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CDC study finds 20 percent of Medicaid enrolled women of reproductive age in New York received an opioid prescription from 2008 to 2013
HHS announces $260 million in funding to increase patient capacity and preventive health services in 45 States
FDA announces new regulations for e-cigarettes, cigars, and other tobacco products

In the News

ATTC seeks participants for pilot online MAT course
House Democratic Whip Rep. Steny Hoyer (D-MD) discusses need for Congress to act on opioids
CHCS launches Medicaid Accountable Care Organization Resource Center

Upcoming Events

Addiction Policy Forum announces Family Day to encourage passage of the Comprehensive Addiction and Recovery Act of 2016
NDEWS announces webinar on national poison data system and drug-related human exposure cases

News from the States

Ohio Governor John Kasich signs executive order banning synthetic opioid U-47700
Ohio Governor John Kasich has signed an executive order making the synthetic opioid U-47700 a Schedule I controlled substance. The executive order identifies U-47700 as 7.5 times more potent than morphine, with high potential for misuse. Governor Kasich signed the order in response to a growing number of overdose deaths attributable to the substance.

Read more about the executive order here.

Around the Agencies

CDC study finds 20 percent of Medicaid-enrolled women of reproductive age in New York received an opioid prescription from 2008 to 2013
The Centers for Disease Control and Prevention (CDC) released a study last week finding that 20 percent of reproductive-aged women enrolled in Medicaid in New York received an opioid prescription at least once from 2008 to 2013. Almost 40 percent of reproductive-aged Medicaid enrolled women in the United States received an opioid prescription during this same time, placing New York below the national average. The CDC attributes New York’s lower prescribing rates to its long history of prescription monitoring programs beginning in 1972. New York’s prescription monitoring was enhanced in 2012 via the I-STOP program, which increased the number of substances monitored by the program. Prescriptions were “lowest during the prenatal period for women who had a live birth (9.5%), intermediate for women with no indication of contraceptive use or infertility (17%), and highest for women with an indication of contraceptive use or infertility (27%).” The CDC cautions that these results only contain Medicaid enrolled women, and do not include women who obtained opioid prescriptions without Medicaid.

Read the full study here.

HHS announces $260 million in funding to increase patient capacity and preventive health services in 45 States
The Department of Health and Human Services (HHS) has announced $260 million in funding to 290 health centers in 45 States. The funding will be used to renovate and expand existing health centers in order to increase patient capacity and increase the number of comprehensive primary and preventive health services available to underserved populations. The Affordable Care Act’s Community Health Center (CHC) Fund is providing the funding following the program’s extension in the Medicare Access and CHIP Reauthorization Act of 2015. HHS previously distributed CHC funds in September 2015 to 160 health centers for the same purpose.

Read the full press release here.

View a map of FQHCs throughout the country here.

FDA announces new regulations for e-cigarettes, cigars, and other tobacco products
The Food and Drug Administration (FDA) has announced new regulations for e-cigarettes, cigars, and other tobacco products. The FDA’s previous authority only monitored cigarettes and smokeless tobacco; the new final rule extends this authority to electronic nicotine delivery systems such as e-cigarettes and vape pens, cigars, hookah tobacco, pipe tobacco, and nicotine gels. The rule further stipulates that the FDA will be able to review new tobacco products not yet on the market and evaluate the manufacturing process of tobacco process in the future. Manufacturers will now have to register and provide product listings and ingredients that are subject to premarket review and authorization by the FDA. The final rule restricts youth access to tobacco by preventing sales to individuals under the age of 18 both in-person and online and prohibiting the distribution of free samples.

Read more about the new regulation here.

