News from NASADAD

• NASADAD attends House Judiciary Committee – Subcommittee on Crime, Terrorism, Homeland Security and Investigations hearing on “America’s Growing Heroin Epidemic”
• NASADAD attends World Hepatitis Day press conference
• NASADAD attends National Journal interview event with U.S. House Energy and Commerce Committee Chairman Rep. Fred Upton (R-MI)

News from the States

• Ohio releases new opioid toolkit
• States begin reforming restrictions on food stamps, welfare for individuals with drug-related felonies

Around the Agencies

• GAO report recommends DEA improve communication with pharmacies and health care entities
• NIDA releases two new online resources on substance use disorders in women and therapeutic communities research
• DEA announces reinstatement of National Prescription Drug Take-Back Days

In the News

• Senators send letter to HHS supporting broader access to naloxone
• University of Maryland Center for Substance Abuse Research finds increased rates of e-cigarette usage
• Obama administration announces plans to restore Pell Grants for prison inmates
• President Obama declares July 28 World Hepatitis Day
• AMA taskforce announces plans to encourage physicians to register for State-based PDMP programs
• House Energy and Commerce Committee approves PDMP reauthorization bill with language to help promote collaboration with State substance abuse agencies
• House Energy and Commerce Committee Considers and Approves H.R. 1462, the Protecting Our Infants Act

News from NASADAD

NASADAD attends House Judiciary Committee – Subcommittee on Crime, Terrorism, Homeland Security and Investigations hearing on “America’s Growing Heroin Epidemic”
Rob Morrison, Executive Director, and Shalini Wickramatilake-Templeman, Public Policy Associate attended the hearing. The hearing featured a discussion between subcommittee members and health officials on the scope of the heroin problem, the role of law enforcement in reducing heroin abuse, and promising law enforcement practices. The panel was made up of representatives from federal agencies with oversight of substance use disorder issues, as well as a Commonwealth Attorney from Virginia and District Attorney from New Mexico. The panelists provided an overview of the shift from prescription drug abuse to heroin abuse and emphasized the importance of medication-assisted treatment and naloxone. Additionally, the panelists discussed the role of law enforcement in inhibiting the supply of heroin, as well as how law enforcement can connect individuals with heroin use disorders with the treatment services they need as an alternative to criminal prosecution.

Panelists:

• Michael Botticelli; Director, Office of National Drug Control Policy
• Jack Riley, Acting Deputy Administrator, Drug Enforcement Administration, Department of Justice
• Nancy G. Parr, Commonwealth Attorney, City of Chesapeake, VA
• Angela R. Pacheco, First Judicial District Attorney, Santa Fe, NM

 

NASADAD attends World Hepatitis Day press conference
Brian Denten, Public Policy Intern, attended the press conference held by U.S. Representatives Mike Honda (D-CA), Hank Johnson (D-GA), and Judy Chu (D-CA) on Tuesday, July 28^th. Each Representative spoke on their personal experiences with viral hepatitis, noting that the viral hepatitis mortality rate exceeds the HIV mortality rate in many areas. Other speakers highlighted the racial disparity in viral hepatitis diagnosis and mortality rates, and encouraged enhanced public awareness campaigns about the importance of early and frequent testing for both at-risk and general populations. The press conference noted that the rise in hepatitis C cases among young people under 30, as observed in Scott County, Indiana, is largely driven by increases in injection drug use. Speakers called for additional syringe services programs, medication-assisted therapy, and further interventions to help this population. Following the press conference, speakers and activists spent the day advocating for additional funding for viral hepatitis treatment and prevention on Capitol Hill.

NASADAD attends National Journal interview event with U.S. House Energy and Commerce Committee Chairman Rep. Fred Upton (R-MI)
Brian Denten, Public Policy Intern, attended the event held by the National Journal on Tuesday, July 28^th. The event, titled “Conversation with the Chair,” was the latest in a series of interviews between the National Journal and U.S. House Energy and Commerce Committee Chairman Rep. Fred Upton (R-MI). Rep. Upton spoke about the committee’s priorities for the upcoming session of Congress, noting that in a major energy and infrastructure bill, and mental health reform will remain a priority.

