The Illinois Senate voted on April 26 to allow doctors to prescribe medical marijuana as an alternative to opioids and those suffering from opioid addiction would be eligible to apply for a medical marijuana program card. Colorado has proposed a new bill that would allow doctors to write a medical-marijuana recommendation for any condition, for which a physician could prescribe an opiate for pain. The Colorado bill is currently pending in the state Senate.
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Entries filed under 'Substance Use Disorders'
- the Substance Abuse and Mental Health Services Administration is in the process of developing a toolkit targeted at state insurance regulators and behavioral health authority staff, human resources professionals and insurance executives to educate these groups on what parity is and how to comply with federal parity laws and regulations;
- HHS plans to continue to update the Parity Portal for consumer in evaluating whether they have experience a parity violation;
- Department of Labor will continue to release data and summaries of parity enforcement activities.
More States Considering Medical Marijuana As An Opioid Alternative
May 3, 2018 12:24 PM by billupsjU.S. House Energy and Commerce Health Subcommittee Hearing May 8
May 3, 2018 12:22 PM by billupsjOn May 8, the House Energy and Commerce Subcommittee on Health will hold a hearing to discuss the Overdose Prevention and Patient Safety Act, which proposes to amend 42 CFR Part 2 that governs confidentiality of substance use records. This Act is intended to align 42 CFR Part 2 with HIPAA. A number of healthcare organizations, including the AHA, have formed a coalition and have advocated for alignment to ensure that providers have access to their patient's entire medical history. The Substance Abuse and Mental Health Services Administration recently released a final rule which takes some steps to modernize Part 2, but, according to the AHA, it does not go far enough. The Act includes changes clarifying definitions for "treatment," "payment," "healthcare operations," and "protected health information" and also strengthens the protection of patient confidentiality in criminal proceedings.
HHS Releases Mental Health and Substance Use Disorder Parity Action Plan
April 26, 2018 12:15 PM by billupsjThe 21st Century Cures Act directed HHS to develop an Action Plan related to the ongoing implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA). The Action Plan provides a brief background on parity; description of the public stakeholder listening session that was held on July 27, 2017; and outlines recent and planned actions to continue parity enforcement.
Recent and planned actions of the Plan are organized into five categories: reporting and enforcement; disclosure requirements and increased transparency; consumer and compliance tools; state technical assistance, and research. Some highlights of planned actions include:
Pennsylvania Adds Treatment for Opioid Withdrawal to State Medical Marijuana Program
April 19, 2018 3:49 PM by billupsjFollowing New Jersey’s lead, Pennsylvania has approved adding the treatment of opioid withdrawal to be added to the list of approved uses for the state's medical marijuana program. By adding opioid withdrawal to this list, Pennsylvania's Secretary of Health is hopeful there will be increased clinical research in both marijuana and opioids at state health systems.
Senate HELP Committee Continues Work on Opioid Epidemic
April 19, 2018 3:47 PM by billupsjThe Senate HELP Committee introduced the Opioid Crisis Response Act of 2018 (“OCRA”), which includes 40 wide ranging proposals aimed at curbing the opioid epidemic. The OCRA puts a focus on leveraging certain technology tools, such as EHR, telemedicine and prescription drug monitoring programs, in tracking and flagging suspicious controlled substances prescriptions. The bill also calls for increased educational efforts and training programs, including those for first responders to improve treatment of cases involving fentanyl overdoses.
Movement on New Federal Bills, Addiction and the Workforce
April 12, 2018 12:53 PM by billupsjThe US House and Senate continue to work on bills to address the opioid epidemic and addiction. The House Energy and Commerce Committee concluded a series of hearings addressing the epidemic. The Senate’s H.E.L.P. Committee released a discussion draft of a substantial, multipronged bill called the Opioid Crisis Response Act of 2018 (“OCRA”) and held a hearing on the OCRA on April 11th. The bill is intended to (i) spur the development of a non-addictive painkiller, (ii) give the FDA authority to require drug manufacturers to package certain opioids for a set duration, (iii) require manufacturers to give patients simple and safe ways to dispose of unused opioids, (iv) improve the detection and seizure of illegal drugs like fentanyl, and (v) improve data sharing so doctors and pharmacies know if patients have a history of substance misuse and states can better track prescriptions. The follow-up to the Comprehensive Addiction and Recovery Act is also on the table.
The American Action Forum found in a recent study that nearly 1 million people were not working because of opioid addiction in 2015. The number of Americans not in the workforce because they were dependent on opioids grew each year between 1999 and 2015. The cost to the U.S. economy was $702 billion, or just under $44 billion each year.
Feds Seek to Join Opioid Suit
April 12, 2018 12:48 PM by billupsjThe US Dept. of Justice filed a motion requesting to join settlement talks in federal court involving hundreds of lawsuits against manufacturers and distributors of opioid painkillers. The plaintiffs (more than 400 US cities and counties) are requesting repayment for the substantial expenses imposed on them by the opioid epidemic. The historic, multijurisdictional proceeding has brought together hundreds of lawsuits from cities, counties, Native American tribes and unions in a single, massive case presided over by Judge Dan Aaron Polster of the Northern District of Ohio.
Surgeon General Issues Advisory on Naloxone
April 12, 2018 12:47 PM by billupsjSurgeon General Jerome Adams has issued a rare advisory for Americans to get trained in administering the overdose reversal drug naloxone. He urges people to talk to their doctors or pharmacists about obtaining naloxone, learn the signs of opioid overdose, and become trained in how to administer naloxone, if needed.
BCBS Adopts New Opioid Prescribing Standards
April 5, 2018 3:11 PM by billupsjThe Blue Cross and Blue Shield Association (BCBS) has adopted new opioid prescribing standards that mirror the guidelines set by the Centers for Disease Control and Prevention. According the new BCBS standard, opioids should not be the first or second treatment options to manage pain. Increasingly, insurers, pharmacies and distributors have been issuing new opioid prescription guidelines and restricting the number and size of opioid prescriptions given to patients. But there is still a fear among physicians that reducing the opioid supply could cut off access to patients who are in actual need of these drugs.
Iowa Law Expands Mental Health Services
April 5, 2018 3:09 PM by billupsjThe Governor of Iowa recently signed two pieces of legislation aimed at treating children and adults facing mental health challenges. The governor signed into law House File 2456 dealing with comprehensive mental-health upgrades and Senate File 2113 to set up required training for Iowa's educators to recognize and address the signs of a young person facing a mental-health crisis. Among the features of the House File 2456 is the establishment of six new access centers that will offer short-term assistance to Iowans in crisis situations. The centers will offer a lower-cost option to psychiatric hospital units which are often already at capacity. The new law also removes the state's cap on subacute beds and expands treatment teams that monitor and assist Iowans with chronic mental illness. Under Senate File 2113, one hour of training in suicide awareness and prevention would be required annually for Iowa school employees working with students.
Dept. of Justice/Opioid Response
March 29, 2018 10:15 AM by billupsjAttorney General Jeff Sessions announced that the U.S. Drug Enforcement Administration is sending 250 task force officers, and dozens of analysts, to places in the nation “where the opioid crisis is at its worst.” Additionally, Sessions has assigned a dozen federal prosecutors to “opioid hot-spots” to focus on investigating opioid-related health care fraud. Further, the DOJ has released its Guidance Regarding Use of Capital Punishment in Drug-related Prosecutions.
$3 Billion in New Federal Funding Signed Into Law
March 29, 2018 10:14 AM by billupsjThe FY 2018 spending bill, signed into law by President Trump, includes over $3 billion in new opioid and addiction funding. An additional $3 billion was included as part of the two-year budget agreement. The bill includes $1 billion in new funding for grants to states and tribes, as well as $350 million extra to help the CDC with overdose surveillance and prevention efforts at the national, state and local levels. The bill also includes funding for law enforcement, research, and treatment and recovery support services for rural Americans, veterans, American Indians and Alaska natives. The new funding is on top of $500 million already appropriated for FY 2018 in the 21st Century Cures Act.
