Around the Agencies

• NIAAA study recommends primary care physicians implement single-question alcohol screening for adolescents
• Latest NIAAA Spectrum newsletter now available online

In the News

• National Alliance for Model State Drug Laws updates report on medical marijuana legislation
• Alcohol Awareness Month begins in April with theme of parental involvement
• NAMD releases report on the Medicaid link between service delivery and payment

News from NASADAD

• NASADAD attends Senate Drug Caucus hearing titled “Is the Department of Justice Adequately Protecting the Public from the Impact of State Recreational Marijuana Legalization?”
• NPN announces call for 2016 National Exemplary Awards applications

News from the States

• Public Policy Institute of California releases report analyzing Washington and Colorado’s regulatory approaches to marijuana legalization

Upcoming Events

• ONDCP announces webinar on community benefit
• SAMHSA and CMS announce webinar on mental health and substance use disorder parity for Medicaid and CHIP
• The Sentencing Project announces webinar on sentencing reform at the State level

Around the Agencies

NIAAA study recommends primary care physicians implement single-question alcohol screening for adolescents
A study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends physicians implement single-question alcohol screenings for adolescents. Researchers examined rates of alcohol use disorder (AUD) among adolescents in rural Pennsylvania, finding that “10 percent of rural youth over age 14 met diagnostic criteria for AUDs in the past year.” Forty-four percent of adolescents who reported drinking on three or more days in the past year were found to have AUDs. While many primary care physicians do not currently screen adolescents for AUDs as a result of time constraints, the report recommends that physicians implement single-question screening related to frequency of alcohol consumption. The study’s authors assert that single-question screening detects AUDs among adolescents with 91 percent sensitivity and that it is effective at identifying problematic usage of alcohol in adolescents.

Read the full study here.

Latest NIAAA Spectrum newsletter now available online
The most recent version of the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) Spectrum newsletter is now available online. The newsletter was previously published in February 2016. This edition of the newsletter contains stories regarding the differences between male and female alcohol consumption, alcohol use disorder prevalence among Native American and Mexican young adults, pediatrician substance use disorder and mental health intervention, and discussion of a new study examining how substance use affects adolescent brain development.

Read the full newsletter here.

In the News

National Alliance for Model State Drug Laws updates report on medical marijuana legislation
The National Alliance for Model State Drug Laws (NAMSDL) has updated its report on State medical marijuana legislation. The report summarizes ongoing and future efforts to regulate medical marijuana at the State level. The updated medical marijuana report follows last week’s updates on follow-up, decriminalization, and personal non-medical use marijuana legislation.

Read the medical marijuana legislation report here.

Read the “follow-up” legislation report here.

Read the decriminalization report here.

Read the personal non-medical use report here.

Alcohol Awareness Month begins in April with theme of parental involvement
This year’s Alcohol Awareness Month began at the start of April with the theme “Talk Early, Talk Often: Parents Can Make a Difference in Teen Alcohol Use.” The National Council on Alcoholism and Drug Dependence (NCADD) sponsors the event and helped to develop the theme. The National Association for Children of Alcoholics (NACoA) has prepared several resources to help parents discuss alcohol use with their children. Other NACoA materials include informational videos, teen web portals with information on alcohol, and recommendations from recovery author Claudia Black.

Access NACoA’s resources here.

View NCADD’s 2016 Alcohol Awareness Month organizing guide here.

NAMD releases report on the Medicaid link between service delivery and payment
The National Association of Medicaid Directors (NAMD) has released results of a study on the efforts State Medicaid agencies are taking to rework the connection between healthcare service delivery and reimbursement. The report asserts that nearly two-thirds of the 34 States participating in the study have or will implement State-designed programs reforming payment at the provider level. Medicaid directors interviewed as part of the project stressed the significant resources involved with implementing new service delivery and payment models, underscoring the need for high-quality data and stakeholder involvement throughout the full span of the process. The report recommends that new rate setting procedures may be required to support alternative payment models, and cautions that efforts to establish multi-payer reform must coordinate between Medicare and Medicaid to ensure that all payers work in the same direction.

Read NAMD’s press release here.

Read the full report here.

