Preliminary data from the Centers for Disease Control and Prevention show that overdose deaths continued to rise to record-breaking levels in 2021, nearing 108,000. The increase of nearly 15% followed a rise of almost 30% in 2020. A growing share of deaths came from fentanyl and methamphetamine. Overdoses long ago surged above the peak deaths from AIDS, car crashes and guns, and they killed about a quarter as many Americans last year as COVID-19. Deaths involving synthetic opioids rose from 58,000 to 71,000, and those associated with stimulants like methamphetamine increased from 25,000 to 33,000. The data show that in the 12 months ending December 2021, there were predicted to be 107,234 overdose deaths, a 14.9% increase over the prior 12-month period. This includes 80,816 opioid overdose deaths, including 71,238 synthetic opioid deaths. There were a predicted 32,856 deaths from psychostimulants with abuse potential and 24,538 from cocaine.
Source: Overdose Deaths Continue Rising, With Fentanyl and Meth Key Culprits (New York Times)
The House Energy and Commerce Committee introduced legislation to reauthorize key programs to address the national mental health/substance use disorder crises. The Restoring Hope for Mental Health and Well-Being Act of 2022 (section-by-section summary) includes provisions that will establish a Behavioral Health Crisis Coordinating Office; reauthorize grant programs to address the youth mental health crisis; and reauthorize programs including the Garrett Lee Smith Memorial Suicide Prevention program, Maternal Mental Health Screening and Treatment program, grants to support American Indian/Alaska Native communities and the Behavioral Health Workforce Education and Training program. The measure also includes provisions to require self-funded, non-federal governmental plans to comply with parity; improve the integration of behavioral health care into primary care; reauthorize the Pediatric Mental Health Care Access program; and direct the Substance Abuse and Mental Health Services Administration to assess flexibilities provided to opioid treatment programs during the COVID-19 public health emergency and increase access to services.
Source: Pallone And Rodgers Introduce Bipartisan Mental Health And Substance Use Disorder Legislation (House Committee on Energy & Commerce)
Sens. Murphy and Cassidy introduced the Mental Health Reform Reauthorization Act of 2022 (section-by-section; one-pager) to reauthorize mental health and addiction programs signed into law in 2016 as part of their Mental Health Reform Act. The bill would also build on the 2016 programs to address the impact of COVID-19. The bill would strengthen parity laws, improve community mental health services, expand access to pediatric mental health, increase recruitment of a diverse mental health workforce and provide paths to recovery for vulnerable individuals. Partnership to End Addiction endorsed the bill.
Sens. Feinstein and Grassley introduced a Senate resolution designating May 10, 2022 as National Fentanyl Awareness Day. Reps. Trone and Upton introduced the resolution in the House. It aims to increase awareness of the impact of fake or counterfeit pills on families and young people and encourage efforts to stop and prevent the spread of illicit counterfeit pills.
Source: Senate Resolution Designates May 10 as National Fentanyl Awareness Day (United States Senator for California Dianne Feinstein)
Department of Health and Human Services Secretary Becerra and Department of Labor Secretary Walsh met with health insurance and business leaders to discuss compliance with the Mental Health Parity and Addiction Equity Act, adequacy of in-network providers and mental health and substance use disorder treatment during the pandemic. They met with industry leaders in a constructive dialogue, with commitments from attendees to continue to engage on these critical issues.
Source: Readout: Secretary Becerra, Secretary Walsh Host Health Insurance, Business Leaders to Discuss Mental Health, Substance Use Disorder Parity (Department of Health and Human Services)
The Office of National Drug Control Policy announced a plan to address methamphetamine and its impact on public health and safety. It is designed to reduce meth use, prevent meth-involved overdoses, expand access to evidence-based treatment and reduce the trafficking and supply of meth. It calls for removing barriers to treatment for meth use disorder in a variety of settings, including expanded capacity of contingency management; expanding harm reduction services; expanding evidence-based primary prevention programs in schools; and updated, comprehensive training for law enforcement and bystanders to identify and assist persons experiencing acute meth intoxication, and for health care providers to respond to meth-associated cardiac arrests. The plan also calls for working with law enforcement task forces to increase focus on meth trafficking; increasing federal oversight of pill and tablet pressing equipment; expanding global partnerships to reduce the supply of meth and precursor chemicals; and expanding training for law enforcement agencies involved in disruption of meth distribution.