In the News

ATTC seeks participants for pilot online MAT course
The Addiction Technology Transfer Center (ATTC) Network is currently seeking participants for a pilot online course on medication-assisted treatment (MAT). The course, titled “Supporting Recovery with Medication-Assisted Treatment,” is a self-paced 3 hour course intended to increase participants’ familiarity with various types of MAT. Topics will include ways to use MAT for alcohol and opioid use disorder treatment, the different types of medications available for treating alcohol and opioid use disorders, workforce and regulatory issues impeding the implementation of MAT, and methods for improving MAT awareness at the community level. Upon the pilot course’s conclusion, participants will be asked to provide feedback to improve the program before its release. The pilot course will be available between May 3^rd and May 31^st.

House Democratic Whip Rep. Steny Hoyer (D-MD) discusses need for Congress to act on opioids
The House Democratic Whip Steny Hoyer (D-MD) discussed the need for Congress to act on opioids during the American Hospital Association’s annual membership meeting last week. Rep. Hoyer enumerated several “innovative solutions” for addressing the ongoing epidemic, and asserted his hope that the necessary changes will be made in the future. Rep. Hoyer stated that, “while health care providers bear some of the responsibility of overprescribing opioids that are easily abused, I recognize a careful balance must be struck when caring for patients suffering from severe pain. This is why policymakers need to ensure that we are giving doctors and hospitals the tools needed to identify patients at the risk of abuse.”

Read the full story here from AHA News.

CHCS launches Medicaid Accountable Care Organization Resource Center
The Center for Health Care Strategies (CHCS) announced the launch of their Medicaid Accountable Care Organization Resource Center last week. The online resource center will provide a collection of resources for States interested in or already developing a Medicaid ACO program. These resources include a resource compendium with tools on ACO topics including general design, scope of services, provider management, quality measures, payment, and federal guidance, as well as an interactive map providing updates of Medicaid ACO activities by State and a news section with the latest updates on ACOs for the Medicaid, Medicare, and commercial populations.

Access the resource center here.

Upcoming Events

Addiction Policy Forum announces Family Day to encourage passage of the Comprehensive Addiction and Recovery Act of 2016
The Addiction Policy Forum has announced a Comprehensive Addiction and Recovery Act (CARA) Family Day on May 18^th-19^th. The Forum encourage families who have been impacted by addiction to meet with members of Congress and encourage them to pass legislation that will comprehensively address the opioid epidemic, including CARA (S. 524; H.R. 953).

D.C. Update – May 4, 2016

May 5, 2016 aaa

News from the States

Senate Committee on Homeland Security and Governmental Affairs holds field hearing on opioid epidemic, featuring testimony from OhioMHAS Director & NASADAD member Tracy Plouck
Jefferson County, New York begins offering Vivitrol to incarcerated individuals leaving the criminal justice system

Around the Agencies

GAO report finds DOD’s Military Health System does not meet mental health appointment requirements
CMS clarifies stance on Medicaid eligibility for incarcerated individuals

In the News

House Full Judiciary Committee Considers and Approves Opioid Bill (H.R. 5046)
House Full Energy and Commerce Committee Completes Markup of Bills on Opioids
University of California study finds seasonal increase in college student drinking rates
Behavioral Health IT Coalition release Integrating Behavioral Health through Technology Act of 2016 (S. 2691) fact sheet
NGA and NCJA launch State criminal justice reform initiative
Pew Charitable Trusts article highlights State efforts to combat synthetic drugs

News from NASADAD

NASADAD Moderates Panel During “Stepping Up Summit” in Washington, D.C.

Upcoming Events

CDC announces webinar on its National Viral Hepatitis Campaigns
SAMHSA announces 2016 National Prevention Week Kick-off webcast

News from the States

Senate Committee on Homeland Security and Governmental Affairs holds field hearing on opioid epidemic, featuring testimony from OhioMHAS Director & NASADAD member Tracy Plouck
The Senate Committee on Homeland Security and Government Affairs and Senators Rob Portman (R-OH) and Sherrod Brown (D-OH) held a hearing on the opioid epidemic in Cleveland on April 22^nd. The hearing featured testimony from several substance use disorder experts, including Ohio Department of Mental Health & Addiction Services Director & NASADAD member Tracy Plouck. Ms. Plouck thanked both Senators for their work in developing a comprehensive approach to the opioid crisis, and highlighted the actions Governor John Kasich’s task force has taken in the past several years. These actions include: comprehensive prescribing guidelines for the outpatient management of acute pain released in January 2016, ongoing improvements and investments into the Ohio Automated Rx Reporting System, the Start Talking! Statewide youth drug prevention initiative, and increased mechanisms for diverting individuals in the criminal justice system into substance use disorder treatment.

