New preliminary data from the Centers for Disease Control and Prevention show that overdose deaths have reached another record high. An estimated 104,288 people died of an overdose in the 12-month period ending September 2021, a 16% increase over the prior year. About two-thirds of overdose deaths involved synthetic opioids, and deaths from methamphetamine and other psychostimulants also increased significantly. The pandemic accelerated existing trends, but even when the pandemic ends, the effects on overdoses are likely to persist. Harm reduction strategies like syringe exchanges and naloxone distribution can help prevent overdose deaths, but using them to their full potential will require an ideological shift. Addressing the overdose crisis will take the type of large response used for the COVID pandemic.
A 50-state analysis of opioid treatment programs (OTPs) found significant disparities in care from state to state and that geography and health insurance coverage, rather than medical need, often determine whether patients can access effective treatment for opioid use disorder (OUD). It found that many OTPs offer a limited a selection of FDA-approved medications to treat OUD; OTPs do not universally accept Medicaid despite Medicaid programs covering methadone for OUD; mental health treatment is not readily available at OTPs; and OTPs often fail to provide tailored treatment for specific populations (e.g., pregnant people, people who speak languages other than English).
Source: Lifesaving Addiction Treatment Out of Reach for Many Americans (Pew Charitable Trusts)
The Centers for Disease Control and Prevention released two new reports on the health and wellbeing of children and adolescents during the COVID-19 pandemic. The first looked at pediatric emergency department visits, finding that overall pediatric visits decreased, but that there were increases in the weekly number and proportion of visits related to behavioral health concerns. The second report examined changes in pediatric emergency department visits for mental health conditions and found that adolescent girls accounted for the largest increases in the number and proportion of emergency department visits for mental health conditions.
Source: New Reports on Health and Well-being of Children During COVID-19 Pandemic (Centers for Disease Control and Prevention)
The Centers for Medicare and Medicaid Services (CMS) issued a Request for Information (RFI) on topics related to health care access in Medicaid, including enrolling in and maintaining coverage, accessing services and ensuring adequate provider payment rates to encourage provider availability and quality. Feedback obtained will help inform future policies, monitoring and regulatory actions, helping to ensure beneficiaries have equitable access to high-quality and appropriate care and will inform CMS’ work to ensure timely access to services such as behavioral health and home and community-based services. The RFI asks about ways CMS can support states in addressing barriers to enrollment and retention of individuals including people with mental health and substance use disorders, as well as whole person care and care coordination for behavioral health, enhancing parity compliance, access to care for pregnant and postpartum women with behavioral health conditions, etc.
Source: Biden-Harris Administration Announces Request for Information on Access to Care and Coverage for People Enrolled in Medicaid and CHIP (Department of Health and Human Services)
New data suggests that while a variety of legal and policy options exist for states to increase permanent access to medications for opioid use disorder during the pandemic, most states have not adopted them. While many states have adopted three types of Medicaid waivers that allow states to make quick adjustments to their Medicaid plans for addiction treatment, only 17 are using all three to make modifications specifically to address COVID. Only 11 states have made changes to their laws to adapt to the need for continued treatment upon release from state correctional facilities since the start of the pandemic. Only 13 states have made changes to their laws specifically meant to increase access to buprenorphine and methadone during COVID.
Source: Many States Leaving Policy Options On The Table In Fight Against Opioid Epidemic During COVID-19, According To New Data (Temple University Center for Public Health Law Research)
The Sacklers have raised their offer to settle the opioid lawsuits, offering up to $6 billion, an increase of more than $1 billion. However, they have not budged from their demand to end all civil claims against them and prohibit future claims. A supermajority of the states that rejected the original proposal have agreed to the new offer, but holdouts remain and the deal is not yet done. The earlier offer included $4.55 billion from the Sacklers, including a $225 million federal settlement, to be paid out over nine years. The new offer includes $5.5 billion from the Sacklers, with an additional contribution of up to $500 million, contingent on the sale of their international pharmaceutical companies. The Sacklers would have 18 years to make payments of the additional $1 billion. The mediator has requested an extension of the deadline for mediation talks through February 28.
Source: Sacklers Raise Their Offer to Settle Opioid Lawsuits by More Than $1 Billion (New York Times)
New York City Mayor Eric Adams released the Subway Safety Plan, which lays out how his administration will begin addressing public safety concerns and supporting people experiencing homelessness and serious mental illness on the city’s subways. Plans include deploying additional Joint Response Teams that bring together the departments of homeless services, health and mental hygiene, police and community-based providers; training police officers in the subway system to enforce rules of conduct in a fair and transparent way; expanding Behavioral Health Emergency Assistance Response Division teams to answer nonviolent 911 mental health calls with mental health professionals; incorporating physical and behavioral health care into homelessness services; improving coordination across government; creating new Drop-in Centers; streamlining the placement process into supportive housing; calling on state government to expand psychiatric bed resources; etc.
Source: Mayor Adams Releases Subway Safety Plan, Says Safe Subway is Prerequisite for New York City’s Recovery (New York City Office of the Mayor)
The New York City Health Department announced an anti-smoking media campaign, “You Quit, You Win!,” reminding New Yorkers who smoke of what they gain if they quit. It also released a new data analysis that found that the department’s anti-smoking media campaigns helped nearly 8,000 New Yorkers stop smoking and averted more than 1,000 deaths between 2015 and 2019. Every $1 spent on a media campaign led to $32 in cost savings for the health care system and society. They created an estimated $864 million in total cost savings. The new campaign will be running citywide via television ads, digital liveboards in the subways, bus shelters, newspapers and the Staten Island Ferry.
Source: Health Department Releases Data on Effectiveness of Anti-Smoking Efforts and Launches Campaign (New York City Department of Health and Mental Hygiene)
Vital Strategies, a public health organization, launched a new, interactive, online memorial to honor those who have lost their lives to an overdose. Inspired by the AIDS quilt, the digital mosaic allows anyone to commemorate a loved one lost to overdose and calls for urgent action in their name. The memorial launch is accompanied by the largest-ever national advertising campaign promoting harm reduction to raise awareness about ways to save lives. The goal is to build support for harm reduction measures such as fentanyl test strips and other substance checking tools, sterile syringes and other safe substance use supplies, naloxone in community hands, methadone and buprenorphine access and overdose prevention centers.
Source: Largest-Ever Harm Reduction Ad Campaign to Run in Conjunction with Memorial to Generate Support for Solutions to Growing Overdose Crisis, Including Full-Page New York Times Ad and TV Spots (Vital Strategies)
The American Public Health Association and Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health proposed a federal policy agenda to expand opportunities and support systems for youth disconnected from school and work. The agenda includes recommendations across sectors to address the immediate needs of such youth and the upstream determinants of disconnection. Youth who are not in school or employed face short- and long-term negative consequences, including those related to mental health and addiction. The agenda addresses the areas of targeted investments in early childhood education, access to comprehensive sex education and reproductive care, equitable and restorative approaches to justice in and out of school, policies/systems/structures to support youth transitions, consistent and expanded access to comprehensive support services and data on the pathways to and predictors of disconnection. It includes several recommendations to improve access to care and reduce negative consequences for youth struggling with substance use.
Source: Reconnecting Opportunity Youth: A Public Health Priority (Johns Hopkins Bloomberg School of Public Health)