Key reads

Law allowing FDA to regulate synthetic nicotine goes into effect

A law took effect this week that allows the Food and Drug Administration (FDA) to regulate products containing synthetic nicotine. This will allow regulators to crack down on vaping companies using a now-closed loophole. The companies include Puff Bar and others that recently switched their formulas to synthetic nicotine to skirt FDA oversight and sell flavored products. Companies must now register with the FDA and submit their products for review within 30 days, bringing synthetic nicotine products under the same regulatory scheme as e-cigarettes with tobacco-derived nicotine.

Source: E-cigs using synthetic nicotine come under FDA oversight (Associated Press)

An effective 988 will require increased investment

Benjamin F. Miller, president of Well Being Trust, explains the importance of investment in 988. With fewer than 100 days until the scheduled rollout, the new mental health crisis hotline is far from ready. Implementing the program has been hampered by a lack of sustainable federal funding to build the capacity to effectively respond to calls. To reach its full potential, 988 must be accompanied by a supportive infrastructure aligned with clear quality standards and supported by robust financing. Trained staff and capacity to answer calls and provide follow-up care are lacking. Some states are moving to fill gaps in federal funding by adding new fees on wireless plans, but most states have not done enough. Consistent, widely disseminated national communication is also needed to inform people about 988.

Source: Not going all in on the 988 hotline will ensure its failure (STAT)

Federal news

SAMHSA provides funding for 988 services

The Substance Abuse and Mental Health Services Administration (SAMHSA) is awarding nearly $105 million in American Rescue Plan funding to 54 states and territories in advance of the 988 launch in July. Funds will be used to improve response rates, increase capacity to meet future demand and ensure calls are first routed to local, regional or state crisis call centers. Funding can also be used to build the workforce necessary to enhance local text and chat response. SAMHSA is also convening national partners to advance 988 planning efforts and adding more communication materials and products to its 988 Partner Toolkit.

Source: As Part of President Biden’s Mental Health Strategy, HHS Awards Nearly $105 Million to States and Territories to Strengthen Crisis Call Center Services in Advance of July Transition to 988 (Substance Abuse and Mental Health Services Administration)

FDA considers requirement for drug take-back envelopes and safe disposal education

The Food and Drug Administration announced a proposed notice to require opioid analgesics used in outpatient settings to be dispensed with prepaid mail-back envelopes and to require pharmacists to provide patient education on safe disposal. The change to the Opioid Analgesic Risk Evaluation and Mitigation Strategy would provide a convenient, additional disposal option for patients and potentially reduce the amount of unused opioids in patients’ homes. The rule is open for public comment until June 21.

Source: FDA Considers New Approach to Improve Safe Disposal of Prescription Opioid Analgesics, Decrease Unnecessary Exposure to Unused Medication (Food and Drug Administration)

HHS Secretary discusses 988 and youth mental health

In a trip to Las Vegas this week as part of the National Tour to Strengthen Mental Health, Department of Health and Human Services Secretary Becerra participated in events, site visits and roundtables underscoring the importance of topics including addressing the health care provider shortage, planning for the launch of 988, improving youth mental health and housing as a social determinant. Becerra noted that the administration will continue to put equity and access at the forefront of the fight for parity in mental health care.

Source: In Nevada, Secretary Becerra Highlighted the Importance of Strengthening the Health Care Workforce, Launching 988, Access to Cancer Screening, and Investing in Youth Mental Health (Department of Health and Human Services)

DEA hosts National Prescription Drug Take Back Day

The Drug Enforcement Administration will host its 22nd National Prescription Drug Take Back Day on April 30 from 10 a.m. to 2 p.m. The biannual event offers free, anonymous disposal of unneeded medications at more than 4,000 drop-off locations nationwide. Take Back Day has removed more than 15 million pounds of medications from circulation since its inception more than a decade ago.

Source: DEA Holds 22nd National Prescription Drug Take Back Day to prevent addiction and reduce overdose deaths (Drug Enforcement Administration)

State and local news

West Virginia and Alabama reach opioid settlements

West Virginia settled with Janssen for $99 million over the company’s role in perpetuating the opioid crisis in the state. The settlement was announced at the start of the third week of testimony in the state’s case against Janssen, Teva and Allergan. Cities and counties could start seeing the settlement money within 45 days. The trial against Teva and Allergan will continue. Also this week, Alabama reached a $276 million settlement with Johnson & Johnson (J&J), McKesson and Endo for their role in the opioid crisis. J&J will pay $70.3 million this year, McKesson will pay $141 million over nine years and Endo will pay $25 million this year. Both states opted out of the $26 billion national settlement with J&J, AmerisourceBergen, Cardinal Health and McKesson, choosing instead to pursue lawsuits against the companies individually.

Source: J&J’s Janssen Settles With WVa for $99M in Opioid Lawsuit (Associated Press); Alabama reaches $276M settlement in opioid cases (The Hill)

States using COVID funds and passing laws to increase school mental health services

With roughly $190 billion in education and health grants over the next four years from pandemic relief funding, states are responding to the youth mental health crisis. Last year, 38 states enacted nearly 100 laws providing additional resources to support mental wellbeing in K-12 schools. Dozens of additional school mental health bills became law this year in at least 22 states. New state laws aim to upgrade school mental health resources and create comprehensive plans to promote child mental wellbeing. At least 16 states now require training for K-12 teachers and staff on how to recognize mental distress in students and how to respond. Seven states enacted laws recommending high school students take the training courses. States are providing money to help schools increase the number of counselors, psychologists and social workers and for mental health screening and data collection tools.

Source: As Teen Mental Health Worsens, Schools Learn How to Help (Pew Stateline)

New Jersey recreational marijuana sales begin

The first sales of recreational marijuana in New Jersey will start today, with at least a half-dozen medical marijuana dispensaries planning to open their doors to all adults after winning final approval from New Jersey’s Cannabis Regulatory Commission last week. Seven companies and thirteen medical dispensaries they operate got approval to sell to all adults.

Source: Legal Marijuana Sales Will Start Next Thursday in New Jersey (New York Times)

Other news in addiction policy

NAM opioid collaborative releases Chronic Pain Journey Map

The National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic released a Chronic Pain Journey Map, a visual illustration that intends to describe the diverse experiences of individuals living with chronic, non-cancer pain. The map identifies five key stages of the journey that have critical touchpoints in the health system. Each stage explains what works well and common challenges. The map identifies actions that specific health care stakeholders can take to improve the pain management process.

Source: Chronic Pain Journey Map (National Academy of Medicine)

Pandemic alcohol use increases must be addressed

Leana Wen, former Baltimore health commissioner, writes about the need to address drinking during the pandemic. A recent study from the National Institute on Alcohol Abuse and Alcoholism found that alcohol-related deaths in 2020 were so high that, for those 16-64, they exceeded the number of deaths from COVID-19. The average annual increase was previously around 2%, compared to more than 25% in 2019-2020. The numbers are likely to be even higher in 2021. The increase is likely due to added stress and reduced coping options during the pandemic. Use by women is particularly worrying. Wen offers resources to help people determine if their alcohol use is excessive and to seek help.

Source: Opinion: We need to talk about pandemic drinking (Washington Post)