Read Ms. Plouck’s full testimony here.

Read more about the Ohio Governor’s Cabinet Opiate Action Team here.

Jefferson County, New York begins offering Vivitrol to incarcerated individuals leaving the criminal justice system
Jefferson County, New York will begin offering Vivitrol to incarcerated individuals whose release from the criminal justice system is imminent. Jefferson County Sheriff Colleen M. O’Neill states that the program will help incarcerated individuals exiting the criminal justice system maintain their sobriety during the critical 30-day period following their release, when many individuals with opioid use disorders are at greatest risk for relapse. Individuals participating in the program must still attend substance use disorder treatment programs at facilities approved by the New York State Office of Alcoholism and Substance Abuse Services (OASAS), which is led by Commissioner Arlene González-Sánchez, who is a member of NASADAD’s Board. All jail administrators, medical staff, and other relevant staff have been trained to administer the drug. Sheriff O’Neill plans for the program to be fully implemented by summer.

Read the full story here.

Around the Agencies

GAO report finds DOD’s Military Health System does not meet mental health appointment requirements
The U.S. Government Accountability Office released a report last week finding that the Department of Defense’s (DOD) Military Health System (MHS) does not meet requirements related to mental health appointment scheduling. Data on domestic and overseas direct care from April 2014 through August 2015 suggests that initial appointments for new or exacerbated conditions did not meet the 7-day access standard required by the DOD. The DOD reported that this deficiency is the result of incorrect coding that is hindering the ability of personnel to access the MHS. The GAO further found that follow-up appointments for mental health do not maintain the official DOD access standard required by federal internal controls. The report concludes that the DOD develop coding for initial appointments and access standards for follow-up appointments.

Read the full report here.

CMS clarifies stance on Medicaid eligibility for incarcerated individuals
Last week the Centers for Medicare and Medicaid Services (CMS) clarified its stance on Medicaid eligibility for incarcerated individuals in a Dear State Health Official letter. The clarification is an update of CMS’s 1997 letter that described the conditions precluding an incarcerated individual from being eligible for Medicaid. Current regulations stipulate that individuals classified as an “inmate of a public” institution are ineligible for federal financial participation for Medicaid services. Last week’s letter clarifies that “individuals on probation, parole, or community release pending trial and individuals in corrections-related supervised community residential facilities” retain Medicaid eligibility.

Read the full CMS letter here.

In the News

House Full Judiciary Committee Considers and Approves Opioid Bill (H.R. 5046)
On Wednesday, April 27, the House Judiciary Committee considered and passed the Comprehensive Opioid Abuse Reduction Act of 2016 by Rep. Sensenbrenner (R-WI) by voice-vote. The Judiciary Committee is Chaired by Rep. Goodlatte (R-VA) and the Ranking Member is Rep. Conyers (D-MI).

The Comprehensive Opioid Abuse Reduction Act authorizes the Attorney General within DOJ to make grants to States, units of local government and non-profits “to provide services primarily relating to opioid abuse” where a number of allowable use of funds are listed. These allowable uses include:

providing training and resources for first responders on carrying/administering an opioid overdose reversal drug approved by the FDA ad purchasing such drug or device for first responders who have received training;
investigations to locate or investigate illicit activities related to the unlawful distribution of opioids;
developing, implementing or expanding a medication-assisted treatment program used or operated by a criminal justice agency, which may include training;
developing, implementing or expanding PDMPs;
developing, implementing or expanding programs to prevent and address opioid abuse by juveniles; and
developing, implementing or expanding an integrated and comprehensive opioid abuse response program.