Doctors Charged in Bribery and Kickback Scheme
March 22, 2018 3:14 PM by billupsjA federal indictment charges five New York doctors with participating in a bribery and kickback scheme that sought to increase the sales of Subsys, a spray form of fentanyl manufactured by Insys. The doctors allegedly received more than $100,000 annually in return for prescribing millions of dollars worth of Subsys. Insys Therapeutics is accused of funneling the illicit payments to the doctors through a sham “speakers bureau.” All of the physicians have pleaded not guilty. Insys and its executives are also the subject of criminal charges.
Trump Announces Initiative to Stop Opioid Abuse
March 22, 2018 3:13 PM by billupsjNew research finds that federal government estimates of opioid overdose deaths have been undercounting by 20 percent to 35 percent. As the death toll increases, President Trump announced his plan for addressing the epidemic, following up on his October 2017 declaration of addiction as a national health crisis. He proposed his “Initiative to Stop Opioid Abuse and Reduce Drug Supply and Demand” featuring an emphasis that is tough on crime and includes additional funding for treatment and recovery support services. His calls for the death penalty for drug dealers has drawn a lot of attention, including from Baltimore City Health Commissioner Dr. Leana Wenn, who stated, “much of his announcement … is deeply troubling.” She is concerned about the focus on punishment, the lack of sustained funding, and failure to propose the use of evidence-based practices.
One proposal is for a nationwide anti-drug ad campaign. A 2009 American Journal of Public Health study found that ads sponsored by the Office of National Drug Control Policy led to no benefits – and potentially increased the risk of later marijuana use. The ads portrayed kids on drugs as “potheads,” or “human puppets.” A 2006 Government Accountability Office report also found similar ads to be ineffective.
Policymakers Consider Strategies
March 15, 2018 11:54 AM by billupsjWhile President Trump is studying the possibility of seeking the death penalty for drug dealers, Congressional deliberations on the opioid and addiction epidemic continue, with the goal of bringing a comprehensive bill to the House floor by Memorial Day Weekend. The House Energy and Commerce Health Subcommittee has scheduled two days of hearings on March 21st and 22nd to consider more than 20 bills that have been introduced in the House.
Opioid Epidemic Escalates
March 15, 2018 11:51 AM by billupsjA Centers for Disease Control and Prevention report found that the opioid overdose problem is yet to be checked. Across the country, emergency department visits due to suspected opioid overdoses continued to climb, by about 30%, from July 2016 to September 2017.
Outcomes in California for Mental Health Services Improve Due to MHSA
March 15, 2018 11:50 AM by billupsjAn evaluation by the Rand Corporation of the impact in Los Angeles County of the one percent tax on personal income over $1 million under the Mental Health Services Act, found that more people were being served. Further, between 2012 and 2016, the rate of homelessness and inpatient hospitalization for mental health issues fell among participants in the program, while the employment rate increased.
White House Opioid Summit; Introduction of CARA 2.0
March 9, 2018 8:34 AM by billupsjThe White House hosted another opioid summit last week and Part 1 and Part 2 are available online. At the end of the event, President Trump spoke, calling for tougher punishments for drug dealers, including the possibility of the death penalty for some. A bipartisan group of senators introduced the Comprehensive Addiction and Recovery Act 2.0 (“CARA 2.0”), building off the original legislative programs passed in 2016. In a statement, sponsor Senator Sheldon Whitehouse (D-RI), said, “CARA 2.0 will build on the original law by increasing the funding authorization levels for CARA’s evidence-based programs to better coincide with the recent budget agreement and laying out new policy reforms to strengthen the federal government’s response to this crisis. CARA 2.0 will authorize $1 billion in dedicated resources to evidence-based prevention, enforcement, treatment, and recovery programs.”
Significant Community Impact Disparities With Opioid Crisis
March 9, 2018 8:32 AM by billupsjWhile very little attention has been given to the impact of the opioid epidemic on communities of color, recent research suggests that it has been devastating to these communities. According to a study from the National Cancer Institute and the National Institute on Drug Abuse, older black Americans have seen the sharpest increase in overdose death rates. Last November, the Chicago Urban League released an Issue Brief, “Whitewashed: The African American Opioid Epidemic,” stating, “The opioid epidemic has largely been portrayed as a problem affecting young whites in suburban and rural areas. In Illinois, the Midwest, and indeed much of the United States, this is a wholly inaccurate depiction.” They found that African Americans make up approximately one third of the population in Chicago but account for nearly half of all opioid deaths.
Kentucky Proposes Taxing Opioids
March 9, 2018 8:31 AM by billupsjAs states grapple with the addiction and opioid crisis, Kentucky is considering imposing a new tax on opioid prescriptions and upping its current tax on cigarettes. Already, the Kentucky House has passed the proposed 25-cent levy on drug distributors for every dose sent to the state. However, unlike similar tax proposals put forth in other states, the funds would not be dedicated to addiction prevention, treatment and recovery services. At the federal level, late last year beer, wine and spirits producers will realize a two-year reduction in federal excise taxes worth $4.2 billion as part of the tax reform law.
Mental Illness and Gun Violence
March 2, 2018 8:52 AM by billupsjThe link between mental illness and gun violence has reignited public policy discussions after the Parkland shootings. In an article examining truths and falsehoods about these links, it determined that “there’s a link, but it’s more limited than widely thought.” Further, according to American Psychiatric Association data, overall, mass shootings by people with serious mental illness represent 1 percent of all gun homicides each year.
Unethical Practices Remain Concern in Industry
March 2, 2018 8:51 AM by billupsjThere’s been growing concern about the unethical activities of some addiction treatment providers. The Recovery Research Institute recently explained practices including patient brokering, patient enticement, insurance fraud and patient privacy violations.
Congress Pursuing Opioid and Addiction Solutions
March 2, 2018 8:49 AM by billupsjAs House and Senate appropriators work on how to spend the $6 billion authorized in the budget agreement, Congressional committees are pushing to further address opioid and addiction issues. This week the US Senate’s HELP committee will hold a hearing entitled ”The Opioid Crisis: The Role of Technology and Data in Preventing and Treating Addiction” and the House Energy and Commerce committee will hold a hearing entitled “Combating the Opioid Crisis: Helping Communities Balance Enforcement and Patient Safety.” This hearing will address eight enforcement and patient safety-related bills and is the first of three hearings scheduled. Panel chairman, Greg Walden (R-OR), says he would like to pass opioid legislation in the House by the Memorial Day weekend. Senators Rob Portman (R-Ohio) and Sheldon Whitehouse (D-RI) are working on what they’re calling CARA 2.0, to build on the 2016-enacted Comprehensive Addiction and Recovery Act (CARA).
ABA Resolution on Well-Being
February 16, 2018 9:40 AM by billupsjThe ABA’s House of Delegates adopted a resolution urging bar associations, law schools, lawyer licensing agencies, and legal employers to step up efforts to help attorneys with mental health and substance use issues.
Practices of Addiction Treatment Centers Under Enhanced Scrutiny; Legislative Efforts Underway
February 16, 2018 9:39 AM by billupsjGrowing concerns about the practices of some addiction treatment centers prompted Senator Marco Rubio (R-FL) to ask US Attorney General Jeff Sessions to investigate claims of kickbacks and false statements associated with federal plans. A panel of prosecutors from the National District Attorneys Association has been tasked with developing with recommendations for addressing fraud within the addiction treatment and recovery housing industry, as well as policies for prevention and rehabilitation. Lawmakers in California are considering new laws and regulations to regulate the addiction industry such as medical exam requirements prior to admission to a facility, state licensure and background clearance requirements for counselors, and enhanced scrutiny of false advertising.