News from the States

Ohio releases new opioid toolkit
Ohio released a new Opioid Toolkit this past week as an additional resource for communities fighting opioid use disorders. The toolkit was created and published by the Ohio Governor’s Cabinet Opiate Action Team (GCOAT), created by Governor John Kasich in 2011. Ohio has worked to increase access to medication-assisted treatment through Medicaid, establishing new prescriber guidelines, increasing access to naloxone, and establishing several notable prevention initiatives. The new toolkit focuses on further opiate prevention initiatives, the promotion of responsible prescribing of opiate painkillers, expanding overall treatment capacity, and expanding access to treatment for individuals within the criminal justice system. Tracy Plouck serves as the NASADAD member in Ohio and has been leading a number of these efforts.

States begin reforming restrictions on food stamps, welfare for individuals with drug-related felonies
Many States across the country have been reforming restrictions on food stamps and welfare for individuals with drug-related felonies, as Pew Trusts reports this week. During the height of the War on Drugs, many States banned people with drug related felonies from receiving welfare and food stamp assistance, leading to inmates facing large difficulties when re-entering society following their sentence. Many States have begun lifting the bans and allowing people with certain types of drug felonies to receive assistance. Pew Trusts reports that, “since 1996, 18 States have lifted restrictions on food stamps, known as the Supplemental Nutrition Assistance Program, and 26 allow people with certain types of drug felonies to get those benefits – leaving six States where a felony drug record disqualifies a person from receiving them.” Despite this, many States are still restrictive in providing welfare benefits through Temporary Assistance to Needy Families – with 14 States lifting the restriction, 24 States with some restriction remaining, and 12 States maintaining full restrictions for felons with drug convictions.

Texas and Alabama are the most recent States to lift bans on individuals with drug-related felonies receiving food stamps. Texas’s food stamp program is now available to anyone convicted of using or selling drugs. However, if someone violates their probation they are ineligible to receive benefits for two years; and if someone is convicted of any other felony they are banned for life. Alabama opted to fully lift the ban without any further restrictions. Some States such as Pennsylvania have continued to impose additional bans; a pending Pennsylvania bill would restrict access to welfare benefits for anyone serving more than 10 years for a drug-related offense.

Around the Agencies

GAO report recommends DEA improve communication with pharmacies and health care entities around Controlled Substance Act compliance
A new Government Accountability Office (GAO) report has recommended that the Drug Enforcement Administration (DEA) improve communication with pharmacies and health care entities (otherwise known as “registrants”) on issues surrounding Controlled Substance Act (CSA) compliance. The report finds that many registrants are unaware of the DEA’s full array of resources for complying with the CSA and preventing the diversion of prescription drugs. While a large percentage of registrants surveyed reported generally high satisfaction with DEA field office staff, other registrants commented that improved communication with the DEA would be helpful in establishing best practices for eliminating the risk of diversion. The report was the result of a series of GAO interviews conducted with various State government agencies and National Associations. The GAO concludes the report with a recommendation that the DEA improve communication with registrants and clarify responsibilities required of them by the CSA.

NIDA releases two new online resources on substance use disorders in women and therapeutic communities research
The National Institutes on Drug Abuse (NIDA) released two new online resources this past week: one focusing on substance use disorders in women, and the other focusing on new research on therapeutic communities. The resource discussing substance use disorders in women outlines data summarizing the most commonly used drugs among women, along with the newest research on substance use during pregnancy and breast feeding. The therapeutic communities resource discusses the commonly used model of “long-term residential treatment for substance use disorders,” and discusses their recovery rather than abstinence orientation. Acknowledging the chronic nature of substance use disorders and prevalence of relapses, the therapeutic community model aims to have patients learn from their relapses as they continue on in recovery.

DEA announces reinstatement of National Prescription Drug Take-Back Days
The Drug Enforcement Administration (DEA) announced the reinstatement of National Prescription Drug Take-Back Days this past week. Acting Administrator Chuck Rosenberg announced that the 10^th National Prescription Drug Take-Back will occur on September 26, 2015 from 10am to 2pm local time in all 50 States with the exception of Pennsylvania and Delaware, where the event will be held on September 12^th. The program will allow residents of communities across the country to return unwanted, unneeded, or expired prescription drugs at DEA sponsored sites. Diversion of prescription drugs has become a significant public health issue, as rates of prescription drug abuse and poisonings continue to rise. The DEA’s reinstatement aims to educate Americans on the proper methods for safe disposal. Previous take-back events held from 2010-2014 collected over 4 million pounds of prescription drugs.

