News from NASADAD

• NASADAD attends briefing on enhancing access to healthcare among minority and low-income communities
• NASADAD attends briefing on prescriber preparation for opioid crisis
• NASADAD attends Alliance for Health Reform briefing on  home and community-based care services

Around the Agencies

• CMS releases EHR reporting period final rule

In the News

• Parental substance use disorders drive growth in number of children in foster care
• AMA Task Force releases report for increasing access to naloxone
• Kelly Ayotte requests study of implementation and enforcement of the Mental Health Parity and Addiction Equity Act
• Governing magazine releases story on challenges facing State Medicaid programs

Upcoming Events

• ASAM announces webinars discussing evidence-based clinical treatment of opioid use disorders

News from NASADAD

NASADAD attends briefing on enhancing access to healthcare among minority and low-income communities
Brian Denten, Public Policy Intern, attended the event hosted by the National Journal on Thursday, October 9^th. Two panels of individuals working in the healthcare industry spoke about healthcare access among minority and low-income communities. Despite the Affordable Care Act’s (ACA) expansion of healthcare coverage, many newly insured remain unclear on how to access and utilize health insurance. Panelists discussed the importance of telehealth in disseminating information to minority and low-income communities about where and how to receive healthcare, stating that many people still rely on emergency departments as their primary source of healthcare. Several panelists emphasized cultural competency among medical professionals as essential in improving healthcare outcomes. Speakers further asserted the need for greater continuity of care within the healthcare system for treating the newly insured.

Panelists:

• Nadine Gracia, M.D.; Deputy Assistant Secretary and Director, Office of Minority Health, U.S. Department of Health and Human Services
• Georges Benjamin, M.D.; Executive Director, American Public Health Association
• Patrice Harris, M.D.; Chair-Elect, American Medical Association
• Justine Handelman; Vice President of Legislative and Regulatory Policy, Blue Cross Blue Shield Association
• Seiji Hayashi, M.D.; Executive Vice President for Transportation and Innovation, Practicing Physician, Unity Health Care
• McCrae Parker; Managing Director, Zero Divide
• Ruth Perot; Executive Director and CEO, Summit Health Institute for Research and Education (SHIRE)
• Ramanathan Raju, M.D.; President and CEO, New York City Health and Hospitals Corporation
• Diane Rowland; Executive Vice President, Kaiser Family Foundation
• Michael Scott; Chief Equity Officer, President, and Co-Founder, Equity Matters

NASADAD attends briefing on prescriber preparation for opioid crisis
Robert Morrison, Executive Director, and Shalini Wickramatilake-Templeman, Public Policy Associate, attended the briefing sponsored by the Hazelden Betty Ford Institute for Recovery Advocacy and National Council for Behavioral Health on Tuesday, October 6^th.  Speakers, including members of Congress, discussed the increasing prescription opioid and heroin problem in the United States. In particular, speakers emphasized the importance of prescriber education in the prevention of opioid use disorders.

Speakers:

• Kelly Ayotte (R-NH)
• Shelley Moore Capito (D-WV)
• Mary Bono, Principal, FaegreBD Consulting
• Michael Botticelli, Director, Office of National Drug Control Policy
• Joe Manchin (D-WV)
• Edward Markey (D-MA)
• Mehmet Oz; Host of The Dr. Oz Show
• Mackenzie Phillips; Actress and Person in Long-Term Recovery from an Opioid Use Disorder
• Dr. Marvin Seppala; Chief Medical Officer, Hazelden Betty Ford Foundation
• Dr. Jeannie Sperry; Adult Pain Rehabilitation Clinical Director, Mayo Clinic
• John Tilley; Kentucky House of Representatives

NASADAD attends Alliance for Health Reform briefing on home and community-based care services
Brian Denten, Public Policy Intern, attended the briefing sponsored by the Alliance for Health Reform. Several panelists working to identify ways to improve the provision of home and community-based healthcare services spoke at the event. As the United States’ population continues to age, home and community-based caretaker services for the elderly will become an increasingly large percentage of healthcare costs. Institutional solutions for the elderly, such as nursing homes, have trended downwards since the late 1990s, with home and community-based services making up the largest percentage of Medicaid long-term care expenditures in 2013. Several panelists discussed methods for improving the quality of long term-services and support (LTSS), including increasing affordability and access, increasing the amount of providers to choose from, increasing quality of life and care, and providing additional support for family caregivers.

Panelists:

• Anne Montgomery; Altarum Institute
• Bea-Alise Rector; Department of Social and Health Services, Washington State
• Abby Marquand; Paraprofessional Healthcare Institute (PHI)
• Jean Accius; AARP

Around the Agencies

CMS releases EHR reporting period final rule
The Centers for Medicare & Medicaid Services (CMS) released a final rule for the Medicare and Medicaid Electronic Health Records Incentive Programs in 2015 (EHR) this past week. The rule adjusts the EHR reporting period to 90 days in order to align with the remainder of the calendar year.  The rule further includes additional measures including “reducing the share of patients that must use the patient portal from 5% to at least one patient, and modifying the summary care requirements.”