Source: ONDCP Releases Plan to Address Methamphetamine Health and Safety Concerns (Office of National Drug Control Policy)
Walgreens reached a $683 million settlement with Florida to resolve claims that the company exacerbated the opioid crisis. The settlement includes $620 million to be paid to Florida over 18 years, plus $63 million for legal fees. The settlement ends a trial that began on April 11, after Walgreens declined to join a combined $878 million settlement with CVS, Teva, Allergan and Endo.
Source: Walgreens reaches $683 mln opioid settlement with Florida (Reuters)
San Francisco launched the Office of Coordinated Care (OCC) as part of the expansion of mental health and substance use disorder services in San Francisco. The OCC was a component of the 2019 Mental Health SF legislation. It assigns case managers to people who are disconnected from behavioral health services or who are making transitions in care from one setting to another. The Emergency Declaration in the Tenderloin in December provided the expedited hiring path needed to complete the staffing required to launch the OCC. Staff include behavioral health clinicians, registered nurses, health workers and peer specialists. When fully expanded, the OCC expects to manage the cases of 4,000 individuals annually.
Source: San Francisco Launches Office of Coordinated Care to Connect People with Mental Health and Substance Use Disorders to Care and Treatment (San Francisco Office of the Mayor)
Boston Medical Center (BMC) has launched the Eilene Grayken Maternal Health Addiction Fellowship to bring more skilled physicians into the emerging field of Obstetric-Addiction Medicine. BMC’s new two-year fellowship will provide training in the complex care of pregnant people with substance use disorder and prepare physicians for both the American Board of Obstetrics and Gynecology and the American Board of Addiction Medicine certifications upon completion.
Source: BMC Launches First Maternal Health Addiction Fellowship (Health City)
People with addiction could find it more difficult to get treatment if the end of the COVID-19 public health emergency brings the end of policies that allow prescribing of medications through video or call visits. Congress has been pressing the Drug Enforcement Administration (DEA) for more than a decade to issue rules allowing some providers to prescribe medications for addiction treatment (MAT) to new patients through telehealth, to no avail. Lawmakers from both parties say the in-person requirement poses an unnecessary barrier to care. While eliminating the in-person requirement will not solve all barriers associated with MAT, it has increased access during the pandemic. It has been a particularly useful option for people who are leaving incarceration, living in rural areas, pregnant or homeless. While the DEA has said it is working to make some of the telehealth flexibilities permanent, it is not clear what that will look like.
Source: End of COVID-19 emergency endangers substance use treatment (Roll Call)
The Washington Post conducted an analysis of previously confidential Mallinckrodt documents, made public after years of litigation and bankruptcy proceedings. The documents show how aggressively Mallinckrodt sought to increase its market share as the opioid crisis raged. Mallinckrodt accounted for 27% of the opioid market between 2006 and 2014, compared to 18% for Purdue. As the opioid crisis took hold, Mallinckrodt’s 30 mg oxycodone tablet became preferred on the street. The company had detailed knowledge of the prescribing patterns of doctors and bemoaned their loss when they fell into trouble with regulators. Company managers pressured sales representatives to find doctors who would write large numbers of prescriptions and targeted them for continued business. They rewarded top performers and fired those failing to meet sales goals. Years after a sales rep cautioned that doctors were running pill mills, several remained on the company’s preferred list of providers. Mallinckrodt paid top prescribers to extol the virtues of their product to fellow doctors at “speaker programs,” and the company played a key role in an industry-wide effort to convince the health care industry that addiction was rare.
Source: Inside the sales machine of the ‘kingpin’ of opioid makers (Washington Post)