One section emphasizes coordination between State criminal justice agencies and substance abuse agencies: The bill notes that in the case where a State is the applicant, a core focus of the grant activities would be “…facilitating or enhancing planning and collaborating between State criminal justice agencies and State criminal justice systems in order to more efficiently and effectively carry out programs described in paragraph (1) that address problems related to opioid abuse…” The programs listed in paragraph 1 include:

developing, implementing, or expanding treatment alternative to incarceration program, which may include pre-booking or post-booking components;
training for criminal justice agency personnel on substance use disorders and co-occurring mental illness and substance use disorders;
a mental health court;
a drug court; and
a veterans court.

Additional language on veterans services: The bill includes additional language authorizing services to “qualified” veterans. The bill defines a qualified veteran as a “…preliminary qualified offender who served on active duty in any branch of the Armed Forces, including National Guard or Reserves, and was discharged or released from such service under conditions other than dishonorable.” The additional language authorizes a Veterans Court program within DOJ, along with a Veterans Assistance Program.

Medication Assisted Treatment (MAT) defined: The bill defines “medication-assisted treatment” as “the use of medications approved by the Food and Drug Administration for the treatment of opioid abuse.”

House Initiative differs from CARA: H.R. 5046 differs from CARA in that H.R. 5046 authorizes grants exclusively within the Department of Justice (DOJ). Overall, CARA authorizes a number of distinct programs targeted towards different aspects of the opioid problem (prevention, treatment, recovery, media campaigns, naloxone and more) not only within DOJ but also within certain Department of Health and Human Services’ (HHS) operating divisions that include the Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC), and others. In the House, as previously reported, a number of bills related to opioids impacting federal health agencies are being considered in the Energy and Commerce Committee.

To view the Comprehensive Opioid Abuse Reduction Act (H.R. 5046), please visit https://judiciary.house.gov/wp-content/uploads/2016/04/HR-5046.pdf

Other bills passed by the Judiciary Committee: In addition to H.R. 5046, the Judiciary Committee considered and approved

H.R. 5052, the Opioid Program Evaluation Act which would require an evaluation of the grants authorized in H.R. 5046 (Rep. McCarthy, R-CA and Rep. Hoyer, D-MD)

H.R. 5048, the Good Samaritan Assessment Act of 2016, which would require a GAO report on the extent to which ONDCP has reviewed Good Samaritan Laws and the results or findings from these reviews along with a compilation of Good Samaritan Laws in effect in the States (Rep. Guinta, R-NH)

House Full Energy and Commerce Committee Completes Markup of Bills on Opioids
The Full House Energy and Commerce Committee considered and passed on Wednesday, April 27 and Thursday, April 28 a number of bills aimed at address the opioid problem. The Chairman of the Committee is Rep. Upton (R-MI) and the Ranking Member is Rep. Pallone (D-NJ).

On Thursday, April 28, the Committee reconvened and passed three more bills related to opioids:

H.R. 3691, Improving Treatment for Pregnant and Postpartum Women Act would reauthorize the residential services for pregnant and postpartum women program (PPW) grant program within SAMHSA’s Center for Substance Abuse Treatment (CSAT). The bill would also create a pilot program for State substance abuse agencies to use up to 25 percent of these funds for services to pregnant and parenting women in non-residential settings. The purpose of the pilot program is to spur innovation and fill gaps in family-centered services across the continuum of care. A section-by-section summary of the bill can be found here. In FY 2016, the PPW grant program was funded at $15.9 million. The bill as introduced authorized $40 million for the PPW and pilot program.