Drug Czar Nominated; Cuts Proposed to Budget of ONDCP
February 16, 2018 9:35 AM by billupsjWhite House deputy chief of staff Jim Carroll is expected to be nominated as the head of White House Office of National Drug Control Policy (ONDCP). On a related note, the FY2019 proposed federal budget includes dramatic cuts to the budget of the ONDCP.
$6 Billion over Two Years For Addiction and Opioids
February 16, 2018 9:34 AM by billupsjThe two-year budget deal signed into law by President Trump includes $6 billion over two years to deal with the opioid crisis. These amounts are in addition to existing opioid-related funding, including the $1 billion over fiscal years 2017 and 2018 that Congress dedicated to the opioid epidemic in the 21st Century Cures Act. While this is a massive infusion of funds, how the funds will be allocated remains to be determined.
Interest in Drug-Induced Homicide Laws Grows
February 8, 2018 3:22 PM by billupsjDrug-induced homicide laws, which punish people who sell drugs that lead to accidental overdose deaths and carry sentences equivalent to those for manslaughter and murder, have been on the books in some states since the 1980s. Today, 20 states have drug-induced homicide laws, according to the Drug Policy Alliance. As local, state and federal policymakers grapple with the growing problem of overdose deaths, some have turned to using and/or strengthening existing laws or passing new ones despite the lack of evidence that these laws are effective in reducing overdose deaths. For example, Florida passed a law that would allow prosecutors to charge drug dealers with capital murder in some circumstances. The heightened penalties were bundled in with allowances for increased naloxone access, and the bill passed unanimously. In 2017, 13 states introduced bills that would create or strengthen drug-induced homicide laws.
Brief State of the Union Mention
February 8, 2018 3:10 PM by billupsjLeana S. Wen, M.D., Commissioner of Health for the city of Baltimore, stated that President Trump’s brief 49 seconds on addiction and the opioid epidemic in his State of the Union address “is indicative of the lack of action taken by the federal government in the three months since the emergency declaration.” She also questioned the lack of commitment of federal funding to the opioid epidemic; where funding will be directed; the availability of naloxone; and the availability of addiction treatment.
Opening Recovery Residences in New Hampshire
February 1, 2018 11:02 AM by billupsjZoning officials in Ossipee, NH turned down a proposal to open up a home for people recovering from addiction. The planned 20-bed facility for women was rejected because officials “worried it was too close to a local elementary school”. The applicant plans to bring the town to court under the federal Fair Housing Act if he is unable to get a permit.
Prescription Drug Monitoring State-by-State
February 1, 2018 11:01 AM by billupsjThe Pew Charitable Trusts compiled and reviewed data from the National Alliance for Model State Drug Laws to determine how states structure laws and regulations that define when and under what circumstances prescribers are required to check the prescription drug monitoring programs (PDMP). Among the findings were that more than half of states have a PDMP mandate, though requirements for when the PDMP must be checked vary.
Cherokee Nation Opioid Litigation
February 1, 2018 10:59 AM by billupsjA federal judge ruled in McKesson Corporation, et al, v. Hembree, et al, U.S. District Court, Northern District of Oklahoma, No. 17-cv-323 that the Cherokee nation did not have the jurisdiction to bring a case against the largest drug distributors in the U.S. The tribe sought to decrease the flow of opioids into the tribe’s district in Oklahoma.
ONDCP Slated for Cuts; Governors Call for Action on Addiction and Opioids
January 26, 2018 8:39 AM by billupsjThe White House Office of National Drug Control Policy (ONDCP) is once again on the cutting block as the Trump Administration prepares its second budget submission to Congress. The Administration proposes shifting the ONDCP’s two main grant programs, the High Intensity Drug Trafficking Areas grant and the Drug Free Communities Act, to the Justice and Health and Human Services departments, respectively – a 95% cut to the agency’s budget. Additionally, the Administration has yet to appoint a permanent ONDCP director. Meanwhile, the National Governors Association released a list of more than two dozen recommendations to Congress and the Administration to address the opioid and addiction crisis, in a coordinated, bipartisan response.
Next Steps in Lawsuits Against Drug Manufacturers
January 26, 2018 8:38 AM by billupsjU.S. District Judge Dan Polster, who is presiding over more than 200 cases filed by government entities against drug manufacturers, has appointed three special masters to help with the litigation and scheduled a January 31 conference with attorneys to continue settlement discussions. Polster told the hundreds of lawyers who attended an earlier hearing that, “he would like to see an all-encompassing settlement struck in 2018 that would put money toward trying to quell the opioid crisis.”
Office of National Drug Policy Under Scrutiny
January 18, 2018 3:14 PM by billupsjDownsizing continues and management issues are in question at the White House Office of National Drug Control Policy (ONDCP) in the face of the opioid epidemic. Taylor Weyeneth, age 24, has been appointed as the deputy chief of staff, apparently ascending to his role, with no experience in the drug policy arena, based in part upon staff turnover and vacancies. Prior to his employment at ONDCP, his only professional experience after college was with Trump’s presidential campaign.
Opioid Epidemic Impacting Children
January 18, 2018 3:13 PM by billupsjResearchers reported on the dramatic effect on the ability of some parents who are dependent on opioids to care for their children. According to the report, a growing number of children are being placed in foster care as a result of the nation’s opioid crisis. The report urged policymakers to consider the epidemic’s effects on child welfare when determining the appropriate public health response.
Google Temporarily Suspends Addiction Treatment Center Ads Globally
January 18, 2018 3:11 PM by billupsjGoogle announced a temporary halt to advertisements on its networks for addiction treatment services in a statement to Tech Crunch. According to Google, “This is a complex issue with varying degrees of regulation in different countries, which is why we’ve decided to suspend ads in the entire addiction treatment center category globally while we consult with experts to find a better way to connect people with the treatment they need.” Treatment centers were allegedly paying large referral and finders fees.
Addressing Insurance Discrimination
January 12, 2018 8:39 AM by billupsjTen years after implementation of the Mental Health Parity and Addiction Equity Act, Marketplace took a look at the ways mental health insurance coverage is still not receiving equal treatment under the law. One source to obtain information regarding such discrimination is Parity Track, a one-stop resource, sponsored by a broad-based coalition of organizations, for finding out about rights under the law, how to file complaints and how to stay on top of this issue.
Confidentiality Regulations Finalized
January 12, 2018 8:37 AM by billupsjThe Substance Abuse and Mental Health Services Administration, finalized changes to the Confidentiality of Substance Use Disorder Patient Record regulations (42 CFR part 2). One purpose of the new rule is to facilitate the sharing of patient information for payment and health care operations with patient consent.
New Funding for Opioid Epidemic in Budget Agreement
January 12, 2018 8:35 AM by billupsjNew efforts are underway to secure new federal funding to address the opioid epidemic. Senators Jeanne Shaheen (D-NH) and Maggie Hassan (D-NH), are calling for an extra $25 billion to be included any final budget agreement. In 2017, efforts to secure an additional $45 billion were unsuccessful. The call for funding comes as the National Center for Health Statistics reports that life expectancy in the U.S. is in decline for the second year in a row. For individuals aged 15-34, the decline is due in large part to the staggering impact of the unchecked opioid epidemic. Of the 63,600 deaths in 2016 attributed to drug overdose, more than 42,200 were due to opioids.
