Key reads

Adolescent overdose deaths rising due to increased fentanyl

A new study found that in 2020, overdose deaths among adolescents aged 14-18 nearly doubled. They rose another 20% in the first six months of 2021. The increase is not due to a rise in substance use, but because substance use has become more dangerous. The majority of deaths were caused by fake versions of prescriptions such as Xanax, Percocet and Vicodin that were laced with fentanyl. The study found 518 adolescents died of an overdose in 2010 (2.4 per 100,000), and that rate continued through 2019. In 2020, however, there were 954 deaths (4.6 per 100,000), and in the first six months of 2021, there were 1,146 (5.45 per 100,000).

Source: Pandemic Brought Surge in Fatal Drug Overdoses in U.S. Teens (HealthDay)

COVID-19 and overdoses lead to highest ever death toll in the U.S.

Provisional data from the Centers for Disease Control and Prevention (CDC) shows that 2021 was the deadliest year in U.S. history, driven by COVID-19. There were 3.465 million deaths last year, about 80,000 more than 2020’s record-setting total. COVID was not solely to blame, however, as overdose deaths continued to rise. Provisional data through October 2021 suggests the nation is on track to see at least 105,000 overdose deaths in 2021, up from 93,000 the year before. While the CDC has not yet reported its calculation for life expectancy in 2021, researchers think it dropped another five or six months in 2021, following a 1.5 year drop in 2020, putting it back to where it was 20 years ago.

Source: COVID-19, overdoses pushed US to highest death total ever (Associated Press)

Federal news

Lawmakers introduce bill to strengthen children's behavioral health care

Reps. Eshoo, Blunt Rochester and Fitzpatrick introduced the Strengthen Kids’ Mental Health Now Act, which would foster improvements across the full continuum of pediatric mental health and substance use disorder care. It would extend support to communities, schools and health care providers by matching Medicaid payment rates with Medicare payment rates for pediatric behavioral health services. The measure would also provide guidance to states to expand access to mental health services, including through telehealth, and provide competitive awards to strengthen and improve the mental health system infrastructure and workforce.

Source: Eshoo, Blunt Rochester, Fitzpatrick Introduce Major Bipartisan Bill to Strengthen Children’s Mental Health (Congresswoman Anna G. Eshoo)

Lawmakers send letters encouraging over-the-counter naloxone

Sen. Baldwin and Rep. Maloney, along with Sens. Hassan and King and Rep. Fitzpatrick, led a group of more than two dozen lawmakers in sending letters to seven drug companies that manufacture naloxone, urging the companies to apply for over-the-counter status for naloxone to expand its access. The Food and Drug Administration is supportive of the switch, but major manufacturers have so far punted on the move.

Source: Baldwin, Maloney, Hassan, King, Fitzpatrick, Lead Bipartisan, Bicameral Group in Calling on Drug Manufacturers to Make Naloxone Available Over the Counter (Tammy Baldwin)

House committee releases report on McKinsey's work for FDA and opioid manufacturers

The House Committee on Oversight and Reform released an interim staff report presenting preliminary findings from the Committee’s investigation into McKinsey’s consulting work during the opioid epidemic. The investigation found that McKinsey consultants, including senior partners, frequently worked on Food and Drug Administration (FDA) contracts while also working for opioid manufacturers, including Purdue. McKinsey’s conflicts, which the firm did not disclose to the FDA, raise serious questions about McKinsey’s ability to provide objective advice and its compliance with the terms of its contracts and federal law. The investigation also uncovered evidence that McKinsey used its government consulting work to solicit more business from opioid manufacturers and tried to influence government officials, including then-Department of Health and Human Services Secretary Azar, to advance interests of its private sector opioid clients. McKinsey consultants also discussed deleting documents related to their work for Purdue.

Source: Committee Releases Report Uncovering Significant Conflicts of Interest at McKinsey & Co. Related to Work for FDA and Opioid Manufacturers (House Committee on Oversight and Reform)

DEA warns of increase in mass-overdose events

The Drug Enforcement Administration (DEA) sent a letter to federal, state and local law enforcement partners warning of a nationwide spike in fentanyl-related mass-overdose events (three or more overdoses occurring close in time at the same location). Such events have happened in at least 7 cities in recent months, resulting in 58 overdoses and 29 deaths. The events typically happen when fentanyl is sold as cocaine or pills. The DEA can offer resources to assist law enforcement partners including interdiction, investigation, resource access, presentation of the investigation and warning the public.

Source: DEA Warns of Increase in Mass-Overdose Events Involving Deadly Fentanyl (Drug Enforcement Administration)

State and local news

Florida trial against Walgreens begins

The Florida trial against Walgreens began this week. The state alleged that Walgreens filled a quarter of opioid prescriptions in the state between 1999 and 2020 and failed to investigate red flags that could have prevented diversion. Walgreens has denied the allegations, saying it filled prescriptions written by doctors. Walgreens has argued it is immune from being sued based on a $3,000 settlement it reached with the state in 2012, following an investigation into its record-keeping policies and efforts to prevent diversion of opioids. Walgreens says that Florida is bound by that accord even if it now regretted the terms, while Florida has said that settlement addressed only a single record-keeping violation.

Source: Walgreens fed opioid addiction, Florida says as trial starts (Reuters)

New Jersey recreational marijuana sales expected to start soon

New Jersey gave seven medical marijuana companies final approval to start selling their products to all adults, opening the door to the first legal marijuana sales within a month. Recreational sales are permitted to start as soon as each of the companies pays upward of $1 million in fees associated with the expanded licenses and satisfies other bureaucratic requirements to gain a final license. Entrepreneurs hoping to open recreational cannabis shops in New Jersey have filed 327 applications for retail licenses since March 15, but decisions about those applicants are not expected for at least another month.

Source: Legal Marijuana Sales Expected to Start Within Weeks in New Jersey (New York Times)

New York releases report on parity compliance

The New York Department of Health, Office of Mental Health and Office of Addiction Services and Supports released a report on parity compliance in Medicaid managed care, alternative benefit plans and Children’s Health Insurance Program (CHIP). It concluded that there are no parity compliance issues with financial requirements for any of the programs or with quantitative treatment limitations for CHIP. Two quantitative treatment limitation issues were identified in the managed care program. Managed Care Organization (MCO) reporting was largely not sufficient to confirm compliance with non-quantitative treatment limitations, though several MCOs were found in violation of parity for reimbursement and retrospective/outlier review. New York will augment parity monitoring through a two-year plan, which includes amendments to MCO contracts for parity documentation and reporting, modifications to the state’s operational survey process for MCOs and further identification and remediation of key parity issues.

Source: Compliance with the Mental Health Parity and Addiction Equity Act Comprehensive Report: New York Medicaid Managed Care, Alternative Benefit Plan, and Children’s Health Insurance Program (New York Department of Health)

Penn State starts prevention project

A team of Penn State experts from Evidence-based Implementation and Intervention Support is leading a five-year Opioid Misuse Prevention Project to support community-based partnerships throughout Pennsylvania to help prevent substance use and promote healthy development in young people and their families. The team is working to implement and evaluate a comprehensive, research-based approach to prevention involving youth, parents, schools, nonprofit organizations, agencies offering substance and alcohol programs, legislators, business owners, community coalitions and other community leaders. The project includes two programs offered in local middle schools (LifeSkills Training and Strengthening Families Program), training for adults working with youth and community outreach.

Source: Penn State team leads effort to prevent youth substance misuse in PA (Penn State)