In the News

Parental substance use disorders drive growth in number of children in foster care
Parents with substance use disorders are a major cause for the increase of children in foster care services, according to a new article by Pew Charitable Trusts. The number of children living in foster care began to increase in 2013, after years of decline. 415,000 children were living in foster care in 2014 according to an Administration for Children and Families (ACF) report, many as a result of their parents’ substance use disorders. Ohio saw a 19 percent increase from 2010 to 2013 in the percentage of child welfare cases involving heroin or cocaine, with seventy percent of children less than a year old in foster care as a result of parents using drugs. Similar trends were observed in Indiana and Vermont. Child welfare cases involving drug addiction present unique challenges, as many parents have difficulty recovering from their substance use disorder in the time allotted by federal law to reunite with their children.

AMA Task Force releases report for increasing access to naloxone
The American Medical Association (AMA) Task Force to Reduce Opioid Abuse issued a new report compiling resources for States and physicians to consider when increasing access to naloxone this past week. The report includes several webinars and overdose prevention resources from a variety of organizations, including the Harm Reduction Coalition and the American Academy of Addiction Psychiatry. One of the AMA Task Force’s primary goals is the encouragement of physicians to “co-prescribe naloxone to a patient or prescribe naloxone to a family member or close friend when it is clinically appropriate.” The report also provides an overview of naloxone laws in States across the country.

Sen. Kelly Ayotte requests study of implementation and enforcement of the Mental Health Parity and Addiction Equity Act
Senator Kelly Ayotte (R-NH) requested a study of the implementation and enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 in a letter to the head of the U.S. Government Accountability Office (GAO) last week. Despite going into effect in January 2014, implementation of mental health parity has proven difficult, as many individuals continue to report denial of coverage for substance use disorder treatment by health insurance companies. In the letter, Sen. Ayotte expresses her concern that large barriers to accessing treatment for substance use disorders remain despite the passage of the law, and suggests the GAO review insurance company compliance with mental health parity.

Governing magazine releases story on challenges facing State Medicaid programs
Governing magazine released a story on the challenges facing State Medicaid programs last week, featuring commentary from several State Medicaid Directors on the current status of Medicaid. Medicaid programs have grown substantially in recent years, yet State Medicaid Directors assert that they have not been given extra resources—such as more administrative positions, salary increases, and more technical assistance—to handle the increased capacity.  Matt Salo, Director of the National Association of Medicaid Directors, states that Medicaid’s role has evolved from being “bill payer” to having a number of new responsibilities. Many States do not consider Medicaid a separate agency, and include Medicaid programs within larger agencies such as health and human services.

Upcoming Events

ASAM announces webinars discussing evidence-based clinical treatment of opioid use disorders
The American Society of Addiction Medicine (ASAM) has announced a series of webinars discussing evidence-based clinical treatment of opioid use disorders to be held throughout the remainder of 2015. These webinars will discuss recommendations from the new ASAM National Practice Guideline for physicians treating patients with opioid use disorders, including the primary components of patient assessment and diagnosis, the use of pharmacotherapy (including buprenorphine, methadone, naltrexone, and naloxone), and the needs of special populations (including pregnant women, adolescents, and individuals within the criminal justice system). The webinars will be held on Wednesday, October 28 at 3PM EST; Tuesday, November 17 at 12PM EST; and Thursday, December 10 at 12PM EST.

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.

Around the Agencies

• CDC study examines alcohol use and binge drinking among women of childbearing age
• CAPT web area moves to the Programs and Campaigns section of the SAMHSA website
• NIDA reorganizes divisional structure to emphasize research on neuroscience and brain development

News from the States

• Maryland opioid task force releases series of recommendations to Governor Larry Hogan
• Indiana governor announces new task force on substance use disorders
• Oregon communities prevent recreational sale of marijuana

In the News

• New article examines provider application of SBIRT to young people
• Study finds substance use disorders associated with increased risk of death after release from prison
• Center for Health Care Strategies releases new tool on mental health and substance use disorder integration into Medicaid accountable care organizations
• States warn insurance agencies against using consumer reports to determine premiums
• Governors Highway Safety Association reports increase in drug use as cause of fatal car crashes
• Affordable Care Act amendment passes Senate, expects to be signed by President Obama