Private Sector and Governmental Response to Opioid Epidemic
December 21, 2017 12:13 PM by billupsjDrug manufacturers and insurers are putting forward proposals to address the opioid epidemic and, over the course of 2017, have “announced new goals to reduce the prescribing of opioid painkillers, limit how many pills patients can get at one time and give them better access to medication-assisted treatment.” Kellyanne Conway has been holding weekly meetings with administration officials from multiple federal agencies to develop a response to the opioid crisis, following up on the recommendations made by the President’s Commission. However, the administration has yet to call for an increase in funding to address addiction.
Evaluation of Responses to the Opioid Crisis
December 21, 2017 11:57 AM by billupsjIn an article in the New England Journal of Medicine, “Coupling Policymaking with Evaluation — The Case of the Opioid Crisis“, researchers studied policies aimed at curbing the opioid epidemic in Massachusetts. According to HealthCareDIVE, “Many policies aimed at curbing the opioid epidemic in Massachusetts proved to be largely ineffective…,” These findings raise questions about the current efforts of private and government stakeholders to prevent overdose deaths. For example, “well-intentioned policies,” such as limiting the supply of opioids dispensed at one time and making so-called doctor shopping illegal, were found to have no meaningful effect, according to the researchers.
New Report to Congress on Serious Mental Illness and Emotional Disturbance
December 21, 2017 11:56 AM by billupsjThe Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), has issued its 2017 report to Congress entitled “The Way Forward: Federal Action for a System that Works for All People Living with Serious Mental Illness and Serious Emotional Disturbances (SED) and Their Families and Caregivers.” The report shines the spotlight on the critical issues and services for Americans with these conditions. The report marks the starting point in a five-year process of improving the lives of people affected. A 8-12-page summary delineates the five focus areas, each with 8-10 recommendations. These recommendations are from the non-federal members and represent common areas in which federal partners and stakeholders can work together to implement over the next five years.
ABA Voices of Recovery
December 21, 2017 11:55 AM by billupsjThe ABA’s Commission on Lawyer’s Assistance Programs (CoLAP) has produced a new podcast series about overcoming substance use disorders, mental health issues and addiction called ABA Voices of Recovery. New stories will be told every two weeks and the aim of the podcast, and its participants, is to reduce the stigma surrounding these issues and encourage others to get the help they need.
Deaths in Opioid-related Hospital Stays
December 14, 2017 3:44 PM by billupsjAccording to a study by Zirui Song, published in Health Affairs, deaths in opioid-related hospital stays in the U.S. quadrupled between 1993 and 2014. The study analyzed data from the National Inpatient Sample of the Healthcare Cost and Utilization Project, a national database compiled by the Agency for Healthcare Research Quality, which encompassed nearly 385,000 hospital stays involving patients who were admitted for opioid use. By 2014, four times as many patients died from opioid-related causes while staying in the hospital, rising from 0.43 percent before 2000 to 2.02 percent in 2014.
Messaging Around Addiction
December 14, 2017 3:41 PM by billupsjIn a recent editorial in the Journal of Addiction Medicine, Keith Humphreys, Ph.D., Professor and the Section Director for Mental Health Policy in the Department of Psychiatry and Behavioral Sciences at Stanford University, lays out the need for rethinking how substance use disorders are messaged to help address the stigma of addiction and gain support for policies that will assist in treatment of the health condition. Humphreys argues that popular comparisons of substance use disorder to diabetes and asthma may miss the mark. Addressing the problem of stigmatization while still realistically acknowledging the potential harm substance use disorders can cause may be a more effective way of gaining support from the general public. He further suggests that the public would be better served to talk about substance use disorder as a legitimate medical condition that can also have a substantial impact on other people and the community at large.
Hearings on Addiction Treatment Fraud
December 14, 2017 3:38 PM by billupsjThe House Energy and Commerce Oversight and Investigations subcommittee held hearings, on December 12, 2017, on addiction treatment fraud. Committee members examined the role of brokers, who are paid a fee for referrals by some treatment centers. Witnesses to the hearing, entitled “Examining Concerns of Patient Brokering and Addiction Treatment Fraud,” included officials from the Massachusetts attorney general’s office and state attorneys from Florida, where many out-of-state patients are sent.
Addressing Mental Health and Addiction in the Legal Profession
December 7, 2017 3:41 PM by billupsjThe Chicago Bar Association, through its CBA Record, took an in-depth look at substance use and mental health issues in the legal profession in a recent article, “Shattering the Silence, Overcoming the Stigma.” The article’s authors examine national findings as well as what’s happening in Illinois; why it’s important; and what can be done to provide assistance to lawyers struggling with substance use and mental health issues.
Justice Department to Award Grants to Combat Opioid Crisis
December 7, 2017 3:38 PM by billupsjThe Justice Department will award $12 million in grants to help law enforcement agencies battle the opioid crisis. The grants will also create a new office in the Appalachian region to crack down on illicit drug trafficking. All U.S. attorneys' offices are now required to designate an opioid coordinator to work with prosecutors and other federal, state, tribal and local law enforcement officials to coordinate opioid prosecutions. At a press conference announcing these steps, Attorney General Jeff Sessions also announced that counselor to the President, Kellyanne Conway, will be overseeing White House efforts to combat the opioid overdose epidemic. The Administration has yet to appoint a head for the Office of National Drug Control Policy.
Hearing on Opioid Epidemic to be Held
December 7, 2017 3:33 PM by billupsjThe opioid epidemic continues to receive attention in Washington, DC. The Senate Appropriations Committee’s Subcommittee on Labor, Health and Human Services, Education, and Related Agencies will hold a hearing on December 5, 2017 titled “Addressing the Opioid Crisis in America: Prevention, Treatment and Recovery.” Senators, government officials, and other experts are expected to testify.
Cost of the Opioid Epidemic
November 30, 2017 3:32 PM by billupsjIn its report, The Underestimated Cost of the Opioid Crisis, the Council of Economic Advisers (CEA) has estimated that the opioid drug epidemic cost the country $504 billion in 2015—in terms of lost lives, lost productivity, health care, treatment, criminal justice and other expenses. The cost is more than six times larger than the previous study because it includes the value of lives lost to the epidemic and is equal to 2.8 percent of GDP according to the report.
Altarum, a nonprofit research and consulting institute dedicated to improving health and health care, arrived at a cost estimate of $95 billion for 2016 using a different methodology than the CEA. According to Altarum, the CEA report’s cost estimate is higher than theirs and previous estimates primarily due to the CEA’ use of the “value of a statistical life,” which seeks to place a cost on the intangible value of a life, above and beyond lost earnings.
When the President’s Opioid Commission issued its Final Report on November 1, 2017, it didn’t put a price tag on addressing the opioid and drug crisis in the country. Time magazine’s Money asked five experts for their estimates and all had varied estimates. According to one expert, “This is a chronic disease that has been around for a millennium, but Washington is acting as if there should be an acute solution, there is not.”
Drug-Induced Homicide Laws Examined
November 16, 2017 12:43 PM by Jason BillupsA new report entitled An Overdose Death Is Not Murder: Why Drug-Induced Homicide Laws Are Counterproductive and Inhumane was published by the Drug Policy Alliance examining a strategy that some are embracing in response to the opioid overdose epidemic – charging drug sellers with drug-induced homicide. According to the report, this strategy has yet to be demonstrated as an effective deterrent and indeed, may be intensifying, rather than helping, the problem.
Drug Overdoses Leading Cause of Death for Americans Under 50
November 16, 2017 12:41 PM by Jason BillupsDrug overdose deaths increased more than 17 percent between 2015 and 2016, according to a new report by the Centers for Disease Control and Prevention. The overdose death rate rose to almost 20 people per 100,000 and drug overdoses are now the leading cause of death for Americans under age 50.
