DC Update

August 1, 2014

News from NASADAD

• NASADAD to develop position statement on 42 CFR Part 2
• NASADAD releases fact sheet on priority grants in the Department of Justice

Events

• NASADAD participates in Coalition for Health Funding Capitol Hill day

Around the Agencies

• NIDA study reaffirms device’s ability to detect marijuana in breath hours after smoking
• NIDA studies show that marijuana use may encourage nicotine use

Capitol Hill News

• Sen. Markey introduces legislation to raise buprenorphine prescriber limit
• Reps. Butterfield and Johnson form State Medicaid Expansion Caucus

In the News

• NGA announces new executive committee leadership

News from the States

• Ohio launches Start Talking! prevention campaign
• OhioMHAS releases recovery housing resources
• Oregon voters to vote on ballot initiative to legalize marijuana

 

News from NASADAD

NASADAD to develop position statement on 42 CFR Part 2 – all States to be invited to future Public Policy Committee call on the topic

As noted by NASADAD Board Chair Mark Stringer (MO) during the most recent All States Public Policy Call (held on July 18th), the Association shall be developing a revised policy statement regarding 42 CFR Part 2. This comes after a tremendous amount of membership feedback noting the benefit of Association leadership in this area. Confidentiality has been discussed in a variety of settings over the past few months. In June, the Substance Abuse and Mental Health Services Administration (SAMHSA) held a listening session and solicited feedback on a number of areas.  During the June Annual Meeting, the State Directors engaged in an initial dialogue regarding confidentiality matters in general, and 42 CFR Part 2 in particular. In addition, NASADAD hosted two conference calls where the issue was reviewed: the first with Paul Samuels of the Legal Action Center (LAC) held in June and the second with Mark Parrino of the American Association of the Treatment of Opioid Dependence (AATOD) held in July where a portion of his presentation covered these issues.  NASADAD’s Public Policy Committee will host a special conference call to consider a statement. All State Directors will be invited to participate. Further, NASADAD has dedicated a portion of the web page to resources on the confidentiality where letters, papers and other documents will be posted. To visit this section, please click here.

NASADAD’s 2010 statement on confidentiality

In 2010, NASADAD issued a one-page statement on 42 CFR Part 2 that has guided the Association’s views up until this point. The statement offers support for stakeholders and policy makers to have a thoughtful and inclusive discussion about how confidentiality protections can best be utilized with more advanced health information technologies. A core principle noted in the statement is the need to maintain the goal of 42 CFR Part 2, which is to protect personal privacy and confidentiality and prevent discrimination of people with alcohol and other drug histories.

NASADAD releases fact sheet on priority grants in the Department of Justice

NASADAD released the fact sheet, Overview of NASADAD Priority Programs within the Department of Justice, earlier today. The fact sheet describes the programs and funding allocations that NASADAD members have identified as priorities that are housed within the Department of Justice. The programs include:

• Harold Rogers Prescription Drug Monitoring Program (PDMP),
• Drug Court Discretionary Program,
• Second Chance Act,
• Enforcing Underage Drinking Laws (EUDL),
• Residential Substance Abuse Treatment for State Prisoners (RSAT) Program,
• Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA),
• Edward Byrne Memorial Justice Assistance Program (Byrne/JAG), and
• Justice Information Sharing Solutions (JIS) Implementation Program.

Events

NASADAD participates in Coalition for Health Funding Capitol Hill day

Rob Morrison, Executive Director attended the “Faces of Austerity Hill Day” as part of the Coalition for Health Funding on July 16^th. The Coalition for Health Funding is a broad coalition that promotes the importance of non-discretionary health spending and published the report, Faces of Austerity: How Budget Cuts Hurt America’s Health. The report also includes information on the Substance Abuse Prevention and Treatment (SAPT) Block Grant, citing the importance of the funding, as well as the effects that reductions in funding have had at the State and local level. The report provides an in-depth look at how SAPT Block Grant cuts have affected the State of Illinois at large, as well as a local Chicago treatment provider. The meetings with Congressional offices focused on the importance of federal health funding and the consequences of austerity and other cost-cutting measures. Mr. Morrison visited offices with representatives from other health care organizations including the American Society for Biochemistry and Molecular Biology, American College of Preventive Medicine, Endocrine Society, and National Multiple Sclerosis Society.

Around the Agencies

NIDA study reaffirms device’s ability to detect marijuana in breath hours after smoking

The study by the National Institute on Drug Abuse (NIDA)’s Intramural Research Program finds that the Breathalyzer-like device detected marijuana’s main psychoactive ingredient, tetrahydrocannabinol (THC) up to two hours after smoking. The small-scale study provides preliminary evidence that breath testing may be a viable option for law enforcement seeking to enforce drugged-driving laws. As efforts to legalize marijuana continue in States beyond Washington and Colorado, concerns about potential increases in drugged driving fuel the need for better testing approaches. The current method, testing blood, cannot be done road-side, therefore delaying the test which could show lower THC-levels than when the driver was pulled over.