Upcoming Events

• IRETA announces webinar discussing substance use disorders in the military

Around the Agencies

CDC study examines alcohol use and binge drinking among women of childbearing age
The Centers for Disease Control and Prevention (CDC) released a new study this past week examining alcohol use among women of childbearing age. The study used Behavioral Risk Factor Surveillance System (BRFSS) data from 2011-2013 to form its conclusions. Fifty-three percent of non-pregnant women reported alcohol use and 18percent of non-pregnant women reported binge drinking.  Ten percent of pregnant women reported alcohol use and 3 percent of pregnant women reported binge drinking. Within the category of pregnant women, “women aged 35-44 years reported a significantly higher prevalence of any alcohol use (18.6%) than all other age groups.” Alcohol use among pregnant women with college degrees was twice as high compared to pregnant women with a high school diploma or less. The study notes an overall increase in alcohol use and binge drinking among pregnant and non-pregnant women compared to a similar study examining 2006-2010, but cautions that this increase may be a result of methodological changes in the BRFSS rather than an increase in alcohol use. The CDC recommends a “comprehensive approach to reduce alcohol use and binge drinking among pregnant women, and binge drinking among women of childbearing age” as a result of the study.

CAPT web area moves to the Programs and Campaigns section of the SAMHSA website
The Center for the Application of Prevention Technologies (CAPT) web area has moved to the “Programs and Campaigns” section of the Substance Abuse and Mental Health Services Administration (SAMHSA) website. The move is intended to streamline access to related resources on SAMHSA’s overall website. The new CAPT web area features the same content as its previous location, and will continue to be updated over the next several months. CAPT online courses will remain on a separate, password-protected online portal.

NIDA reorganizes divisional structure to emphasize research on neuroscience and brain development
The National Institute on Drug Abuse (NIDA) has reorganized its internal structure to emphasize research on neuroscience and brain development. The reorganization follows an evaluation by a NIDA Advisory Council Workgroup in response to reduced staffing and new scientific advances. The Advisory Council Workgroup found that “advances in addiction neuroscience outpaced or rivaled those achieved for any other brain disease.” The new structure will “strengthen functional integration throughout NIDA and continue to emphasize translational neuroscience, brain development, and neurobehavioral interventions research as core elements of NIDA’s mission.”

NIDA’s Division of Clinical Neuroscience and Behavioral Research (DCNBR) will merge with the Division of Basic Neuroscience and Behavioral Research to form the Division of Neuroscience and Behavior as a result of the restructuring. Additionally, DCNBR’s behavioral treatment portfolio will merge with the Division of Pharmacotherapies and Medical Consequences of Drug Abuse to form the Division of Therapeutics and Medical Consequences (DTMC). The focus of the new Division will be treatment development and interventions targeting the “brain circuits” associated with substance use disorders. The new structure is effective October 1^st.

News from the States

Maryland opioid task force releases series of recommendations to Governor Larry Hogan
The Maryland Heroin and Opioid Emergency Task Force submitted its initial report and series of recommendations to Governor Larry Hogan last month, as the National Governors Association (NGA) reports. The task force was created by Governor Hogan in February 2015 to advise the governor on ways to improve access to treatment, healthcare quality, and alternatives to incarceration for individuals with substance use disorders. The initial series of recommendations include “earlier and broader incorporation of heroin and opioid prevention into the health curriculum, the infusion of heroin and opioid prevention into additional disciplines, student-based heroin and opioid prevention campaigns, and Maryland State Police training on the Good Samaritan Law,” among several other suggestions. The task force also released ten funding announcements to treatment facilities in an effort to expand access to treatment and overall quality of care. The task force’s final report is expected to be released in December 2015.

Indiana Governor Mike Pence announces new task force on substance use disorders
Indiana Governor Mike Pence announced a new task force focusing on combating substance use disorders last month, as the National Governors Association (NGA) reports. The Task Force will employ Indiana experts from a variety of backgrounds to examine substance use disorders within the State. Key goals of the Task Force include assessing the existing resources used to treat substance use disorders, identifying ways for federal, State, and local law enforcement to collaborate, identifying best practices for substance use disorder treatment, and identifying successful prevention programs. The Task Force will meet on a monthly basis for the remainder of the year before issuing a series of final recommendations to the Governor.

Oregon communities prevent recreational sale of marijuana
Several Oregon cities have moved to prevent the recreational sale of marijuana in their communities, despite recreational marijuana being legal in the State. Oregon Live reports that many rural communities are fearful that the recreational sale of marijuana will lead to increases in adolescent use and crime. The recreational sale of marijuana was legalized last year in Oregon through the ballot initiative Measure 91, which stipulated that “any local attempt to ban sales would have to go to the ballot after 10 percent of local voters signed a petition.” To date 13 counties in eastern Oregon have voted to ban medical and recreational marijuana sales of any type, with eight other cities planning similar votes next year.