How to Pay for Addiction Care
November 16, 2017 12:39 PM by Jason BillupsHow and if the country will pay for the necessary care to address the opioid epidemic and addiction crisis remains unclear. Several factors led many to believe that “Congress is unlikely to create a major new stream of funding before the new year.” Senators have been calling for $45 billion in funding over the next decade, but there has been no action to formalize the proposal. Further, despite a declaration of an opioid epidemic by the White House, the administration and some members of Congress have supported a budget that cuts $1.1 trillion in planned Medicaid spending over the next 10 years. Medicaid is the nation’s largest payer for addiction treatment services.
Over 22 Million Americans in Recovery
November 9, 2017 11:18 AM by Jason BillupsAccording to a landmark survey that measured the prevalence and pathways of alcohol and other drug problem resolution among adults living in the US, approximately 22.35 million individuals have resolved alcohol and other drug problems. The most commonly reported resources used to resolve these problems were mutual aid groups (45%), professional treatment (28%), and medication support (9%).
Opioid Commission Finalizes Report to President
November 9, 2017 11:15 AM by Jason BillupsAt the fifth and final public meeting of the President's Commission on Combating Drug Addiction and Opioid Crisis, members approved their final report to the President and heard testimony about the barriers to care caused by insurance discrimination and the urgency of addressing the issue. The report included 56 recommendations on how to curb the crisis including enhancing prescription drug monitoring programs, expanding drug courts, and establishing prescribing guidelines, regulations and education. The report called on Congress to appropriate “sufficient funds” for the effort but didn’t name a specific dollar amount. Commissioner Patrick Kennedy, a former member of Congress and a person in long-term recovery from addiction, called for a robust infusion of federal funds to combat the opioid epidemic, to the tune of $100 billion over 10 years “just as a starting point, at a minimum, minimum, minimum.”
President, Advocates, and Congress Weigh in on Opioid Epidemic
November 2, 2017 3:33 PM by Jason BillupsPresident Trump signed a directive declaring the opioid epidemic a public health emergency last week. The much-anticipated announcement did not include calls for additional funds to address the crisis and included personal remarks about simply not using drugs as a way to address the epidemic. The designation “would allow for some grant money to be used to combat opioid abuse, permit the hiring of specialists to tackle the crisis, and expand the use of telemedicine services to treat people in rural areas ravaged by opioid use, where doctors are often in short supply.” The President also called for and hailed the benefits of a new advertising campaign, a strategy that was a hallmark of earlier anti-drug efforts. However, according to prior government and academic assessments, “past marketing efforts have shown few results and experts say other measures could be far more effective in curbing the current epidemic.”
Opioid Commission Meets
October 26, 2017 11:03 AM by Jason BillupsThe report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis is expected to be released within the next few weeks. The commission met recently to hear from insurers and payers.
President Expected to Announce Opioid National Emergency Thursday
October 26, 2017 11:00 AM by Jason BillupsThe long-awaited declaration of the opioid epidemic as a national emergency is expected to occur on Thursday. A wide-ranging plan is expected that will involve leading Administration officials. President Trump could use the emergency declaration as leverage to involve Attorney General Jeff Sessions in the litigation efforts of states and cities against the drug industry players. “That would give those cases the full weight and financial resources of the Justice Department and increase the chances of a big settlement,” said Jake Novak.
Fentanyl Manufacturers and Distributors Charged
October 19, 2017 3:50 PM by Jason BillupsFederal authorities have brought their first-ever charges against manufacturers and distributors of fentanyl who control international trafficking routes and money laundering organizations.
Call to Remove High Dosage Opioids from Market
October 19, 2017 3:49 PM by Jason BillupsBrandeis University's Andrew Kolodny and former CDC Director Tom Frieden have recommended that a comprehensive approach to the opioid epidemic be considered. Actions that the can be taken immediately to stem the opioid epidemic include an FDA ban on “ultra-high-dosage” painkillers and law enforcement stepping up efforts to curb the flow of heroin and fentanyl into the US.
Changes to DEA Authority Escalated Opioid Epidemic; Marino Withdraws from ONDCP Job
October 19, 2017 3:47 PM by Jason BillupsThe Washington Post and “60 Minutes” released a wide-ranging investigation into the lobbying efforts that resulted in Congress weakening the DEA’s ability to go after drug distributors through passage of the Ensuring Patient Access and Effective Drug Enforcement Act. The Act’s main House sponsor, Rep. Tom Marino (R-PA), had been nominated by President Trump to head the White House Office of National Drug Control Policy. Marino has withdrawn his nomination in light of the investigation.
Sen. Claire McCaskill (D-MO), who “says it’s time for pharmaceutical companies to start worrying about their role in causing the opioid epidemic, the deadliest drug overdose crisis in US history”, according to Vox, has said that she will sponsor a bill to repeal the law. President Trump, who has promised to declare the opioid epidemic a national emergency, announced that he will take that action next week.
PBS' Week-long Focus on Opioid Epidemic; Opioid Commission to Meet 10/20
October 12, 2017 3:34 PM by Jason BillupsThe PBS News Hour wrapped up a 5-day look at the opioid crisis last Friday. America Addicted presented a comprehensive look at the epidemic and how it can be stopped. The President’s Commission on Combating Drug Abuse and the Opioid Crisis will meet Oct. 20th and will be open to the public through livestreaming.
Opioid Hearings on Capitol Hill
October 12, 2017 3:32 PM by Jason BillupsThe House Energy and Commerce Committee’s Health subcommittee held a hearing, “Member Day: Testimony and Proposals on the Opioid Crisis,” on Wednesday, October 11. The purpose of the Member Day hearing is to allow representatives, both on and off the Committee, to testify about the opioid epidemic and share personal and local stories. Meanwhile, the U.S. Senate HELP Committee held the first of two hearings last week, focusing on the federal response to the opioid epidemic. A second hearing on its impact on states and localities will be held soon. Senators and witnesses seemed to agree that more research is needed to better understand and combat the crisis.
Join the Section for a Tweet Chat on Healthcare Solutions to the Opioid Epidemic
October 10, 2017 11:42 AM by Susan PachikaraConcerned about the opioid epidemic and eager to find solutions to address it? Join the Health Law Section for a tweet chat on "The Addiction Crisis: What are the Healthcare Solutions to the Opioid Epidemic" moderated by two addiction experts at 11 a.m. CT on October 18. Tom Coderre is Senior Advisor at the Altarum Institute and formerly with SAMHSA having served as Chief of Staff and Senior Advisor to the Assistant Secretary at SAMHSA. While at SAMHSA, Tom led the team that produced Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Stuart Gitlow, MD, DFASAM, former President of the American Society of Addiction Medicine (ASAM) is the Executive Director of the Annenberg Physician Training Program in Addictive Disease, which he started in 2005 to ensure medical student access to training that stimulates them to develop and maintain interest in working with patients with addiction.The hashtag for the tweet chat will be #HLSChat. The Section’s Twitter account is @abahealthlaw. APAM's account is @ASAMorg.
Prescription Drug Monitoring Programs' Effectiveness
October 5, 2017 3:47 PM by Jason BillupsOne of the tools in combating the opioid epidemic is prescription drug monitoring programs. It is believed that these programs could be more useful if integrated with other health data and shared across states, as recommended by the President’s Commission on Combating Drug Addiction and the Opioid Crisis. This is an approach being adopted by the Department of Veterans Affairs.
More Calls for National Emergency Declaration; First Lady Getting Involved
October 5, 2017 3:45 PM by Jason BillupsThe leadership of the Congressional Bipartisan Heroin Task Force called on President Trump to formally declare the opioid crisis a national emergency. The leaders of the Task Force outlined an emergency bipartisan consensus on specific shared policy objectives. The New York Times editorial board delivered an eight-step program to tackle the “despair and devastation of addiction.” Their recommendations included some from the draft interim report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis. First Lady Melania Trump is taking on a larger role in addressing the addiction crisis, meeting recently with experts and people affected by addiction at the White House. "I am here today to listen and learn from all of your stories, and hope you will feel free to give me your thoughts and opinions on how best I can help," the first lady said as she opened the meeting.
