Policy News Roundup: September 30, 2021

    Key reads

    DEA issues warning on pills laced with fentanyl and methamphetamine

    The Drug Enforcement Administration (DEA) issued a public safety alert this week about the rise in counterfeit prescription drugs being sold on the black market containing fentanyl and methamphetamine. This was the agency’s first such alert since 2015, when it warned of an increase of fentanyl-laced heroin. The DEA said the pills, which are made to look like oxycodone, Percocet or Adderall, are sold on the street by dealers and online, including on social media. The agency has seized more than 9.5 million fake pills so far this year, more than the last two years combined. Two of every five fake pills with fentanyl contain a potentially lethal dose.

    Source: The DEA Is Warning Of A Rise In Overdose Deaths From Fake Drugs Laced With Fentanyl (NPR)

    Investment needed in addiction care infrastructure

    Partnership to End Addiction’s Marcia Lee Taylor and Emily Feinstein and Legal Action Center’s Paul Samuels suggest in an op-ed that investments to revitalize and modernize addiction care infrastructure should be included as Congress moves its infrastructure legislation. Addiction treatment programs were created outside the mainstream health care system because addiction was not considered a health care issue. Misguided policies, regulatory practices and insurance provisions have continued to limit evidence-based treatment. This has created a system with inconsistent quality standards, inadequate funding and lack of available treatment. Addiction treatment should be integrated into mainstream health care. Simply adding new dollars to old institutions, more beds and traditional outpatient treatment slots, they say, would be a missed opportunity. They state that upcoming legislation should include provisions to enhance professional education and address the workforce shortage; promote telehealth options; and expand treatment, employment and housing opportunities for recovering individuals.

    Source: Harm reduction and addiction treatment need infrastructure investment (The Hill)

    Federal news

    Bipartisan Addiction and Mental Health Task Force releases legislative agenda

    A bipartisan group of 144 House lawmakers, spearheaded by the Bipartisan Addiction and Mental Health Task Force, unveiled their agenda for expanding access to mental health care and combatting the overdose crisis. The agenda includes 66 bills and one resolution and includes 12 policy subcategories — prevention, treatment, rural and underserved communities, workforce development, first responders, interdiction, children and families, veterans, prescribing, education, health care access and health parity. An aide for House Majority Leader Steny Hoyer declined to make any calendar announcements on when a package would move but said leaders support the work. Previous iterations of the group’s agenda formed a basis for the Comprehensive Addiction and Recovery Act (CARA) and the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act. The Senate Finance Committee is also working towards a bipartisan behavioral health package. A Senate Democratic aide said the goal is to develop the proposal by year’s end with the hopes of realistically passing legislation next year.

    Source: House group unveils bipartisan mental health, addiction legislative plan (Roll Call)

    House passes EQUAL Act to eliminate crack and powder cocaine sentencing disparities

    The House passed the Eliminating a Quantifiably Unjust Application of the Law (EQUAL) Act, which would eliminate the federal sentencing disparity for crack and powder cocaine offenses that disproportionately harms Black people. The bill passed 361-66, with a majority of Republicans voting for the bill along with all Democrats. The 66 opposing votes all came from the GOP. The Anti-Drug Abuse Act of 1986 established a five-year minimum sentence for possessing at least five grams of crack cocaine, while an individual would have to possess at least 500 grams of powder cocaine to receive the same sentence. The Fair Sentencing Act reduced the sentencing disparity in 2010, but did not eliminate it, and the 2018 First Step Act applied the reduction retroactively. The EQUAL Act would eliminate the disparity and allow it to be applied retroactively. It now heads to the Senate.

    Source: House passes bill to end crack and powder cocaine sentencing disparity (The Hill)

    Vape companies struggle with FDA bans, and lawmakers and public health groups want more

    Small- and medium-sized e-cigarette companies are fighting to stay open after the Food and Drug Administration (FDA) denied their applications to continue selling flavored e-cigarettes. The FDA has yet to act on applications from the biggest manufacturers (Juul, Vuse, NJOY). Smaller firms are weighing whether to ignore the orders and face potential financial and legal consequences. Some are exploring the use of synthetic nicotine, which falls outside of the FDA’s regulatory authority. The FDA conducts inspections and online monitoring and surveillance, can send warning letters to companies and can issue increasing financial penalties and eventually order violators to stop selling tobacco products. It is unclear how aggressively the agency will enforce the new limits. Senators Tim Kaine and Mitt Romney sent a letter to the FDA expressing concern about the delay in decisions for the largest companies and lack of clear guidance on menthol-flavored products. Public health organizations also sent a letter expressing frustration over the inaction on large companies, pushing FDA to immediately take all flavored e-cigarettes off the market.