In the News

New article examines provider application of SBIRT to young people
A new article written by Alexa Eggleston, Senior Program Officer at the Conrad N. Hilton Foundation, examines the growing application of screening, brief intervention and referral to treatment (SBIRT) to young people. Many health care providers do not currently examine adolescent patients for substance use disorders, despite the negative health implications alcohol and drugs can have on patients’ lives. Young people in recovery for substance use disorders often lament “missed opportunities” for intervention by health professionals, according to many recovery advocates. SBIRT provides a robust methodology for healthcare providers to approach the topic of substance use with adolescent patients, and screen them for substance use disorders if necessary. Positive feedback is provided to youth not using alcohol and drugs, while those who have begun using substances are advised on stopping use and remaining safe. Several organizations have partnered to increase the use of SBIRT, including the American Academy of Pediatrics, the School-Based Health Alliance, YouthBuild USA, Reclaiming Futures, and Young People in Recovery.

Study finds substance use disorders associated with increased risk of death after release from prison
A new study tracking formerly-incarcerated individuals in Sweden has found that inmates with substance use disorders experienced higher rates of death post-incarceration than inmates without substance use disorders. The study examined individuals released from prison in Sweden from January 1, 2000 to December 31, 2009, finding an “estimated probability of death within 5 years of release from prison of 10.2% among men with substance use disorders compared to 3.2% among those without.” Women with substance use disorders exhibited a probability of death within 5 years of 6.5% compared to 2.6% among those without. The study’s authors conclude that more expansive treatment options are required “beyond the immediate period after incarceration,” and suggest investigating alternatives to incarceration for individuals with substance use disorders.

Center for Health Care Strategies releases new tool on mental health and substance use disorder integration into Medicaid accountable care organizations
The Center for Health Care Strategies released a new tool examining State integration of mental health and substance use disorders into Medicaid accountable care organizations (ACOs) last week. Many States have begun developing ACOs for Medicaid populations in order to reduce health care costs and improve health care quality by increasing communication across the continuum of care. The Center for Health Strategies asserts that many Medicaid patients with co-occurring mental health and substance use disorders are not receiving optimal care due to the fragmented nature of the healthcare delivery system. ACOs address this problem through greater mental health and substance use disorder integration. The new tool explores strategies States can use when creating ACO systems.

States warn insurance agencies against using consumer reports to determine premiums
Several States have warned insurance agencies against using consumer reports to determine premiums, as Pew Charitable Trusts reports. Ten States (including California, Florida, Indiana, Maine, Maryland, Ohio, Pennsylvania, Rhode Island, Vermont, Washington, and the District of Columbia) have issued warnings to insurance agencies using spending habits or shopping history as factors in determining insurance premium increases. State agencies and the Consumer Federation of America (CFA) have expressed concern that if left unchecked, insurance companies’ technology will outpace the ability of insurance regulators to regulate the industry – leading to larger annual premium increases. Insurance companies have countered these assertions by stating that new “price optimization” practices only analyze groups of people, and that the practice is necessary to stay competitive.

Governors Highway Safety Association reports increase in drug use as cause of fatal car crashes
A new Governors Highway Safety Association (GHSA) report has found increased rates of driving while under the influence of drugs as the cause of increased fatal car accidents over the past decade, as the Washington Post reports this week. The report finds that 40 percent of fatally injured drivers tested positive for drugs in 2013, compared to 29 percent in 2005. The report analyzed federal data from the National Highway Traffic Safety Administration (NHTSA), finding that driving under the influence of drugs has increased as a result of the proliferation of prescription medications and the legalization of marijuana. The GHSA recommends the NHTSA issue best practices on preventing marijuana-impaired driving in response to the report, concluding that “marijuana is by far the most common drug that is used… and found in fatally-injured drivers.”

Affordable Care Act amendment passes Senate, expects to be signed by President Obama
An amendment to the Affordable Care Act (ACA) was passed by the Senate lastweek and is expected to be signed by President Obama. The amendment (HR 1624) modestly adjusts the categorization of midsized employers under the ACA, allowing business with 51 to 100 workers to be placed into the large employer category, while providing States discretion to categorize them as small employers if they choose. The bill aims to prevent midsized employers from being forced to change coverage and absorb large premium increases associated with the small group marketplace. The bill additionally provides $205 million to “a Medicare improvement fund that was cut under the health law.”

Upcoming Events

IRETA announces webinar discussing substance use disorders in the military
The Institute for Research, Education & Training in Addictions (IRETA) announced a new webinar discussing substance use disorders in the military last week. The webinar will be held on October 14^th from 1-2PM EST. Ariel David, Project Coordinator of the Armed Services Network of Louisiana, will present on the aspects of substance use disorders unique to the military and the best practices used to address them. The webinar will also examine ways health care providers can be more productive when dealing with members of the military.

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.