Some time ago, Senators Kelly Ayotte (R-NH), Edward Markey (D-MA), Charles Schumer (D-NY), Sherrod Brown (D-OH), Shelley Moore Capito (R-WV), Dianne Feinstein (D-CA), Charles Grassley (R-IA), Orrin Hatch (R-UT), and Joe Manchin (D-WV) sent a letter to the DEA asking for reinstatement of the program.  The letter called on the DEA to reinstate the program in response to the growing heroin and prescription drug epidemic seen throughout the country. Following the DEA’s announcement, Senator Kelly Ayotte stated that, “National Prescription Drug Take-Back Days allow for a safe, convenient way to dispose of unused, unneeded, or expired medications, and I am pleased the DEA is taking steps to reinstate this successful program.

In the News

Senators send letter to HHS supporting broader access to naloxone
Senator Edward Markey (D-MA) and several members of Massachusetts Congressional delegation drafted a letter to the Department of Health and Human Services (HHS) expressing support for increased access to naloxone this past week. The letter specifically requests HHS examine policies for co-prescribing naloxone with opioid painkillers, as well as reducing barriers to payment for naloxone coverage and reimbursement. Naloxone has proven successful in preventing opioid overdose fatalities when used by medical professionals, first responders, and trained community and family members. More than 1,000 opioid overdoses were recorded in Massachusetts in 2014. Senator Elizabeth Warren (D-MA), and Reps. Michael Capuano (D-MA), Katherine Clark (D-MA), Jim McGovern (D-MA), Seth Moulton (D-MA), William Keating (D-MA), Joe Kennedy (D-MA), and Richard Neal (D-MA) joined Senator Markey in submitting the letter.

University of Maryland Center for Substance Abuse Research finds increased rates of e-cigarette usage
The University of Maryland Center for Substance Abuse Research published a new study this past week finding increased rates of e-cigarette usage among U.S. teenagers. The study used information from the most recent Monitoring the Future survey, discovering that “more than twice the percentage of 8^th and 10^th graders reported past month use of e-cigarettes compared to use of tobacco cigarettes (9% vs. 4% and 16% vs. 7%, respectively).” This difference was smaller among 12^th graders, with 17% reporting past month e-cigarette use compared to 14% reporting past month tobacco cigarette use. The study notes that while tobacco cigarette use continues to decline, e-cigarette use remains popular even among individuals who have never tried tobacco cigarettes. The study reports that “between 4% and 7% of 8^th, 10^th, and 12^th graders who reported past 30-day e-cigarette use had never smoked a tobacco cigarette.

Obama administration announces plans to restore Pell Grants for prison inmates
President Obama’s administration has announced plans to restore Pell Grant funding for prison inmates seeking to pursue education. The restoration plans to offer thousands of U.S. inmates access to up to $5,775 a year in tuition, fees, books, and other expenses. The Wall Street Journal reports that the U.S.’s prison population doubled between the mid-1990s and 2013, with recidivism as a leading cause of the overall growth. A 2013 Rand Corporation study suggested that increasing access to education within prisons would significantly lower recidivism rates. The program is expected to last 3-5 years as officials gauge the effect of restoring Pell Grants. More information is expected following the announcement Friday by Education Secretary Arne Duncan and Attorney General Loretta Lynch.

President Obama declares July 28 World Hepatitis Day
President Obama declared July 28 World Hepatitis Day in an announcement released earlier this week. Noting that more than 1 million people die annually from viral hepatitis infections, the press release expresses the importance of regular testing to detect the disease early. The proclamation cites recent gains in terms of access to testing and treatment. The proclamation also notes more work is needed to reduce the disparities observed between minorities in treatment and mortality rates.

AMA taskforce announces plans to encourage physicians to register for State-based PDMP programs
An American Medical Association (AMA) task force has announced plans to encourage physicians to register for and use State-based prescription drug monitoring programs (PDMPs) in an effort to reduce rates of opioid use disorders across the country. The AMA Task Force to Reduce Opioid Abuse is made up of 27 physician organizations, including the AMA, American Osteopathic Association, the American Dental Association, and a number of other specialty and State-based medical societies. The task force will initially focus on educating physicians and other medical professionals on the benefits of using PDMP programs when considering treatment plans for patients. The AMA has also created a webpage dedicated to providing physicians with resources aimed at increasing knowledge and awareness about PDMP programs.