    Source: Vape makers struggle to stay in business after FDA bans flavored e-cigs (Politico)

    State and local news

    State attorneys general urge Supreme Court to review Safehouse ruling

    D.C. Attorney General Karl A. Racine led a coalition of 11 attorneys general (D.C., Delaware, Illinois, Massachusetts, Michigan, Minnesota, New Mexico, Oregon, Rhode Island, Vermont and Virginia) in a friend-of-the-court brief urging the Supreme Court to hear a case supporting states’ rights to enact public health policies that can prevent overdose deaths and treat those with addiction. In the brief, the attorneys general ask the Supreme Court to review a ruling by the U.S. Court of Appeals for the Third Circuit that prevented Safehouse from operating a safe injection site. They urge the Supreme Court to hear the case because it is an issue of national importance that requires innovation at the local and state levels; the ongoing COVID-19 pandemic has heightened the opioid crisis and reinforced the need for more solutions; and states have a well-established role in enacting public health and safety programs.

    Source: AG Racine Leads Coalition of 11 Attorneys General in Fight for States’ Power to Enact Public Health Policies That Will Protect Their Residents From Opioid Overdose Deaths (Office of the Attorney General for the District of Columbia)

    Cherokee Nation reaches settlement with opioid distributors

    The Cherokee Nation in Oklahoma has reached a $75 million opioid settlement with AmerisourceBergen, Cardinal and McKesson. The distributors issued a statement strongly denying any wrongdoing. Payouts will be spread over the next six to seven years. Cherokee Nation officials said they will continue to pursue separate litigation against pharmacy chains, including CVS, Walgreens and Walmart.

    Source: The Cherokee Nation Has Agreed To A $75 Million Settlement With Opioid Distributors (NPR)

    Rhode Island enacts laws to prevent addiction and reduce harm

    Rhode Island Governor Daniel McKee signed several health-related bills into law, including bills to establish a pilot program to create harm reduction centers (S-0016B/H-5245A); decriminalize buprenorphine (S-0065A/H-6328); and create penalties for irresponsible prescription practices (S-0256Aaa/H-5098A). The state is the first to pass a law allowing pilot supervised consumption sites.

    Source: Governor McKee Signs Several Health-Related Bills into Law (State of Rhode Island Governor Daniel J. McKee)

    Other news in addiction policy

    FDA must take more urgent action to get flavored vapes off the market

    In an op-ed, Michael Bloomberg urges the Food and Drug Administration (FDA) to take action on flavored e-cigarettes, which are fueling the youth e-cigarette epidemic. He writes that the FDA has dragged its feet in getting high-nicotine, flavored e-cigarettes off the market, blowing past the September 9 deadline. The FDA’s delay is dangerous, he says, with more children developing nicotine addictions and becoming more likely to smoke cigarettes and suffer from cigarette-related diseases every day the products stay on the market. The FDA did reject many applications, but it has not addressed the top-selling youth-oriented brands — Juul, Vuse, blu and NJOY — which constitute more than two-thirds of the market. With students now returning to school, he writes, it is a terrible time to leave the most popular brands on the market. Bloomberg concludes that, regardless of not having a permanent commissioner, the FDA needs to act immediately to end the sale of such products.

    Source: The FDA Is Late in Banning E-Cigarettes That Tempt Kids (Bloomberg Opinion)

    Dire crisis calls for trying overdose prevention sites

    American Society of Addiction Medicine (ASAM) President William F. Haning, III, expresses support for overdose prevention sites in an op-ed. He recommends that federal, state and local leaders allow pilot overdose prevention sites to operate without fear of prosecution in communities where there is need and local support by people who use substances, as well as other community members. The success of such pilots could lead to more widespread adoption. To ensure that legal concerns are not a barrier to implementation, he argues, the Biden administration should provide explicit assurances that it will not challenge the sites. There are more than 100 legal sites in other countries, and Rhode Island recently passed a law to open a site. He notes that the sites should complement, rather than replace, existing interventions. They are not a panacea, he says, as they cannot address social determinants that lead to addiction or solve for systemic failures like racism, lack of economic opportunity or safe and affordable housing issues faced by many who use substances.

    Source: Overdose prevention sites can save lives and promote recovery. We must be willing to try them (STAT)

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    September 2021