Around the Agencies

• HHS Secretary announces plans to revise MAT regulations and new naloxone grant program
• CMS prepared to implement ICD-10 beginning October 1^st
• NIH announces new grant program researching the effect of substance use on adolescent brain development
• BJA announces grant awards for FY 2015 Harold Rogers PDMP program

News from the States

• Pennsylvania Governor Tom Wolf approves stocking and usage of naloxone in schools
• Pamela Martin leaves position as Director of the Oregon Health Authority’s Addictions and Mental Health Division
• Ohio experiences rise in drug overdose deaths related to fentanyl

In the News

• Congress to consider continuing resolution
• President Obama’s weekly address focuses on National Prescription Drug Take-Back Day
• National Association of Drug Court Professionals announces Carson Fox as new CEO
• National Alliance for Model State Drug Laws updates reports on marijuana legislation
• Kaiser Family Foundation survey finds increase in average premiums for single person and family health coverage

Upcoming Events

• ONDCP announces webinar discussing evidence-based substance use prevention for parents

Around the Agencies

HHS Secretary announces plans to revise MAT regulations and new naloxone grant program
On September 17^th, at the 50 State Convening to Prevent Opioid Overdose and Addiction, Department of Health and Human Services (HHS) Secretary Burwell announced plans to revise medication-assisted treatment (MAT) regulations. Physicians are currently allowed to prescribe buprenorphine to 30 patients in the first year of their certification, before expanding to 100 patients after receiving further authorization. HHS estimates that of the 2.5 million individuals with opioid use disorders, less than 1 million receive treatment. NASADAD anticipates draft revisions of the regulations to appear for comment in a future Federal Register.

Secretary Burwell also announced a new grant program from the Office of Rural Health Policy within the Health Resources and Services Administration (HRSA), which will provide funding to States to purchase naloxone and train health care professionals and law enforcement on administering the drug to individuals who experience an opioid overdose.

CMS prepared to implement ICD-10 beginning October 1^st
The Centers for Medicare & Medicaid Services (CMS) announced that it is prepared to begin using the International Classification of Diseases, 10^th Revision (ICD-10) beginning October 1^st. The new ICD-10 will include new codes for medical diagnoses and hospital procedures that aim to better identify complex medical conditions. Additionally, it aims to increase coordination of care among health providers, and support the growth of new payment methods. All health care claims must use the new ICD-10 codes starting on October 1^st. CMS is prepared to monitor the transition in real-time, and address potential problems through its ICD-10 Coordination Center. Read more about the transition here.

NIH announces new grant program researching the effect of substance use on adolescent brain development
The National Institutes of Health (NIH) announced a new grant program researching the effect of substance use on adolescent brain development this past week. The Adolescent Brain Cognitive Development (ABCD) Study will grant awards to 13 research institutions around the country to track approximately 10,000 children from the ages 9 to 10 as they enter periods of high-risk for substance use and mental health disorders. Researchers will examine the relationship between exposure to certain substances and academic achievement, cognitive ability, and brain structure and function.  The study seeks to determine the impact of occasional versus regular use of various substances, and pinpoint the “brain pathways” connecting substance use and risk for mental health disorders.

BJA announces grant awards for FY 2015 Harold Rogers PDMP program
The Bureau of Justice Assistance (BJA) announced awards for FY 2015 Harold Rogers Prescription Drug Monitoring Program (PDMP) grants this past week. Grant awards were broken down into four separate categories: PDMP implementation and enhancement (Category 1), PDMP practitioner and research partnerships (Category 2), data-driven multi-disciplinary approaches to reducing prescription abuse (Category 3), and tribal PDMP data sharing (Category 4). Over $8.6 million in funding was awarded to various State public health departments, State justice departments, and State pharmacy boards.

News from the States

Pennsylvania Governor Tom Wolf approves stocking and usage of naloxone in schools
Pennsylvania Governor Tom Wolf approved the stocking and usage of naloxone within the State’s school districts and colleges last week. Governor Wolf and his administration determined that school districts do not need specific legal permission to stock naloxone, and that administrators in both local school districts and colleges should begin stocking the drug to reverse opioid overdoses. The announcement came with the support of State Secretary of Education Pedro Rivera, State Secretary of Health Karen Murphy, and the State Secretary of the Department of Drug and Alcohol Programs, Gary Tennis (SSA), who sits on NASADAD’s Board of Directors. The Secretaries drafted a letter to the State’s public school districts asserting schools have a right to carry naloxone without additional legal approval. Online training will be made available for individuals in charge of administering naloxone in schools.

Pamela Martin leaves position as Director of the Oregon Health Authority’s Addictions and Mental Health Division
Pamela Martin (SSA) announced plans to move on from her position as Director of the Oregon Health Authority’s Addictions and Mental Health Division last week. Dr. Martin began working with the Oregon Health Authority in May 2013, after having previously served as the Director of the Behavioral Health Services Division and the Director of Behavioral Health for juvenile justice facilities in New Mexico. Dr. Martin has administered several Medicare, Medicaid, and commercial health plan programs throughout her career, and has played an active role in many national and State advocacy groups. Dr. Martin’s last day as Director will be October 12, after which she will move on to pursue a variety of professional and personal goals.