House Energy and Commerce Committee approves PDMP reauthorization bill with language to help promote collaboration with State substance abuse agencies
On Wednesday, July 29, the Full House Energy and Commerce Committee considered and approved H.R. 1725, the National All Schedules Prescription Electronic Reporting (NASPER) Reauthorization Act of 2015.  The author of the bill is Representative Ed Whitfield (R-KY) and co-sponsors include Representatives Kennedy (D-MA), Buscon (R-IN), and Pallone (D-N.J.).  The Chairman of the Full House Energy and Commerce Committee is Rep. Upton (R-MI) and the Ranking Member is Rep. Frank Pallone (D-NJ).  The Energy and Commerce Subcommittee on Health approved the bill last week.

The bill seeks to continue the momentum gained by States on issues related to data interoperability by requiring applicants for NASPER funds to include certain information in their application.  For example, H.R. 1725 requires applicants to report the extent to which the PDMP program is able to share information with other health IT systems such as e-prescribing systems, health information exchanges and electronic health records systems.

Coordination with NASADAD members:  The NASPER Reauthorization Act of 2015, under Section (h), the “Education and Access to the Monitoring Section,” requires States receiving NASPER funding to “…facilitate linkage to the State substance abuse agency and substance use disorder services.”  Additional language regarding State substance abuse agencies is included in a section requiring the release of a federal report not later than three years after federal funds are first appropriated under NASPER.  This report, among other issues, must include an analysis of the “…extent to which the operation of controlled substance monitoring programs have reduced inappropriate use, abuse, or diversion of controlled substances, established or strengthened initiatives to ensure linkages to substance use disorder services” and other matters.

Federal appropriations for NASPER would still need to be approved: In order for grants to move forward under NASPER, Congress would have to consider and pass federal funding for the bill.  The bill authorizes $10 million for this purpose.  Successful applicants would receive funds based on a formula.  No FY 2016 funds were proposed to be directed to NASPER by the Administration, Senate or House Appropriations Committees.

Representative Whitfield promoting collaboration between NASPER and Hal Rogers Program: Last week, during the Subcommittee consideration, Rep. Whitfield, noted how work to reauthorize NASPER has been moving forward for a number of years.  He also noted other programs that help support PDMPs are housed in the Department of Justice (DOJ) and Centers for Disease Control and Prevention (CDC). He expressed his hope that work could be done to develop and adopt an amendment to NASPER to help coordinate these efforts.  No amendment was announced during the Full Committee mark-up although amendments may be considered on the House floor should a rule be adopted to allow for this to move forward.

House Energy and Commerce Committee Considers and Approves H.R. 1462, the Protecting Our Infants Act
On Wednesday, July 29, the Full House Energy and Commerce Committee considered and approved H.R. 1426, the Protecting Our Infants Act authored by Representatives Katherine Clark (D-MA) and Steve Stivers (R-OH).  The author in the Senate is Majority Leader Mitch McConnell (R-KY).  The bill would authorize the Secretary of HHS, through the Agency for Healthcare Research and Quality (AHRQ) to conduct a study and develop recommendations for preventing and treating prenatal opioid abuse and NAS.  The bill would also authorize the Secretary of HHS to lead a review of planning and coordination efforts across HHS.  Finally, the legislation would require the Centers for Disease Control and Prevention (CDC) to offer technical assistance to States to improve the availability and quality of data related to NAS.

View a NASADAD two pager on the Protecting Our Infants Act here.

View a NASADAD two pager on NAS here.

View a NASADAD statement on the Use of Medications for substance use disorders here.

Next Steps for Both Bills
The two bills will now move forward to the House for further consideration.  We are not aware of a specific date for this next step.

Additional Resources
View the Committee’s Majority Staff backfround memo on the bills here.

View the opening statement by Rep. Pitts from last week here.

View the opening statement for today’s mark up by Rep. Pallone here.

View the opening statement by Rep. Upton here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Colleen Haller, Public Policy Associate, at (202) 293-0090.