News from NASADAD

NASADAD Attends Senate Drug Caucus Hearing titled “Is the Department of Justice Adequately Protecting the Public from the Impact of State Recreational Marijuana Legalization?”
On April 5th, 2016, Brian Denten, NASADAD Public Policy Graduate Intern, attended the hearing convened by the Senate Caucus on International Narcotics Control. The Chairman of the Caucus is Senator Grassley (R-IA) and the Ranking Member is Senator Feinstein (D-CA).  Other members of the Caucus include Senators Sessions (R-AL), Schumer (D-NY), Risch (R-ID), Cornyn (R-TX), and Whitehouse (D-RI).

The hearing focused on the release of a report by the Government Accountability Office (GAO) titled “State Marijuana Legalization: DOJ should Document its Approach to Monitoring the Effects of Legalization.”  The report examines DOJ’s enforcement of the Controlled Substances Act (CSA) with regard to marijuana and actions taken on marijuana in Colorado and Washington State.  The CSA established that it is a federal crime for anyone to knowingly or intentionally manufacture, distribute, dispense, or possess marijuana.  However, over time States have passed laws allowing for the purchase and use of limited quantities of marijuana for certain medical conditions and more recently States passed laws allowing for the retail purchase of marijuana.

In response, DOJ issued on August 29^th, 2013 a memorandum designed to serve as guidance to all U.S. Attorneys. This memo, known as the “Cole Memo” because it was written by then-Deputy Attorney General James Cole, listed eight federal priorities that the federal government would focus on in terms of enforcement.  A few of these eight priorities included:

• preventing the distribution of marijuana to minors;
• preventing revenue from the sale of marijuana being directed towards criminal organizations;
• preventing diversion if legal marijuana to States where it remains illegal; and
• preventing drugged driving and other adverse public health consequences.

DOJ noted that it would consider stepping up its enforcement if certain areas were found to be problematic.

Senators Grassley and Feinstein asked GAO to investigate the mechanisms used by DOJ to monitor actions in States that have allowed retail purchase of marijuana for personal use (Washington State and Colorado) and lessons learned by DOJ on enforcement efforts of States with medical marijuana laws.

The report found that DOJ has not documented its monitoring process and a number of questions were raised about the data currently being collected.

During the hearing, Senators expressed concern over what they considered insufficient oversight, highlighting data from Colorado suggesting that emergency room visits related to marijuana and adolescent marijuana use have both increased since legalization.

The DOJ witness indicated that the Department plans to create a public web portal with information tracking State legalization efforts.

Witnesses:

• Benjamin B. Wagner; U.S. Attorney of the Eastern District of California
• Jennifer Grover; Director, Homeland Security and Justice, U.S. Government Accountability Office
• Doug Petersen; Attorney General for the State of Nebraska
• Kathryn Wells; Medical Director, Denver Health Clinic at the Family Crisis Center

View a video of the hearing here.

Read the GAO report on marijuana legalization here.

Read the DOJ’s Cole Memo on marijuana enforcement here.

News from the States

Public Policy Institute of California releases report analyzing Washington and Colorado’s regulatory approaches to marijuana legalization
The Public Policy Institute of California (PPIC) has released a report analyzing Washington and Colorado’s regulatory approaches to marijuana legalization. The report was compiled with the intention of providing information for California’s potential legalization of marijuana. The report makes three main recommendations based on Washington’s and Colorado’s experiences: (1) marijuana regulation must be flexible to deal with rapid changes in the time following legalization, (2) collecting data on the marijuana market and its impact on society must be gathered by robust mechanisms, and (3) California should develop a single restrictive regulatory model for both the recreational and medical marijuana markets in light of marijuana’s illegal status under federal law.

Read the full report here.

Upcoming Events

ONDCP announces webinar on community benefit
The Office of National Drug Control Policy (ONDCP) has announced a webinar discussing community coalition partnerships in collaboration with the Community Anti-Drug Coalitions of America (CADCA). The webinar, titled “Community Health Needs Assessment and Substance Use Disorders: How Partnerships with Community Coalitions can Benefit Local Substance Use Prevention Efforts,” will feature several speakers from ONDCP, CADCA, and the National Institute on Drug Abuse (NIDA). The webinar will be held on Thursday, April 14^th from 2:30-4 PM EST.

Learn more and register for the webinar here.