NIDA studies show that marijuana use may encourage nicotine use

Studies by the National Institute on Drug Abuse (NIDA)’s Intramural Research Program find that marijuana use makes smoking cigarettes more pleasurable and may encourage nicotine use. The animal studies found that tetrahydrocannabinol (THC)-treated rats were more likely to self-administer nicotine, at higher amounts over time. In addition, the brain signaling systems activated by THC and nicotine overlap. In fact, blocking the cannabinoid receptors, or those for THC, has been shown to also weaken the reinforcing effect of nicotine. This effect seems to be unique to nicotine – similar effects were not found for cocaine or heroin.

Capitol Hill News

Sen. Markey introduces legislation to raise buprenorphine prescriber limit

The bill, The Recovery Enhancement for Addiction Treatment Act (TREAT Act) was introduced by Sen. Edward Markey (D-MA) and co-sponsored by Senators Diane Feinstein (D-CA), John Rockefeller (D-WV), Sherrod Brown (D-OH), and Mazie Hirono (D-HI) and announced on July 23^rd. The legislation would increase the number of patients that a waivered provider is allowed to treat to 100 in the first year and then request to remove the limit after the first year if they are substance abuse treatment specialists or if they completed additional training and practice in a qualified practice setting (named in the legislation). The legislation would also allow certain nurse practitioners and physician assistants to treat up to 100 patients per year if they are licensed in a State that allows that to prescribe controlled substances, complete the training, and are supervised by a waivered physician or are certified addiction treatment nurse practitioners who practice in a qualified practice setting. The Government Accountability Office (GAO) will also be required to produce a report on the legislation looking at chances in treatment availability and utilization, quality of treatment, primary care integration, diversion, and more. The legislation has been endorsed by a variety of organizations including the American Society for Addiction Medicine (ASAM), Trust for America’s Health (TFAH), Association of State and Territorial Health Officials (ASTHO), National Association of State and Territorial AIDS Directors (NASTAD), and others.

Also check out a summary of the legislation.

Reps. Butterfield and Johnson form State Medicaid Expansion Caucus

Representatives G. K. Butterfield (D-NC) and Hank Johnson (D-GA) announced the formation of the caucus on July 23^rd (Families USA announcement). The State Medicaid Expansion Caucus will promote all States to expand Medicaid under the Affordable Care Act (ACA) via floor speeches, op-eds, social media, briefings, and other events. According to Rep. Johnson, “Expanding Medicaid will ensure access to health care for millions of low-income Americans. It will bring the security of health insurance to working people who are struggling to make ends meet. But it will also bring billions of dollars into each State’s economy as people go to work providing care and beneficiaries see improved health outcomes. The people who will benefit from expanding Medicaid are no less deserving of health care than anyone else” (press release).

In the News

NGA announces new executive committee leadership

The National Governors Association (NGA) announced the leadership changes on July 13^th. The new leadership will serve throughout the 2014-2015 year. Colorado Governor John Hickenlooper will serve as the NGA Chair and Utah Gov. Gary Herbert as the NGA Vice Chair. The other Executive Committee members include Gov. Dan Malloy (CT), Gov. Terry Branstad (IA), Gov. Mark Dayton (MN), Gov. Steve Bullock (MT), Gov. Pat McCrory (NC), Gov. Mary Fallin (OK), and Gov. Scott Walker (WI). As a review, the NGA also has a Health and Human Services Committee. That Committee is chaired by Gov. Bill Haslam (TN) and Gov. Peter Shumlin serves as Vice Chair.

News from the States

Ohio launches Start Talking! prevention campaign

Ohio Governor John Kasich launched the campaign to prevent substance abuse among children and youth. The Start Talking! campaign gives “parents, guardians, educators, and community leaders the tools to start the conversation with Ohio’s youth about the importance of living healthy, drug-free lives” (program home page). The program website includes educational tools, videos, discussion guides, and much more. NASADAD member and Ohio State Director Tracy Plouck will be participating in a webinar on August 19^th to discuss how they’re using the campaign materials and to raise awareness about the program. The webinar will also feature stories from individuals and families whose lives have been affected by substance abuse.

OhioMHAS releases recovery housing resources

In the Mid-Biennium Review (House Bill 483), the legislature made a very large investment of $5 million into recovery housing. The purpose of the initiative is to increase community capacity to provide recovery housing to individuals recovery from drug addiction. A funding opportunity related to the release of the dollars will be going out to the field early next week. In preparation, the Ohio Department of Mental Health and Addiction Services (OhioMHAS) is making available several new housing resources, including a housing definitions document and a crosswalk of housing categories and definitions. Also, helpful information about recovery housing is available in a two-part series webinar from Faces and Voices of Recovery. If you have any questions related to recovery housing, please contact Alisia Clark at Alisia.Clark@mha.ohio.gov.

Oregon voters to vote on ballot initiative to legalize marijuana

Come November, Oregon voters will vote on a ballot initiative to legalize marijuana for personal use for adults age 21 and older. The initiative was spearheaded by New Approach Oregon and would allow possession of up to eight ounces of marijuana at home and to cultivate up to four plants. Oregonians would not be legally allowed to consume marijuana in public. Under the initiative, the Oregon Liquor Control Commission would oversee and regulate sales of the drug beginning in January 2016. Revenues from the drug sales would be used to fund schools, law enforcement, substance abuse treatment, and mental health treatment. A similar ballot initiative was rejected by Oregon voters in 2012. Currently Washington and Colorado are the only States that have legalized marijuana for personal use.