Ohio experiences rise in drug overdose deaths related to fentanyl
A new report released last week by Ohio’s Department of Health has found a significant increase in fentanyl-related overdose deaths over the past two years. Ohio experienced 502 fentanyl-related overdose deaths in Ohio in 2014, compared to 84 deaths in 2013. Cumulative drug overdose deaths in Ohio also increased from 2,110 in 2013 to 2,482 in 2014. Fentanyl is estimated to be 30 to 50 times more potent than heroin, posing a significant risk to individuals with opioid use disorders. Ohio continues to fight the opioid crisis by expanding treatment options and instituting stricter prescribing guidelines for opioid painkillers. The Centers for Disease Control and Prevention (CDC) is working with Ohio to examine fentanyl-related overdose data to gain a better understanding of how to address and treat individuals using fentanyl.

In the News

Congress to consider continuing resolution
October 1^st marks the start of the new fiscal year, but Congress and the Administration have not yet agreed on a budget for FY 2016. Senate introduced a continuing resolution (CR) on Tuesday, September 22nd, but it was voted down on Thursday, September 24th due to provisions to defund Planned Parenthood. By Tuesday, another short-term CR—which would keep the government open through December 11th—is expected to be introduced without language defunding Planned Parenthood. If the CR does not pass, a federal government shutdown is possible.

Prior to the 2013 government shutdown, the Office of Management and Budget issued a memorandum to plan for agency operations during a potential lapse in appropriations. No such memo has been issued thus far in anticipation of a 2015 shutdown. Based on the 2013 shutdown, a lapse in appropriations for the Substance Abuse and Mental Health Services Administration will preclude the agency from having authority to spend FY 2016 funds.  During the 2013 shutdown, States were able to use previous Fiscal Year resources during the lapse.

As Speaker of the House, Rep. John Boehner (R-OH), announced his retirement on Friday, September 25^th, it is more likely that Congress will pass a clean CR. The House of Representatives will need determine who its next Speaker will be before Rep. Boehner leaves at the end of October. Early indications are that Rep. Kevin McCarthy (R-CA), the current Majority Leader, is likely to assume the role of Speaker.

Please know NASADAD will be closely monitoring the appropriations process and reporting developments to the membership.

If you have questions, or require additional information, please contact Rob Morrison (rmorrison@nasadad.org; 202-293-0090).

President Obama’s weekly address focuses on National Prescription Drug Take-Back Day
On September 26^th, during President Obama’s weekly address, he spoke about the National Prescription Drug Take-Back Day and the opioid crisis, and the importance of preventing and treating substance use disorders.  Drug disposal programs are part of the President’s 2011 Prescription Drug Abuse Prevention Plan, which also included increasing education for prescribers, expanding Prescription Drug Monitoring Programs, and pursuing Smart on Crime enforcement.  In his address, the President encouraged efforts to reduce substance use disorders through evidence-based prevention, treatment, and recovery.

National Association of Drug Court Professionals announces Carson Fox as new CEO
The National Association of Drug Court Professionals (NADCP) announced on Friday, September 25^th that Carson Fox will serve as its new Chief Executive Officer.  Mr. Fox will lead NADCP in its justice reform efforts for Drug Courts, DWI Courts, Tribal Healing to Wellness Courts, and Veterans Treatment Courts.  Mr. Fox has served the criminal justice field for nearly twenty years, and spent almost a decade as Chief Counsel and Chief Operating Officer of NADCP. When notified of his new position, Mr. Fox said that “Drug Courts represent the very best of our justice system, and as CEO, I will ensure they are the foundation of American justice reform.”

National Alliance for Model State Drug Laws updates reports on marijuana legislation
The National Alliance for Model State Drug Laws (NAMSDL) updated its series of reports on medicinal, legal, and illegal marijuana legislation last week. The reports summarize ongoing and future efforts to regulate both the medical marijuana and legal marijuana industries at the State level. Four reports are available, summarizing legislation on: medicinal use of marijuana (including low-THC / high cannabinoid products), “follow-up” legislation in States that have legalized the personal usage of marijuana (Alaska, Colorado, District of Columbia, Oregon, and Washington), the usage of marijuana in States with ongoing legalization efforts, and legislative efforts to decriminalize or lower penalties for illicit, personal non-medical use. NAMSDL has also updated its summary of enacted State medical marijuana laws, available here.

Kaiser Family Foundation survey finds increase in average premiums for single person and family health coverage
A recent Kaiser Family Foundation survey conducted from January through June 2015 found modest increases in the average healthcare premiums for single person and family coverage. The average premium for employer-sponsored family health coverage “rose 4% this year to $17, 545.” The average premium for single coverage “also rose 4%, to $6,251.” The survey also examined broader trends in health coverage, noting that “the percentage of firms that offer health benefits to at least some of their employees (57%) and the percentage of workers covered at those firms (63%) are statistically unchanged from 2014.” Additionally, 4% of employers with 50 or more full-time equivalent employees “reported switching full-time employees to part-time status,” 10% changed part-time workers to full-time workers, and 5% reduced the number of full-time employees to be hired in the future. The study notes that many companies have continued to expand preventive care programs for their employees, including health risk assessments and wellness programs.

