Policy News Roundup: October 24, 2024

Youth tobacco use hits 25-year low

The main point: According to the 2024 National Youth Tobacco Survey, tobacco use among middle and high school students is at a 25-year low, but disparities persist.

The stats:

• Current use of any tobacco product was reported by 10.1% of high school students (1.58 million) and 5.4% of middle school students (640,000). It was highest among American Indian/Alaska Native students.
• E-cigarettes were the most commonly reported tobacco product currently used (5.9%). They were followed by nicotine pouches (1.8%), which were the second most commonly used tobacco product for the first time. Cigarettes (1.4%) were at the lowest prevalence ever recorded by the survey. They were followed by cigars, smokeless tobacco, other oral nicotine products, heated tobacco products, hookahs and pipe tobacco.
• From 2023 to 2024, declines occurred in current use of any tobacco product, e-cigarettes and hookahs. Current use of any tobacco product declined by an estimated 550,000 students, largely driven by the decline in high school e-cigarette use, which dropped to the lowest level in a decade.

But:

• Approximately 1 in 12 students still reported current use of any tobacco product in 2024.
• Use of most tobacco products increased among American Indian/Alaska Native students, while decreasing or remaining stable for all other racial/ethnic groups. Current use of nicotine pouches increased among white students.
• E-cigarettes remained the most commonly used tobacco product for the 11th year in a row.

Source: Tobacco Product Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2024; Youth Tobacco Product Use at a 25-Year Low, Yet Disparities Persist (Centers for Disease Control and Prevention)

The news: According to provisional data from the Centers for Disease Control and Prevention, the 12-month period ending May 2024 represented the largest recorded reduction in overdose deaths over the prior year and the sixth consecutive month of reported decreases.

The stats:

• There were a predicted 98,820 overdose deaths, a 12.7% decrease from the 12-month period ending May 2023.
• This includes a predicted 72,755 opioid deaths (including 66,545 deaths from synthetic opioids), 34,298 deaths involving psychostimulants with abuse potential (methamphetamine) and 28,060 involving cocaine.

In the states:

• All but 9 states and D.C. experienced decreases.
• North Carolina reported the largest change in overdose deaths, seeing a 48.8% drop. Nebraska, Pennsylvania, Michigan, Ohio, Oklahoma, Virginia, Delaware and New Jersey also reported at least a 21% decrease.
• But: Several Western states reported increases. Alaska led with a 36.1% increase, and Oregon, Nevada, Utah and Washington saw 5-15% increases. Colorado, D.C., Hawaii, Montana and Wyoming also saw increases.

The main point: While continued reports of decreased overdose deaths show progress in addressing the crisis, there is a lot more work to do, with nearly 99,000 deaths annually.

Source: White House Drug Policy Director Statement on Latest Drug Overdose Death Data (Office of National Drug Control Policy); CDC reports record drop in drug overdose deaths (Roll Call)

KFF released an issue brief on substance use and overdose trends among adolescents.

The findings:

• Overdose deaths: Adolescent drug fatalities more than doubled in recent years due to opioids, but slightly decreased by the end of 2023.
• Fentanyl: Fentanyl overdose deaths increased by 2% from 2022-2023, marking the smallest annual increase since the start of the pandemic. In 2020, adolescent overdose deaths involving fentanyl increased by 177%. The share of overdose deaths involving fentanyl increased faster among adolescents than adults in recent years, though the number and rates remain much lower among adolescents.
• Social media: Adolescents may obtain drugs through social media, and these drugs are often contaminated with fentanyl. The National Crime Prevention Council estimates that 8 in 10 teen and young adult fentanyl overdose deaths are associated with social media contact.
• Substance use: Despite the increase in overdose deaths in recent years, adolescent use of drugs and alcohol has declined slightly.
• Prevention: More than 6 in 10 adolescents report receiving information on drug and alcohol use disorder and prevention in school. A similar share viewed messages on substance use prevention outside of schools, while approximately half spoke with their parents on substance use harms, and 7% participated in prevention programs outside of school.
• Treatment: In 2023, only 2 in 10 adolescents with substance use disorder received treatment in the past year. Among adolescents, treatment was more commonly received in an outpatient setting, followed by an inpatient setting. Many residential facilities do not accept adolescent patients, and facilities that do may not have beds available. Few facilities provide buprenorphine to adolescents.

Recent efforts in response to the adolescent drug crisis include:

• The Biden administration allocated $94 million to community efforts to prevent youth overdoses via the Drug Free Communities Support Program, and the Bipartisan Safer Communities Act expanded behavioral health services in schools.
• Many states have policies allowing schools to stock naloxone, but only a few require it. Some states have passed legislation that integrates fentanyl education into school curricula.
• Outside of schools, policymakers are attempting to address adolescent substance use through online safety legislation.

The main point: Prevention efforts are proving effective, with substance use decreasing among adolescents. But with the increasing potency of drugs due to fentanyl, overdose deaths have been increasing.

Source: Teens, Drugs, and Overdose: Contrasting Pre-Pandemic and Current Trends (KFF)

The Sacklers are signaling that they intend to fight the lawsuits filed against them by challenging the use of public nuisance laws.

What happened: Attorneys for the family disclosed their lines of defense as part of a court filing in the Purdue bankruptcy case.

• The Sacklers argue that public nuisance claims cannot be established against Purdue, pointing to a handful of court rulings around the country that found the laws do not apply to the misuse of opioids prescribed lawfully by doctors.

The details: The strategy has a mixed track record in trials.

• In 2021, the Oklahoma Supreme Court overturned a judge’s decision in a trial against Johnson & Johnson, ruling the public nuisance law does not apply. In 2022, a federal judge in West Virginia ruled that the three major distributors did not cause a public nuisance, and the state Supreme Court is considering an appeal.
• But: Federal courts in California and Ohio have found opioid companies liable under public nuisance claims, as did a New York jury that ruled against Teva. Baltimore is in trial against McKesson and Cencora (AmerisourceBergen), using public nuisance claims.

Why it’s important:

• If a new settlement deal is not struck (after the Supreme Court struck down a plan), lawsuits against the Sacklers may proceed and offer high-profile tests of the novel strategy of going after opioid companies using public nuisance laws.
• This is the first time the Sacklers have publicly outlined their defenses since Purdue filed for bankruptcy. It suggests they are digging in for protracted litigation even as settlement talks continue through November 1.
• It is not clear what relief for states or individuals would look like in a new settlement or if the case goes to trial.

Source: Sacklers lay out strategy for defending opioid-related lawsuits (The Washington Post)