankruptcy settlement moving on its current path

    In a surprise ruling, a federal judge allowed work to continue on implementation of Purdue’s bankruptcy plan. During an earlier hearing, the judge had signaled support for a stay, but in her subsequent ruling, she said work on the settlement can go forward. She said the only steps being taken are preliminary and administrative and would not commence consummation of the plan itself. Appeals courts have historically been reluctant to second-guess federal bankruptcy settlements once they have been partially consummated, a procedural roadblock known as “equitable mootness.” The judge acknowledged that equitable mootness was a serious concern and ordered supporters of the plan to enter written agreements that they will not try to block an appeal using the argument. The U.S. Trustee and several states also lost their bid to take their challenges of the settlement directly to a higher appeals court, with the bankruptcy court judge saying the challenge should remain with a federal district judge for now.

    Source: Federal judge rejects a government bid to delay Purdue Pharma’s bankruptcy settlement (NPR); Purdue Opioid Deal Appeal Will Stay With District Court for Now (Bloomberg Law)

    Governor Newsom vetoes bill that would have allowed billboard cannabis ads

    California Governor Gavin Newsom vetoed legislation that would have permitted cannabis ads on billboards along interstate freeways and state highways that cross state borders, except within 15 miles of another state. In his veto message, Newsom said that allowing such ads could expose young passengers to cannabis advertising. A judge ruled in November that California officials exceeded their authority when they allowed cannabis businesses to advertise on billboards along the state’s interstate freeways in violation of Proposition 64, the legalization initiative. State officials interpreted Proposition 64’s provision barring ads on interstate highways as meaning they could ban billboards within 15 miles of the state border but allow them elsewhere. The judge’s ruling was in response to a lawsuit filed by a father who expressed concern about his children’s exposure to the ads. This bill would have overridden the judge’s ruling.

    Source: Newsom vetoes bill that would have allowed cannabis advertising on freeway billboards (Los Angeles Times)

    Other news in addiction policy

    Pediatric groups declare youth mental health a national emergency

    The American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and the Children’s Hospital Association declared a National State of Emergency in Children’s Mental Health. The declaration calls on policymakers and advocates to join in the declaration and advocate for the following: increase federal funding to ensure access to evidence-based mental health screening, diagnosis and treatment; address regulatory challenges and improving access to technology to assure continued availability of telemedicine; increase implementation and sustainable funding of effective models of school-based mental health care; accelerate adoption of effective and financially sustainable models of integrated mental health care in primary care pediatrics; strengthen youth suicide prevention programs in schools, primary care and community settings; address the challenges of acute care needs, including shortage of beds and emergency room boarding; fund comprehensive, community-based systems of care; promote and pay for trauma-informed services; accelerate strategies to address workforce challenges; and advance policies that ensure compliance with and enforcement of parity laws.

    Source: AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health (American Academy of Pediatrics)

    FDA e-cigarette marketing authorization lacks key provisions to protect public health

    The Food and Drug Administration’s (FDA) authorization order for Vuse e-cigarettes does not adequately protect public health. It requires age verification only to prevent digital sales/advertising from reaching those under 21, but not adults who do not use tobacco. It only restricts television and radio advertising to programs for which youth are not more than 15% of the audience, rather than prohibiting all such advertising. The order allows marketing through manufacturer-supported partners, influencers, bloggers or brand ambassadors. It does not prevent encouraging celebrities, social media stars, bloggers and others to post about using Vuse on youth-accessible social media. The order notes that RJ Reynolds intends to use additional measures to reduce youth appeal, but it does not actually require implementation. It also encourages, but does not require, limiting ads to print publications where 85% of readership is over 21. It requires labeling to state that the product contains nicotine, which can be addictive. The labeling will not state that the product is for adult use only as a smoking substitute, nor will the products be sold with instructions for using the product to reduce harms.

    Source: FDA’s First PMTA Order Allowing the Legal Marketing of an E-Cigarette Is Seriously Flawed (Georgetown University O’Neill Institute for National and Global Health Law)

    Ask your members of Congress to support the Medicaid Reentry Act

    Ask your members of Congress to support the Medicaid Reentry Act (H.R. 955/S. 285), which would allow states to restart Medicaid benefits for eligible individuals 30 days prior to release from incarceration. The bill would make it easier for individuals to access affordable addiction treatment, allow for transitions to community-based services and reduce the risk of overdose following release.

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    October 2021