Upcoming Events

ONDCP announces webinar discussing evidence-based substance use prevention for parents
The Office of National Drug Control Policy (ONDCP) has announced a new webinar on evidence-based strategies to prevent substance use for parents. The webinar will be held on Tuesday, October 6^th from 2pm-3pm EST. Director of ONDCP, Michael Botticelli, will make opening remarks before Dr. Wilson Compton, Deputy Director of the National Institute on Drug Abuse (NIDA), delivers a keynote presentation. The webinar will also feature personal anecdotes from several substance use disorder professionals.

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

• Kasharena Horton joins NASADAD as new CSAP fellow
• NASADAD attends 50-State Convening to Prevent Opioid Overdose and Addiction
• NASADAD signs on to NDD United letter requesting raise of sequestration spending caps
• NASADAD attends congressional briefing on SAFE Justice Act

Around the Agencies

• CDC releases draft Opioid Prescriber Guidelines
• NIDA renames National Drug Facts Week

In the News

• Study finds association between marijuana dispensary density and marijuana hospitalizations
• Michael Botticelli featured in Politico 50 list
• House of Representatives passes PDMP reauthorization bill
• House of Representatives passes Protecting Our Infants Act

Upcoming Events

• Upcoming webinar on Alternatives to Opioids for Post-Surgery Pain Management

News from NASADAD

Kasharena Horton joins NASADAD as new CSAP fellow
NASADAD is pleased to announce that Kasharena Horton has joined NASADAD as the new CSAP fellow. Kasharena L. Horton, better known as Kasha, began working with NASADAD as the Center for Substance Abuse Prevention (CSAP) Fellow in September 2015. She is responsible for providing support to the National Prevention Network (NPN) and substance abuse prevention efforts within NASADAD. Prior to her current position, Kasha served as a Policy Intern at Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria. She is awaiting publication within the Journal of Nutrition, Education, and Behavior on a manuscript she has co-authored focusing on low-income adults’ perceptions of farmers’ markets and community-supported agriculture programs within D.C. Kasha is originally from Massachusetts and received her Bachelor’s of Science in Public Health from American University in May of 2015.

NASADAD attends 50-State Convening to Prevent Opioid Overdose and Addiction
On September 17^th and 18^th, Robert Morrison and Shalini Wickramatilake attended the 50-State Convening to Prevent Opioid Overdose and Addiction, hosted by Health and Human Services (HHS) Secretary Burwell. The meeting focused three topics: prescribing practices, medication-assisted treatment, and naloxone. All fifty States were represented at the meeting, with presentations from State Directors from GA, NY, OK, RI, and WV. State delegates participated in regional breakout sessions to develop regional goals for the coming year. Robert Morrison introduced the Director of the Office of National Drug Control Policy, Michael Botticelli.

NASADAD signs on to NDD United letter requesting raise of sequestration spending caps
NASADAD has signed on to a Non-Defense Discretionary (NDD) United letter requesting changes to impending sequestration spending caps taking effect in FY 2016. The 2013 Bipartisan Budget Act (BBA) negotiated by Senator Patty Murphy and Representative Paul Ryan provided two years of relief from full sequestration before implementing the full spending caps in FY 2016. Appropriations bills for FY 2016 are currently being written adhering to the sequestration spending caps. NDD United is circulating a letter requesting that these sequestration spending caps be raised to higher amounts, and that cuts be balanced between “non-defense discretionary” programs and defense programs.

NDD United represents “non-defense discretionary” programs, such as education, housing, health, and natural resources. The original terms of the BBA set a precedent for parity between these non-defense discretionary programs and defense programs, aiming to balance cuts between the two program categories. NDD United is committed to ensuring that this precedent remains in effect.

NASADAD attends congressional briefing on SAFE Justice Act
Brian Denten, Public Policy Intern, attended the briefing held on Thursday, September 10^th. The briefing featured discussion from Reps. James Sensenbrenner (R-WI) and Bobby Scott (D-VA) about the provisions within their proposed SAFE Justice Act.  The SAFE Justice Act aims to reform the criminal justice system by refocusing federal mandatory minimum drug sentences to only apply to high-level offenders, rather than broadly applying mandatory minimum sentences to low-level noncriminal offenders. The bill does not eliminate any federal mandatory minimum sentences, but seeks to change their application in an effort to reduce prison populations and costs. The SAFE Justice Act states that any savings gained from smarter sentencing will be reinvested into evidence-based criminal justice policies. The briefing was hosted by Families Against Mandatory Minimums (FAMM), and included commentary from several other speakers currently or formerly involved with the criminal justice system.