Young Americans Lead Rise in Suicide Attempts
September 29, 2017 8:26 AM by Jason BillupsSuicide attempts by young adults, particularly those with mental illness and less education are increasing, according to HealthDay, reporting on findings in JAMA Psychiatry. Between 2004 and 2014, the annual suicide rate increased among U.S. adults. While middle-aged adults (aged 45-64 years) had the highest suicide rate, young adults (aged 21-34 years) had the biggest increase in suicide attempts.
Opioid Overdoses Impact Life Expectancy
September 29, 2017 8:23 AM by Jason BillupsOpioid overdoses reduced Americans’ life expectancy by 2.5 months between 2000 and 2015, according to a new report from the Centers for Disease Control and Prevention. During that period, U.S. life expectancy increased overall from almost 77 years to 79 years, as deaths from major killers such as cancer and heart disease decreased. But during that period, the death rate from drug overdoses more than doubled, and the death rate from opioid overdoses—including heroin and prescription opioids—more than tripled. By the final year of the study, Americans’ average life expectancy began to decrease again.
October 5 HELP Committee Hearings
September 28, 2017 4:20 PM by Jason BillupsElinore McCance-Katz, Assistant Secretary for Mental Health and Substance Use; Brenda Fitzgerald, Director, Centers for Disease Control and Prevention, and Administrator, Agency for Toxic Substances and Disease Registry; Francis Collins, Director, National Institutes of Health; and Scott Gottlieb, Food and Drug Administration Commissioner, will testify at an October 5 Senate HELP committee hearing on the federal response to the opioid crisis. The agenda will cover implementation of the Comprehensive Addiction and Recovery Act and opioid-related provisions of the 21st Century Cures Act.
Role of Insurers in Opioid Epidemic
September 21, 2017 3:51 PM by Jason BillupsAn analysis of Medicare prescription drug plans, looking at data of 35.7 million people during the second quarter of 2017, was conducted to determine of the role that insurers are playing in the opioid epidemic. The report found that many insurers are limiting access to pain medications that carry a lower risk of addiction or dependence, even as they provide comparatively easy access to generic opioid medications. Only one-third of the people covered, for example, had any access to Butrans, a painkilling skin patch that contains a less-risky opioid, buprenorphine. And every drug plan that covered lidocaine patches, which are not addictive but cost more than other generic pain drugs, required that patients get prior approval for them. Yet, the insurers still generally restricted access to addiction treatment.
New Deadline for Opioid Commission Report
September 21, 2017 3:48 PM by Jason BillupsThe President’s Commission on Combating Drug Addiction and the Opioid Crisis, chaired by New Jersey Governor Chris Christie, has yet to release its final recommendations and report which has been delayed to November 1. Additionally, the President has yet to formally declare the opioid crisis a national emergency. Such a declaration would unleash significant amounts of emergency funding to fight opioid addiction.
$340 Million in Federal Funds to Fight Addiction
September 21, 2017 3:46 PM by Jason BillupsDuring the week of September 11th, the US Dept. of Health and Human Services (HHS) provided in excess of $340 million in funding for programs aimed at providing greater access to addiction treatment. Part of this funding was more than $144 million in grants to fund six initiatives, including training and medication to first responders for treatment of opioid overdoses and expand residential substance abuse treatment for single mothers. It also included more than $200 million provided to 1,100 community health centers across the country. However, while laudable, the vast majority of those funds come from last year's legislative actions.
House Energy and Commerce Committee Meeting Oct. 23 on Opioid Crisis
September 15, 2017 8:49 AM by Jason BillupsRep. Greg Walden, Chair of the House Energy and Commerce Committee, recently announced the Committee will be holding a hearing the week of October 23rd to discuss the implementation of the Comprehensive Addiction and Recovery Act (CARA). The Committee also expects to receive an update from officials on the progress of CARA. CARA was signed by President Obama on July 22, 2016, and is a comprehensive effort to address the opioid epidemic by expanding prevention and treatment efforts. CARA also aims to strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.
Recovery Centers of America's Care Under Investigation
August 31, 2017 2:54 PM by Jason BillupsFollowing up an investigation by the Boston Globe and STATNews, the state of Massachusetts shut down admissions at one of Recovery Centers of America’s (RCA) inpatient addiction treatment centers because of safety concerns. The quality of care at addiction treatment centers has received growing attention and nine people have died in licensed substance use treatment programs in Massachusetts this year. According to STATNews, “RAC describes itself as the ‘fastest-growing’ addiction treatment provider in the country,” offering “five-star,” resort-like accommodations.
National Geographic Tackles Addiction
August 31, 2017 2:52 PM by Jason BillupsAs the nation seeks to address the opioid epidemic and the problem of addiction, there are a growing number of efforts to broaden public understanding of the nature of addiction and its solutions. The latest is from National Geographic, where a cover article, “How Science Is Unlocking the Secrets of Addiction,” offers a comprehensive look at the issue and challenges the view that addiction is a moral failing.
Interdepartmental Serious Mental Illness Coordinating Committee Launched
August 24, 2017 3:22 PM by Jason BillupsThe 21st Century Cures Act established the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), whose public members were recently appointed. The ISMICC is to improve federal coordination of efforts that address the needs of adults with serious mental illness and children and youth with serious emotional issues. The ISMICC is composed of senior leaders from ten federal agencies including HHS, the Departments of Justice, Veteran Affairs, and the Social Security Administration along with 14 non-federal public members.
Dr. Elinore McCance-Katz Confirmed as First Assistant Secretary for Mental Health and Substance Use
August 24, 2017 3:18 PM by Jason BillupsDr. Elinore McCance-Katz is the first Assistant Secretary for Mental Health and Substance Use. In her position, created in the 21st Century Cures Act, she will work across federal agencies to bring the full force of the government to bear in support of the clinical priorities identified by Secretary of the Department of Health and Human Services (HHS). She is to address the opioid epidemic and focus on the treatment and care needs of Americans with serious mental illness. She will lead the Substance Abuse and Mental Health Services Administration (SAMHSA) in HHS.
Aiding Incarcerated Americans with Mental Illness
August 17, 2017 2:48 PM by Jason BillupsIn a special Mental Health issue, Politico takes a look at what is happening – or not – for people with mental illness. In the decades since deinstitutionalization began in 1975, the number of Americans incarcerated and in prisons has soared, and federal statistics show that roughly half of them have diagnosable mental disorders. In Alaska, the Southcentral Foundation was a trailblazer in incorporating mental health care into primary care, “making life easier for patients and breaking down the stigma that makes it so hard for many Americans to get care,” according to Politico, Integrating care was strongly encouraged under the Affordable Care Act, where changes in billing codes as well as grant programs have helped stimulate this strategy.
President to Declare National Emergency Around Opioid Crisis
August 17, 2017 2:46 PM by Jason BillupsPresident Trump reversed course and announced that he will be declaring the opioid crisis a national emergency, a recommendation from his Commission on Combating Drug Addiction and the Opioid Crisis. What it will look like and mean has yet to be determined and is “uncharted territory,” according to TATNews. According to advocates, the president must spell out what resources will be available and “a declaration is … some official-sounding words on a piece of paper — unless it is accompanied by further action.” First Lady Melania Trump, Presidential advisor Jared Kushner, and White House counselor Kellyanne Conway have been engaged on the opioid epidemic along with HHS Secretary Tom Price and Attorney General Jeff Sessions. Meanwhile the economic and human toll of the opioid epidemic continues to be felt. A study led by Beth Israel Deaconess Medical Center in Boston found that the cost of treating opioid overdose victims in hospital intensive care units jumped 58 percent in a seven –year span, an escalation rate far exceeding the overall medical inflation rate.