SAMHSA and CMS announce webinar on mental health and substance use disorder parity for Medicaid and CHIP
The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare & Medicaid Services (CMS) have announced a webinar on mental health and substance use disorder parity for Medicaid and CHIP. The webinar will discuss the implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) for “individuals enrolled in Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and CHIP.” Changes from the Notice of Proposed Rulemaking will also be discussed by several speakers from both SAMHSA and CMS. The webinar will be held on Thursday, April 14^th from 1-2 PM EST.

Register for the webinar here.

The Sentencing Project announces webinar on sentencing reform at the State level
The Sentencing Project has announced a webinar on sentencing reform at the State level. The webinar will examine State sentencing policies that have driven the increase in incarceration rates throughout the United States. Current sentencing reform efforts and potential consequences associated with them will be discussed by a number of speakers representing jurisdictions across the country, including Delaware, Georgia, and Michigan. The webinar will be held on Tuesday, April 19^th on 3 PM EST.

Register for the webinar here.

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

News from NASADAD

• NPN announces call for 2016 National Exemplary Awards applications

News from the States

• CDC issues report examining fentanyl-related drug overdose deaths in Ohio
• Kansas passes juvenile justice reforms, shifting focus from detention centers to community-based programs

Around the Agencies

• CMS finalizes rule on mental health and substance use disorder parity for Medicaid and CHIP
• SAMHSA announces Daryl Kade as CBHSQ Director, Monica Feit as OPPI Director
• HHS releases new guidance on federal funding for syringe service programs

In the News

• NAATP announces new study tracking treatment outcomes data
• National Alliance for Model State Drug Laws updates reports on marijuana legislation
• President Obama announces additional actions to address the opioid crisis

News from NASADAD

NPN announces call for 2016 National Exemplary Awards applications
The National Prevention Network (NPN) has announced their call for applications for the 2016 National Exemplary Awards for Innovative Substance Abuse Prevention Programs, Practices, and Policies. The Exemplary Awards program identifies and honors outstanding achievements in substance abuse prevention throughout the country. The 2016 Awards will recognize exceptional substance abuse efforts and serve to focus national attention on the field of substance abuse prevention. They are intended to showcase “grassroots,” evidence-based substance abuse prevention programs and strategies that have been evaluated and may be replicated by others.  Applications are due Friday, May 6^th, 2016.

Access the 2016 Exemplary Awards application here.

News from the States

CDC issues report examining fentanyl-related drug overdose deaths in Ohio
The Centers for Disease Control and Prevention (CDC) has released a report analyzing fentanyl-related drug overdose deaths in Ohio. Ohio’s Department of Health had previously requested assistance from the CDC after data suggested fentanyl-related overdose deaths increased from 84 in 2013 to 502 in 2014. The CDC’s investigation examined death certificates, medical examiner reports, emergency department visit data, and prescription history data from the Ohio Automated Rx Reporting System, the State’s prescription drug monitoring program (PDMP). Results from the study indicate that individuals experiencing fentanyl-related overdose deaths are 69 percent male, 89 percent white, and 94 percent with some college or less education. The average age of those experiencing fentanyl overdoses was 37.9 years old. The study recommends that counties continue to monitor fentanyl-related deaths and perform targeted interventions as necessary. The CDC suggests improving access to naloxone for first responders.

Read the full report here.

Kansas passes juvenile justice reforms, shifting focus from detention centers to community-based programs
The Kansas House of Representatives has passed a bill reforming the State’s juvenile justice system. The bill places larger emphasis on therapeutic treatment options for non-violent juvenile offenders by shifting support from detention centers to community-based programs. Kansas expects the bill to save the State about $72 million in funding over the next five years, as research suggests community-based programs decrease recidivism and increase high school graduation rates. The Kansas State Senate passed a similar measure earlier in the session that phases out Kansas’s use of youth residential facilities by 2018. This phasing out contradicts the House version of the bill that keeps 50 beds available in youth facilities. This disagreement will be negotiated by both chambers before being submitted to Governor Brownback.

Read more about Kansas’s juvenile justice reforms here.