Speakers:

• Vann Jones; CNN Contributor
• Mark Holden; Senior Vice President and General Counsel, Koch Industries, Inc.
• Tim Heaphy; former U.S. Attorney from the Western District of Virginia
• Bernie Kerik; former NYPD Police Commissioner
• Dionne Wilson; Victim’s Rights Advocate and Survivor Outreach Coordinator for Californians for Safety and Justice

Around the Agencies

CDC releases draft Opioid Prescriber Guidelines
The Centers for Disease Control and Prevention (CDC) has released draft Opioid Prescriber Guidelines that will provide recommendations for the prescribing of opioid pain medication for patients 18 and older in primary care settings. Recommendations focus on the use of opioids in treating chronic pain (i.e., pain lasting longer than 3 months or past the time of normal tissue healing) outside end-of-life care.

According to the CDC, in drafting the Guidelines they aim to meet scientific standards, consult with experts in the field, and allow stakeholders to provide input. The Guidelines are intended to address three overarching clinical practices: determining when to initiate or continue opioids for chronic pain outside end-of-life care; opioid selection, dosage, duration, follow-up, and discontinuation; and assessing risk and addressing harms of opioid use.

NIDA renames National Drug Facts Week
The National Institute on Drug Abuse (NIDA) announced plans to change the name of the National Drug and Alcohol Facts Week to the National Drug and Alcohol Facts Week, highlighting a new collaborative relationship with the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The initiative, which will be held January 25-31, 2016, seeks to eliminate myths about teen substance use and provide a venue for teens to converse with scientific experts about drugs and alcohol. Many communities across the country are planning events in observance of the week. NIDA and NIAAA encourage local events to register on their website.

Please contact drugfacts@nida.nih.gov for more information about National Drug and Alcohol Facts Week.

In the News

Study finds association between marijuana dispensary density and marijuana hospitalizations
A recent study published in the Drug and Alcohol Dependence Journal has discovered an association between marijuana dispensaries and marijuana hospitalizations. The study was conducted from 2001 to 2012 within California, and sought to investigate the relationship between proximity of marijuana dispensaries and marijuana abuse within a neighborhood. The authors state that “an additional one dispensary per square mile in a ZIP code was cross-sectionally associated with a 6.8 percent increase in the number of marijuana hospitalizations.” Median household incomes and racial distributions were also associated with marijuana hospitalizations. The study recommends that communities consider additional prevention and intervention programs targeting marijuana users, along with regulations limiting marijuana dispensary density.

Michael Botticelli featured on Politico’s list of “Thinkers, Doers, and Visionaries Transforming American Politics”
Michael Botticelli, Director of the Office of National Drug Control Policy (ONDCP) and former NASADAD Board Member from Massachusetts, was featured on Politico Magazine’s list of top 50 “Thinkers, Doers, and Visionaries Transforming American Politics.” The profile highlights Director Botticelli’s personal story of recovery, and his determination to emphasize recovery instead of punishment for drug users within the criminal justice system. Politico notes that while the Director of ONDCP traditionally works with the State Department and Drug Enforcement Administration (DEA) to target drug trafficking, Director Botticelli has also focused on increasing access to naloxone among police departments and educating prescription providers on signs of substance use disorders. The profile concludes with a description of ONDCP’s new $2.5 million heroin response strategy program that aims to expand and enhance treatment and recovery programs.

House of Representatives passes PDMP reauthorization bill with language to help promote collaboration with State substance abuse agencies
On Tuesday, September 8^th, the House of Representatives 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), Bucshon (R-IN), and Pallone (D-NJ).  Chairman of the House Committee on Energy and Commerce, Representative Upton (R-MI) submitted a report to accompany the bill, which includes a summary of the bill and an overview of changes the bill would make to existing law.

Passed by voice vote, 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 information technology systems such as e-prescribing systems, health information exchanges, and electronic health record systems. Read the report accompanying the bill here.

House of Representatives passes Protecting Our Infants Act
On Tuesday, September 8^th, the House of Representatives approved by voice vote H.R. 1462, 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 Health and Human Services, through the Agency for Healthcare Research and Quality (AHRQ) to conduct a study and develop recommendations for preventing and treating prenatal opioid abuse and neonatal abstinence syndrome (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 NASADAD’s statement on the Use of Medications in Treatment of Substance Use Disorders here.

Upcoming Events

Upcoming webinar on Alternatives to Opioids for Post-Surgery Pain Management
On Thursday October 1^st, Faces and Voices of Recovery (FAVOR) will host a webinar on alternatives to opioids in the management of pain after surgery. The webinar will inform individuals who are facing surgery and have concerns for risk of opioid addiction about non-opioid pain management strategies. Dr. Scott A. Sigman, a board-certified orthopedic surgeon, will explain the drivers of the prescription opioid crisis, and describe alternatives to opioids post-surgery, especially for patients with prior history of substance use disorders.

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.