Policy News Roundup: September 22, 2022

Key reads

Study shows substance use varies based on how youth spend their time

A study using 1991-2019 Monitoring the Future data found that while substance use has generally declined among teenagers over time, marijuana use and vaping have increased. Substance use varied based on how teens spent their time, however. Substance use rates were highest among teens who had a job or who spent a lot of time with friends, without adult supervision, and lowest among kids who did not socialize much or who took part in structured activities. Partnership to End Addiction’s Vice President of Prevention Research and Analysis Linda Richter explains that in addition to changes in the way kids spend their time, education/prevention has improved over time, though commercialization of cannabis and vaping have contributed to increased use of those substances. She noted that research shows that when young people are engaged in activities they enjoy and feel are meaningful, they have less reason for substance use. Parents do not need to over-schedule their children, but their presence is important.

Source: U.S. Teens’ Drinking, Smoking Declines While Vaping & Pot Use Keep Rising (HealthDay)

Parity legislative efforts are hitting roadblocks

Parity has become a priority for more lawmakers, but senators are encountering stiff headwinds. In working to create a mental health legislative package, the Senate Finance Committee announced five focus areas, including insurance coverage, earlier this year. The committee released discussion drafts on two of the less controversial areas, telehealth and youth mental health, but enforcing parity is prompting resistance from insurer and employer groups. One sticking point is proposed financial penalties on insurers that violate parity requirements already in law. Republicans have “jurisdictional concerns” because the Senate Health, Education, Labor and Pensions Committee shares jurisdiction with Finance. If insurers have to cover more mental health care, premiums and costs could rise, leading to opposition from employers in addition to insurers. Mental health legislation could be included in an anticipated year-end omnibus spending deal but is not likely to be rolled into this month’s continuing resolution.

Source: Push for mental health parity hits turbulence (Axios)

Ways & Means Committee passes bills on mental health and insurance

The House Ways and Means Committee held a markup of and passed out of committee health and worker and family support legislation. The bills include Improvements to Medicare Inpatient and Outpatient Mental Health Services; Improvements to the Medicare Program Related to Physician Services and Education; Improved Information in Provider Directories, Plan Definitions, and Crisis Services for Private Insurance Plans; and Improved Information for Network Coverage and Plan Documents in Private Insurance Plans. They would improve Medicare coverage for behavioral health services, require insurers to maintain accurate provider directories and disclose information on their networks and set benchmarks for behavioral health coverage and increase information for beneficiaries on required and available benefits.

Source: Markup of Worker and Family Support and Health Legislation (Ways & Means Committee)

Representatives host Recovery Month press conference and Congress Goes Purple

Representatives David Trone (D-MD), Brian Fitzpatrick (R-PA), Annie Kuster (D-NH), and Madeleine Dean (D-PA), along with Mobilize Recovery, Caron Treatment Centers, and other community leaders hosted a Recovery Month press conference last week. It addressed the Bipartisan Addiction and Mental Health Task Force efforts to increase resources for prevention, harm reduction, treatment and recovery. Every September during National Recovery Month, the Task Force leads Congress Goes Purple to reaffirm Congress’s commitment to passing effective, bipartisan legislation to combat the nation’s substance use crisis.

Source: Trone Hosts Recovery Month Press Conference Alongside Bipartisan Lawmakers and Recovery Organizations (Congressman David Trone)

FDA warns about social media challenges involving medicines

The Food and Drug Administration issued a consumer update on the dangers to youth of social media challenges involving misusing medicines, including the trend of online videos of people misusing nonprescription medications and encouraging viewers to do so too. The video challenges, which often target youth, can lead to harm and death. Over-the-counter (OTC) drugs are readily available in many homes, making the challenges more risky. Recent challenges encourage people to cook chicken in NyQuil or another similar OTC cough/cold medication and urge people to take large doses of Benadryl to try to induce hallucinations. OTC and prescription medications should be kept away from children and locked up, and parents should discuss with their children the dangers of using substances and how social media trends can lead to real damage. If a child has taken too much medication, call 911 or poison control. The update also includes information on how to use OTC drugs safely.