US Senate Passes Jessie's Law
August 10, 2017 11:43 AM by Jason BillupsThe U.S. Senate passed “Jessie’s Law,” S. 581, in early August 2017. The bill would require a history of opioid addiction to be displayed in medical records of individuals who have consented, and the information would also be shared with clinicians and pharmacists. The bill enjoys bipartisan support and now moves on to the House for consideration. If enacted, standards would be developed that could be used by hospitals and physicians to "prominently" display a patient's history of opioid addiction in his or her medical record, but only if the patient has consented to providing the history to a clinician.
US Attorney General Announces Formation of Opioid Fraud and Abuse Detection Unit
August 10, 2017 11:39 AM by Jason BillupsAttorney General Sessions introduced the new Opioid Fraud and Abuse Detection Unit, a pilot program to utilize data in the fight against the opioid crisis impacting citizens nationwide. The Department will fund twelve experienced Assistant United States Attorneys for a three-year term with the primary focus on investigating and prosecuting health care fraud related to prescription opioid abuse. States selected to participate include: Florida, Michigan, Alabama, Tennessee, Nevada, Kentucky, Maryland, Pennsylvania, Ohio, California, North Carolina, and West Virginia.
Over One Third of Americans Report Prescription Opioid Use in 2015
August 10, 2017 11:36 AM by Jason BillupsA study financially supported by HHS reported that in 2015 more than one third of U.S. noninstitutionalized adults reported prescription opioid use, with substantial numbers reporting misuse. One primary reason for misuse reported was relief from physical pain. Factors of abuse may be associated with economic disadvantage and behavioral health problems.
New Research Expands Understanding of the Opioid Epidemic
August 3, 2017 3:48 PM by Jason BillupsNew research is broadening understanding of the scope and causes of the opioid epidemic. According to Keith Humphreys, writing in the Washington Post, “what was once a rural epidemic is now a national one.” HHS researchers found that the proportion of the population using prescribed opioids in the past 12 months was sizable and of similar magnitude across large metropolitan areas (36.0 percent), small metropolitan areas (40.1 percent) and non-metropolitan areas (39.9 percent). And researchers at the National Institute on Drug Abuse found that one-third of adults – about 92 million people – used prescription opioids in 2015. A new website, mytopcare.org (Transforming Opioid Prescribing in Primary Care) was developed by a team of researchers at Boston Medical Center who propose a novel system change in delivery of primary care services to decrease misuse of and addiction to prescription opioids for patients with chronic pain
Opioid Commission Recommends Declaring National Emergency
August 3, 2017 3:46 PM by Jason BillupsIn a draft of its initial report to President Trump, his Commission on Combating Drug Addiction and the Opioid Crisis, chaired by New Jersey’s Gov. Chris Christie, called on the President to declare a national emergency to deal with the epidemic. A final report is due in October according to the New York Times. “Your declaration would empower your cabinet to take bold steps and would force Congress to focus on funding and empowering the executive branch even further to deal with this loss of life,” the Commission stated. Other recommendations include expanding capacity for drug treatment under Medicaid; increasing the use of medication-assisted treatments; encouraging the development of non-opioid pain relievers; expanding naloxone use; requiring prescriber education initiatives; and broadening “Good Samaritan” laws that shield people from prosecution when they report a drug overdose. According to Vice, while the Commission reported receiving more than 8000 comments from the public, over 7800 comments were related to marijuana and its use for reducing opioids. VICE News filed a Freedom of Information Act request for all public comments received by the Commission.
Largest Opioid-related Crackdown in Nation's History
July 28, 2017 9:31 AM by Jason BillupsMore than 100 of the individuals charged in a nationwide enforcement action regarding health care fraud were involved in prescribing and diverting opioids. According to DOJ, “the charges … aggressively target schemes billing Medicare, Medicaid, and TRICARE (a health insurance program for members and veterans of the armed forces and their families) for medically unnecessary prescription drugs and compounded medications that often were never even purchased and/or distributed to beneficiaries. The charges also involve individuals contributing to the opioid epidemic, with a particular focus on medical professionals involved in the unlawful distribution of opioids and other prescription narcotics, a particular focus for the Department.”
Blue Cross Blue Shield Analyzes Opioid Use/Problems
July 28, 2017 9:29 AM by Jason BillupsBlue Cross Blue Shield recently released, “America's opioid epidemic and its effect on the nation's commercially-insured population” analyzing 30 million medical records. Dr. Trent Haywood, chief medical officer of Blue Cross Blue Shield, discussed the findings on the PBS NewsHour. The study found that 20 percent of patients filled at least one prescription for opioid painkillers in 2015. Almost half of those patients were prescribed high doses of those drugs, which are more likely to cause dependence. According to Haywood, “Starting in the ’90s, we really went aggressive as physicians making sure that we address pain. Unfortunately, it was found out later, as we are starting to see unfold now, we underestimated the risk related to that particular high doses of prescribing those particular opioids. And now we are suffering the consequences of that.” The report also found gender differences in opioid-related problems. For younger people, men are more vulnerable, and as people age, women become more vulnerable to addiction.
Nearly Half a Million Projected to Die from Opioid Epidemic Over the Next Decade
July 21, 2017 10:37 AM by Jason BillupsPresident Trump’s Opioid Commission, chaired by New Jersey Governor Chris Christie, has missed the second deadline for issuing a report with recommendations for addressing the opioid epidemic. Meanwhile, STAT, a publication focused on science, medicine and health, published a story highlighting the seriousness of the epidemic. STAT asked leading public health experts to estimate the number of people who will die from opioid-related problems in the next decade. The experts estimated that nearly half a million people across America over the next decade will die as the crisis of addiction and overdose accelerates. According to STAT, “Deaths from opioids have been rising sharply for years, and drug overdoses already kill more Americans under age 50 than anything else.” According to STAT, the consensus from the leading public health experts at 10 universities was that the problem “will get worse before it gets better.”
National Academy of Sciences Issues Report on Opioid Epidemic
July 21, 2017 10:34 AM by Jason BillupsThe Los Angeles Times recently reported on a panel of experts who published a comprehensive look at the opioid epidemic. On July 13, 2017, a panel of the National Academies of Science, Engineering and Medicine issued a wide-ranging report. The panel noted that it is “imperative to couple a strategy for reducing lawful access to opioids with an investment in treatment for the millions of individuals” already addicted to the painkillers. The panel called on the federal government and the states to provide “universal access” to treatment in community-based programs, jails, prisons and hospitals.
Addiction Solutions Campaign Tackling Parity Launched
July 13, 2017 9:59 AM by Jason BillupsThe Addiction Solutions Campaign was launched by The National Center on Addiction and Substance Abuse, the Legal Action Center, Partnership for Drug-Free Kids and the Treatment Research Institute with an initial focus on securing equitable insurance coverage for addiction treatment. The Campaign released an in-depth analysis, The Parity Act Tracking Project: Making Parity a Reality, of publicly available documents for seven major health plans offered in 2015 and 2016 in the small and large group markets in New York and Maryland. The analysis raised questions about whether the current enforcement framework protected the rights afforded to consumers under the Parity Act. They found that consumers are not provided with sufficient information by insurance plans to determine what treatment benefits they are eligible for and what barriers exist to accessing those benefits.
Addiction Treatment, Opioid Epidemic and Senate Healthcare Bill
June 30, 2017 11:02 AM by Jason BillupsU.S. Senators Martin Heinrich (D-N.M.), Edward J. Markey (D-Mass.), Bob Menendez (D-N.J.), Amy Klobuchar (D-Minn.), Joe Manchin (D-W.V.), Chris Murphy (D-Conn.), Richard Blumenthal (D-Conn.), and Maggie Hassan (D-N.H.) held a press conference on June 27, 2017, to assert that the Senate Republican healthcare bill would have a devastating impact on curbing the opioid epidemic, according to Fox News.