During the markup, an amendment was offered to change the authorization of funds in the bill from $40 million to $16.9 million. Further, Rep. Ben Ray Luján (D-NM), the original sponsor of the bill, offered an amendment that would authorize the use of funds for the pilot program only if the amount for the overall PPW program exceeded FY 2016 funding levels. Both amendments passed.

H.R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015, for the Secretary of Health and Human Services to carry out a grant program for the co-prescribing of opioid overdose reversal drugs (Rep. Sarbanes, D-MD)

H.R. 4586, Lali’s Law, to authorize grants to States for developing standing orders and educating health care professionals regarding the dispensing of opioid overdose reversal medication without person-specific prescriptions, and for other purposes (Rep. Dold, R-IL)

The Committee considered and approved the following opioid-related bills on Wednesday, April 27:

H.R. 4641, To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes (Rep. Brooks, R-IN and Rep. Kennedy, D-MA)

H.R. 4978, Nurturing and Supporting Healthy Babies Act which would mandate the Government Accountability Office (GAO) to write a report neonatal abstinence syndrome (NAS) – including prevalence, coverage available under Medicaid, any federal barriers to treatment, particularly in non-hospital settings, and more.

H.R. 4981, Opioid Use Disorder Treatment Expansion and Modernization Act: The Opioid Use Disorder Treatment Expansion and Modernization Act (H.R. 4981), would change the number of patients to whom a practitioner can prescribe buprenorphine from 100 to 250. During the markup four amendments were offered to H.R. 4981. The first, offered by Congresswoman DeGette (D-CO), aimed to increase the cap to 500 patients, and the second by Ranking Member Pallone would increase the cap to 300. In a roll call vote, neither of the amendments to further increase the cap passed. Congresswoman Yvette Clarke (D-NY) offered an amendment to raise awareness of safe prescribing of opioids for the treatment of pain, but she later withdrew the amendment. Finally, Congressman Ben Ray Luján (D-NM) offered an amendment to authorize $1 billion for opioid use disorder prevention and treatment, primarily in the form of State targeted response cooperative agreements as proposed by the Administration. With a vote of 22-24, Congressman Luján’s amendment did not pass. (H.R. 4981 was introduced by Rep. Bucshon, R-IN and Rep. Tonko, D-NY)

H.R. 4969, John Thomas Decker Act of 2016 to authorize a grant program within CDC to educate teens and youth injured playing sports regarding the dangers of prescription drug misuse and abuse (Rep. Meehan, R-PA)

H.R. 4599, Reducing Unused Medications Act of 2016 to amend the Controlled Substances Act in order to allow partial fills of schedule II controlled substances (Rep Clark, D-MA)

H.R. 4976, Opioid Review Modernization Act to require the Food and Drug Administration (FDA) to seek recommendations from an advisory committee before approval of certain new opioid-based drugs without abuse-deterrent properties (Rep. Sean Maloney, D-NY)

H.R. 4982, Examining Opioid Treatment Infrastructure Act of 2016 would require the GAO to develop a report on the availability of substance use disorder treatment in inpatient, outpatient and detox settings (Rep. Foster, D-IL)

H.R. 3250, DXM Abuse Prevention Act would prohibit the sale of medicine containing dextromethorphan (DXM) to individuals under 18 without a prescription (Rep. Johnson, R-OH and Rep. Matsui, D-CA)

NASADAD will continue to track relevant legislation and provide updates to membership.

University of California study finds seasonal increase in college student drinking rates
The University of California – San Diego published a study finding seasonal increases in drinking rates among college students earlier last month. The study examined 462 college freshmen at eight different points during their first year. Researchers found that the freshmen’s drinking decreased 29 percent in the summer, increased 31 percent in the spring, and increased another 18 percent around spring break.

November 23, 2015 – ROSC for Women Recording

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WSN

November 23, 2015 – ROSC for Women involved in Human Trafficking

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MembersOnly

SOTA Orientation Call – 03.22.2016

Image April 28, 2016 aaa