Source: A Recipe for Danger: Social Media Challenges Involving Medicines (Food and Drug Administration)

HHS releases Roadmap for Behavioral Health Integration

The Department of Health and Human Services released the HHS Roadmap for Behavioral Health Integration, which details policy solutions that would help to better integrate mental health and substance use disorder care into the larger health care system and other systems. It is based on feedback received from patients and providers during more than two dozen stops on the National Tour to Strengthen Mental Health. The Roadmap aims to ensure that the full spectrum of behavioral health care will be integrated into the health care, social service and early childhood systems to ensure all people have equitable access to evidence-based, culturally appropriate person-centered care.

Source: After Launching National Tour to Strengthen Mental Health, HHS Releases Roadmap Based on Patient and Provider Feedback (Department of Health and Human Services)

OTP regulations impact access to care and patient experience

Pew Charitable Trusts released an issue brief on state opioid treatment program (OTP) regulations that impact access to care and patient experience. Nineteen states and D.C. restrict opening new OTPs. Eleven states explicitly permit medication units, and one prohibits them. Seven states and D.C. restrict where OTPs can operate. Only nine states require OTPs to be open outside of business hours, and eight require clients to show government identification. Ten states prohibit take-home doses in the first 30 days of treatment, seven of these during the first 90 days. Ten states impose stability criteria for take-home doses beyond federal criteria. Nearly half of states impose a set counseling schedule. Only two prohibit administrative discharge for not being abstinent, and all states allow it for missed doses and nonparticipation in counseling or other ancillary services. Twenty-six states require more than eight annual drug screenings (federal requirement). Eight states have rules that establish discontinuation as the goal of treatment.

Source: Overview of Opioid Treatment Program Regulations by State (Pew Charitable Trusts)

CVS and Walmart settle opioid lawsuit in West Virginia

CVS and Walmart have agreed to pay $147.5 million to settle West Virginia’s claims over their alleged roles in the opioid crisis. West Virginia had been prepared to proceed to trial next week against those two companies and Walgreens. The state has accused the pharmacies of fueling the opioid crisis through lax oversight of prescription pills sold in the state. Walgreens has not settled, and a trial has been rescheduled for June 2023.

Source: CVS, Walmart reach $147.5 mln opioid settlement with West Virginia -attorney general (Reuters)

New York City approves program to increase naloxone access in nightlife establishments

The New York City Council approved a bill that would require the Department of Health and Mental Hygiene to create a Nightlife Opioid Antagonist Program to help prevent opioid overdoses in nightlife establishments. The program would permit nightlife establishments to request and retain naloxone on premises, free of charge, for administration to patrons, staff or individuals experiencing an opioid overdose. It would also require the department to offer free naloxone resources and training to staff of such establishments.

Source: Council Approves Legislation to Address Gun Violence, Support Language Access at Abortion Providers, Prevent Opioid Overdoses in Bars and Clubs (New York City Council)

AMA releases 2022 Overdose Epidemic Report

The American Medical Association’s 2022 Overdose Epidemic Report calls for policymakers, insurers, pharmacy chains and other stakeholders to remove barriers to evidence-based care and make non-opioid pain care alternatives more accessible and affordable; health care professional licensing boards to help patients with pain by rescinding arbitrary restrictions on opioid therapy; and for state officials to remove punitive policies against pregnant individuals and parents with substance use disorder and ensure evidence-based care for incarcerated individuals. The report also calls for employers to review insurance/benefits plans to ensure access to pain specialists and affordable access to comprehensive pain care, medications for opioid use disorder (MOUD) and in-network psychiatrists; public health officials to support syringe service programs, distribute naloxone and fentanyl test strips and pilot overdose prevention centers; and faith leaders to destigmatize addiction and harm reduction by educating members and holding awareness events. The report includes state data for opioid prescriptions, MOUD, naloxone and prescription medication monitoring program use.

Source: Trends on overdose deaths require specific actions, all-hands approach (American Medical Association)