The bill would cut an estimated $772 billion through 2026 from Medicaid. Considering the need for extra services and the fast growth of the opioid problem, Dr. Richard Frank, a Harvard University health economics professor, said roughly $190 billion over 10 years is needed, commenting in the Washington Post about proposals to appropriate funds outside of Medicaid for addiction treatment. A $45 billion proposal was floated by Republican Sens. Shelley Moore Capito (W VA) Rob Portman (OH) to make up for drug-treatment services that would be lost. The Senate bill proposed $2 billion.
Approximately 34 percent of the estimated 2.66 million Americans with an opiate-use disorder are currently covered by Medicaid, Frank estimates. This estimate includes 99,000 people who gained coverage through the Medicaid expansion.
President’s Commission on Combating Drug Addiction and the Opioid Crisis Meets
June 22, 2017 4:01 PM by Jason BillupsOn June 16, 2017 the President’s Commission on Combating Drug Addiction and the Opioid Crisis met and heard testimony from stakeholders in the addiction prevention, treatment and recovery communities. The Pew Charitable Trusts submitted a letter to the Commission regarding drug sentencing and drug problems. Their research found that, “higher rates of drug imprisonment did not translate into lower rates of drug use, lower drug arrests, or lower overdose deaths. These results hold even with statistical controls applied for standard demographic variables,” such as education level, employment, race, and median household income. Their research compared publicly available data from law enforcement, corrections, and health agencies from all 50 states.
Opioid Epidemic Stokes ER and Hospital Use
June 22, 2017 3:58 PM by Jason BillupsAs the U.S. Senate and House consider steep reductions in access to care for people with addiction, the Agency for Healthcare Research and Quality reports that in 2014, there was a 64 percent increase for inpatient care and a 99 percent increase for emergency room treatment for opioid addiction compared to figures from 2005 – 1.27 million visits for opioid-related issues in a single year. According to the Center for American Progress, a $45 billion fund is being proposed in the Senate bill to assist people with addiction. If enacted, it would not address the fact that millions of Americans would be denied health coverage including access to addiction treatment.
Webinar Recording on the Use and Disclosure of Substance Use Disorder Treatment Records
June 21, 2017 10:42 AM by Susan PachikaraBefore there was the HIPAA Privacy Rule, there was 42 C.F.R. Part 2 (“Part 2”) – a rule governing the confidentiality of alcohol and drug abuse treatment records. Due to Part 2’s strict requirements, providers and plans have long struggled over the use and disclosure of substance use disorder treatment records as part of new initiatives, such as electronic health information exchanges and coordinated care efforts. The 2017 Rule amendments to Part 2 address some of these longstanding issues, but may have also introduced new challenges. This program presents Part 2, discuss the positive and negative impact of the 2017 final rule and supplemental notice of proposed rulemaking, and identify strategies for complying with the more challenging aspects of the new rule.
Sessions Wants To Undo Federal Medical Marijuana Protections
June 16, 2017 10:33 AM by Jason BillupsAttorney General Jeff Sessions sent a letter asking top-ranking U.S. members of Congress to allow the Justice Department to use its funds to prosecute medical marijuana-related crimes, even in states that have legalized medical marijuana. Protections under the Rohrabacher-Farr amendment, which would prohibit such prosecutions, have been in place since 2014.
AHCA Could Limit Access to Substance Use Disorder and Mental Health Care
June 16, 2017 10:27 AM by Jason BillupsAccording to a new report from the Urban Institute, substance use disorder and mental health coverage could roll back to pre-ACA (Affordable Care Act) levels if the American Health Care Act (AHCA) becomes law. In addition, parity protections that ensure benefit criteria for both conditions are not stricter than those for other medical care could be limited. According to the report, ACA closed a significant coverage gap by extending parity for behavioral health coverage to the individual insurance market. Further other proposed reforms threaten access for millions and could reverse the decades long effort to reduce historical disparities in the treatment of mental illness and substance use disorders.
Ohio Joins Other Entities in Filing Suits Against Pharmaceutical Companies on Opioids
June 9, 2017 8:47 AM by Jason BillupsOhio joined Illinois, Mississippi, four counties in New York, and Santa Clara and Orange Counties in California, the city of Everett, Washington and the Cherokee Nation in filing lawsuits against pharmaceutical companies over the opioid epidemic according to The Atlantic.
Ohio’s lawsuit accuses Purdue Pharma, Teva Pharmaceuticals, Johnson & Johnson and two other companies of spending millions on marketing campaigns that “trivialize the risks of opioids while overstating the benefits of using them for chronic pain.” The article explores the differences between tobacco litigation and the developing litigation around opioids, with a number of experts saying that it may be difficult to prove that the pharmaceutical companies are responsible for the epidemic. Meanwhile, the epidemic continues to grow. A recent New York Times article analyzes drug deaths in America and finds that they are rising faster than ever, exceeding 59,000 in 2016, the largest annual jump ever recorded in the U.S. “Drug overdoses are now the leading cause of death among Americans under the age of 50 and early data from 2017 suggests that drug overdose deaths will continue to rise this year,” according to the New York Times. “It’s the only aspect of American health, said Dr. Tom Frieden, the former director of the Centers for Disease Control and Prevention (CDC), that is getting significantly worse.”
Law Student with Felony Record Denied Character and Fitness Recommendation
May 25, 2017 4:12 PM by Jason BillupsThe ABA Journal reported that Tarra Simmons, a third-year law student, did not have her character and fitness review approved by the Washington State Bar Association. “Bar admissions rules for felons differ by state,” says Terry Harrell, chair of the ABA’s Commission on Lawyer Assistance Programs. According to Simmons, a convicted felon and person in recovery from addiction, “I hope to use my experiences and achievements to assist former justice-involved individuals by offering them a lawyer who has lived their experience.” Simmons plans to request review from the Washington Supreme Court. She received a Skadden Fellowship and will keep the award even if she does not get admitted to the bar. Simmons co-chairs Washington’s Statewide Re-entry Council and was recently appointed by the state’s governor to the Public Defense Advisory Committee.
President's 2018 Budget Proposes Deep Cuts in Medicaid, Supports ONDCP
May 25, 2017 4:09 PM by Jason BillupsThe President’s proposed 2018 budget, which assumes the repeal of Obamacare, includes dramatic cuts in Medicaid, which would affect millions of people with addiction and mental health problems. In addition to reducing Medicaid spending by $627 billion, the proposal “would cut key programs at the Centers for Disease Control and Prevention that work on vaccine-preventable and respiratory disease, HIV/AIDS, viral hepatitis, sexually transmitted infections, tuberculosis prevention and chronic-disease prevention.” While earlier reports indicated a drastic cut in funding for the Office of National Drug Control Policy (ONDCP), the budget request for drug control efforts spanning prevention, treatment, interdiction, international operations, and law enforcement came in at $280 million above the FY 2017 enacted levels and includes the largest-ever funding levels for the Drug-Free Communities Program.
Dept. of Justice Directive on Sentencing
May 19, 2017 8:42 AM by Jason BillupsAttorney General Jeff Sessions has released a new directive for federal prosecutors regarding charging and sentencing recommendations, saying that his new first principle is "that prosecutors should charge and pursue the most serious, readily provable offense." CNN reported that Senator Richard Durbin (D-IL) “said the policy shift will raise prison costs, undermine ‘public safety priorities’ and ‘flies in the face of the growing bipartisan consensus that we need to reduce -- not increase -- the length of prison sentences for nonviolent drug offenders.’”