Around the Agencies

CMS finalizes rule on mental health and substance use disorder parity for Medicaid and CHIP
The Centers for Medicare & Medicaid Services (CMS) announced the finalization of a rule related to mental health and substance use disorder parity for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries last week. The rule was released in conjunction with President Obama’s visit to the National Rx Drug Abuse and Heroin Summit in Atlanta. The rule intends to expand access to evidence-based treatment by providing States flexibility in managed care delivery mechanisms while requiring that Medicaid beneficiaries are able to access mental health and substance use disorder benefits in a similar way to other medical benefits. Plans are required to provide information on mental health and substance use disorder benefits, including determination of medical necessity criteria, under the new rule. States must now disclose the rationale behind any denial of reimbursement for mental health and substance use disorder benefit claims.

View the final rule here.

SAMHSA announces Daryl Kade as CBHSQ Director, Monica Feit as OPPI Director
The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced Daryl Kade as the new Director of the Center for Behavioral Health Statistics and Quality (CBHSQ) and Monica Feit, Ph.D. as Director of the Office of Policy, Planning, and Innovation (OPPI). Ms. Kade and Dr. Feit were both already serving as Acting Directors of both CBHSQ and OPPI, respectively.

As CBHSQ Director, Ms. Kade will provide national leadership in substance use disorder treatment, substance abuse prevention, and mental health statistics. Ms. Kade previously served as Acting Director of the Center for Substance Abuse Treatment (CSAT) and as Director of SAMHSA’s Office of Financial Resources. Ms. Kade has also worked within the Office of National Drug Control Policy (ONDCP) as a budget and legislative analyst.

As OPPI Director, Dr. Feit will assist SAMHSA in policy formulation and implementation in conjunction with external stakeholders. Dr. Feit previously joined the Department of Health and Human Services (HHS) as Director of the Division of Public Health Services in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in 2013. Before joining HHS, Dr. Feit worked as a Senior Program Officer at the Institute of Medicine (IOM).

HHS releases new guidance on federal funding for syringe service programs
Last week the U.S. Department of Health and Human Services (HHS) released new guidance for State, local, and tribal health departments seeking to fund syringe service programs (SSPs) through federal grant money. The guidance states that health departments are now able to use federal funding to create or enhance SSPs to help prevent the spread of HIV and viral hepatitis. It is important to note that while federal funds can be used for a large array of services, they cannot be used to purchase sterile needles or syringes.

HHS will require that health departments consult with the Centers for Disease Control and Prevention (CDC) to determine whether there is a need for SSPs in their jurisdiction. Once consulted, CDC will decide whether health departments are eligible to apply for SSP funding from their respective federal agencies.

Read the full guidance document here.

In the News

NAATP announces new study tracking treatment outcomes data
The National Association of Addiction Treatment Providers (NAATP) has announced a new study tracking patient outcomes from residential and outpatient treatment programs. The NAATP will collaborate with the OMNI Institute to collect data from over one-thousand patients following their first year after treatment. The study will examine a number of outcomes, including: detoxification, patient engagement, medication, counseling, peer and family support, and twelve-step activity.

Read the full press release here.

National Alliance for Model State Drug Laws updates reports on marijuana legislation
The National Alliance for Model State Drug Laws (NAMSDL) has updated its series of reports on medicinal, legal, and illegal marijuana legislation for 2016. The reports summarize ongoing and future efforts to regulate both the medical marijuana and legal marijuana industries at the State level. Three reports are now available: a report examining “follow-up” legislation in States that have legalized the personal use of marijuana, a report examining legislation to decriminalize the personal use of marijuana, and a report examining general marijuana legalization efforts.

Read the “follow-up” legislation report here.

Read the decriminalization report here.

Read the personal non-medical use report here.

President Obama announces additional actions to address the opioid crisis
On March 29^th President Obama announced the following policies during a speech at the National Rx Drug Abuse and Heroin Summit:

• HHS will issue a proposed rule increasing the buprenorphine treatment cap from 100 to 200 patients for qualified physicians treating opioid use disorders.
• HHS will release $94 million in new funding to 271 Community Health Centers – expected to help treat approximately 124,000 new patients with substance use disorders.
• SAMHSA will release $11 million in funding opportunities to expand medication-assisted treatment in up to 11 States.
• President Obama will sign a memorandum authorizing the creation of a Mental Health and Substance Use Disorder Parity Task Force to be chaired by the Domestic Policy Council. The Task Force will be held to an October 31 deadline to ensure that important parity protections are implemented.
• HHS will finalize a rule bolstering mental health and substance use disorder parity in Medicaid and CHIP.

For more information, click here.

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