Key reads

The economic cost of the opioid crisis was over $1 trillion in 2017

The U.S. economic cost of opioid use disorder ($471 billion) and fatal opioid overdose ($550 billion) in 2017 totaled $1.02 trillion. A CDC study of 39 jurisdictions found that the costs varied from $985 million in Wyoming to $72.6 billion in Ohio, and per capita costs varied from $1,204 in Hawaii to $7,247 in West Virginia. States with high per capita costs were located mainly in the Ohio Valley and New England.

Source: State-Level Economic Costs of Opioid Use Disorder and Fatal Opioid Overdose – United States, 2017 (Centers for Disease Control and Prevention)

Emergency department visits for behavioral health increased during the pandemic

Emergency department visits Dec. 2020-Jan. 2021 were 25% lower than during the same months the year before. Higher proportions of patients are seeking care for mental and behavioral health-related concerns, especially pediatric patients. Among adults, the proportion of visits for mental and substance use conditions was higher than during the pre-pandemic period. Among children, the proportion for suicidal ideation and attempts, intentional self-harm, psychotic disorders, and lifestyle and life management factors were higher than pre-pandemic. Efforts to ensure public understanding of the importance of seeking guidance and emergency care for acute and behavioral health conditions are necessary.

Source: Update: COVID-19 Pandemic-Associated Changes in Emergency Department Visits – United States, December 2020-January 2021 (Centers for Disease Control and Prevention)

Federal news

Cannabis banking bill passed in the House

The House passed the SAFE Banking Act, which would allow banks and financial institutions to work with cannabis businesses, in a bipartisan vote of 321-101 (106 Republicans voted in favor). The same bill passed the House last year on a similar margin. The bill now goes to the Senate, where it stalled last Congress. Under Democratic control, the bill has a stronger chance of being brought up for a vote in the Senate. Sen. Schumer said he supports the bill but wants to move it at the same time as comprehensive reform.

Source: House passes cannabis banking bill (The Hill)

Schumer pushing for marijuana reform

Speaking on 4/20, Senate Majority Leader Schumer said that he planned to draft and advance legislation, led by Sens. Wyden and Booker, “not only to end the federal prohibition on marijuana, but to ensure restorative justice, protect public health and implement responsible taxes and regulations.” While Schumer referred to the legislation as “legalization,” it is unlikely to affect state laws restricting cannabis. It could undo federal laws by reclassifying or removing marijuana from the controlled substances schedule. While Schumer has repeatedly promised a vote on cannabis reform, several Democrats remain opposed to (e.g., Sens. Shaheen, Tester) or undecided on (e.g., Sens. Manchin, Casey, Kelly) legalization. Gaining support among Republicans would be an even harder fight, as even those in states with legal recreational marijuana (e.g., Sens. Rounds, Daines, Sullivan) are opposed or undecided.

Source: Schumer vows to undo federal marijuana laws; GOP continues to balk (Washington Post); Senate Democrats split over legalizing weed (Politico)

Excellence in Recovery Housing Act introduced

Reps. Trone, Chu, Levin and McKinley introduced H.R. 2376, the Excellence in Recovery Housing Act (summary) which would help states expand the availability of high-quality recovery housing. It would require SAMHSA, along with national accrediting entities and reputable providers of recovery housing services, to develop guidelines for states to promote the availability of high-quality recovery housing; provide grants to states to implement these guidelines and promote high-quality recovery housing; require the National Academy of Sciences to study the issue and make recommendations for increasing availability, improving data collection, and improving inclusivity for those who use MAT; and create an interagency working group to increase federal agency collaboration in promoting availability of high-quality recovery housing.

Source: Following spike in overdose deaths, Rep. Trone introduces bipartisan legislation to expand access to recovery housing (Congressman David Trone)

State and local news

Opioid settlement money diverted from addiction efforts

New York received $32 million from a settlement with McKinsey, which was supposed to be put toward abating the effects of the opioid crisis. However, during budget negotiations, nearly two-thirds of the money went into the state’s general fund. The other $11 million went to pay for MAT in state prisons at the same level as the previous year. While the settlement stipulated that the funds must be used “to the extent practicable” to address the opioid crisis, a provision in state law prevents a state agency or official from determining how money acquired through a settlement can be allocated. The legislature is working to avoid future diversions through legislation to create a lockbox that all opioid settlements would go into and an advisory board to ensure that 100% of funds are used for prevention, treatment, recovery and harm reduction.

Source: ‘Blood money’ from opioid settlements diverted from fighting addiction, advocates say (The Buffalo News)

Opioid trial begins in California

The trial in the case Oakland and Los Angeles, Santa Clara, and Orange Counties brought against Johnson & Johnson, Teva, Endo and Allergan began this week. The California communities accused the companies of causing a deadly wave of opioid addiction with their aggressive marketing, while the drug makers argued that they properly marketed their drugs under regulatory oversight and that the plaintiffs will not be able to show examples of local deaths stemming from their prescriptions. The case may be a roadmap for thousands of similar claims against drug makers, distributors and pharmacies. It is unlikely that the plaintiffs will get anything close to the $50 billion they are demanding, but the trial ratchets up the settlement pressure on Teva and J&J, which have made proposals to end all cases against them. J&J was ordered to pay $465 million for creating a public nuisance in Oklahoma in 2019, and the companies’ prospects for a win are worse here because California’s public nuisance law is broader.

Source: Drugmakers Accused of Causing Opioid Addiction in Trial (Wall Street Journal); J&J, Teva Opioid Trial May Signal Cost of Drug Maker Accords (Bloomberg)

More children are ingesting edibles as marijuana legalization spreads

Poison control centers have seen a spike in the number of children who have ingested THC after eating parents’ edibles, rising from just 19 cases in 2010, before recreational marijuana was legal in any state, to 554 cases last year. Poison control officials attribute the rise to a growing number of states legalizing marijuana, with an uptick in pediatric ER visits by children who have ingested edibles following legalization of recreational sales in a state. Packaging makes it difficult for children to distinguish an edible marijuana product from food. High levels of THC can have dangerous side effects in children. Several states have implemented legislation and regulations to address the issue, including requiring childproof packaging and strict labeling requirements or banning edibles outright.

Source: As more states legalize marijuana, more children accidentally ingest THC-laced edibles (Washington Post)

Other news in addiction policy

National Academy of Medicine creates research agenda on addiction

The National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic’s Research, Data, and Metrics Needs working group created a comprehensive research agenda for the priority areas of health professional education and training; pain management guidelines and evidence standards; and prevention, treatment and recovery services. The agenda emphasizes the crosscutting need to better understand the intersection of health disparities and COVID with the pain management and opioid use disorder care continuum.

Source: National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic Research Agenda (National Academy of Medicine)