News from NASADAD

• Heather Dougherty joins NASADAD’s Research and Program Applications Department

News from the States

• Interview with Vermont Governor Peter Shumlin highlights substance use disorder treatment success

Around the Agencies

• SAMHSA study finds variations in first-time substance use among college students

In the News

• President Obama proclaims September 2015 as National Alcohol and Drug Addiction Recovery Month

Upcoming Events

• SAMHSA announces webinar on campus-based prevention data collection
• ONDCP announces online event in celebration of National Alcohol and Drug Addiction Recovery Month
• Medicaid Innovation Accelerator Program announces webinar on incorporating substance use disorder services into Medicaid managed care contracts

News from NASADAD

Heather Dougherty joins NASADAD’s Research and Program Applications Department
NASADAD is pleased to announce that Heather Dougherty has been hired to join the Research and Program Applications Department.  Heather will serve as liaison to the Women’s Services Network (WSN) and Youth Coordinators Committee, among other duties.  Heather previously served as a contractor for the United States Army where she worked as a Drug and Alcohol Prevention Specialist.  In this capacity, she worked closely with military and civilian populations located at Fort Dietrich and Walter Reed Naval Hospital.  Heather also worked with homeless populations in Connecticut as a member of AmeriCorps.  Heather earned her B.S. degree from James Madison University where she majored in Health Science with a Public Health Concentration.  Heather earned her Master’s in Public Health at the University of Massachusetts.

Heather can be reached via email at heather@nasadad.org or by phone at (202) 293-0090 x4874.

News from the States

Interview with Vermont Governor Peter Shumlin highlights substance use disorder treatment success
A new interview in Governing Magazine with Vermont’s Governor Peter Shumlin highlights the State’s success in fighting substance use disorders by increasing access to medication-assisted treatment. Governor Shumlin invested $6.7 million for a “’hub and spoke” treatment system of central facilities with small treatment outposts, medication-assisted treatment accessibility, tougher sentences for drug traffickers, and new regulations for prescribing and monitoring prescription drugs. Individuals arrested for possession of illicit drugs in Vermont now have the option of avoiding jail time and a criminal record by choosing to enter treatment. Vermont has rapidly built new treatment facilities to facilitate this policy, and now leads the country in number of providers per 1,000 adults with substance use disorders. The program has seen measurable success, with Vermont reporting in January 2015 that “medically assisted drug treatment increased by 40 percent, and of those who completed treatment plans 75 percent showed improved functioning.”

Around the Agencies

SAMHSA study finds variations in first-time substance use among college students
A new Substance Abuse and Mental Health Services Administration (SAMHSA) study has found first-time substance use among college-students varies substantially depending on the type of drug being used. Using information from SAMHSA’s National Survey on Drug Use and Health from 2002 to 2013, the study found that first-time marijuana use among college students peaks in June with an average of 1,500 new users a day – compared to a 1,000 new users per day year-long average. A similar pattern is observed among first time users of alcohol, with an average of 1,883 college students trying alcohol for the first time in June compared to a 1,200 a day year-long average. Conversely, non-medical use of prescription medication including pain relievers and stimulants peaks during the winter with 850 initiates a day in December, compared to a 700 per day year-long average. SAMHSA notes that the increase in prescription medication during December may be related to the belief that prescription stimulants aid exam performance.  The study concludes with a call for parents and college staff to discuss the risks of substance abuse with college students.

In the News

President Obama proclaims September 2015 as National Alcohol and Drug Addiction Recovery Month
President Obama announced September 2015 as National Alcohol and Drug Addiction Recovery Month. This year’s theme is  “Join the Voices for Recovery: Visible, Vocal, Valuable!” This year’s Recovery Month aims to eliminate the negative stigma associated with substance use disorders, and encourage communities to increase prevention and treatment efforts. The proclamation further affirms the Obama Administration’s pursuit of evidence-based strategies to treat substance use disorders as part of a broader drug control strategy.

NASADAD encourages members to submit a copy of their State’s recovery month proclamation to Shalini Wickramatilake-Templeman, Public Policy Associate, at swickramatilake@nasadad.org.

Upcoming Events

SAMHSA announces webinar on campus-based prevention data collection
The Substance Abuse and Mental Health Services Agency (SAMHSA) has announced a webinar on campus-based prevention data collection. The webinar will be held on October 1, 2015 from 3:00-4:00PM EST, and will discuss ongoing efforts with college campuses to improve the collection of primary and secondary prevention data for college student populations. Best practices for approaching college administrators and other stakeholders will be discussed.

ONDCP announces online event in celebration of National Alcohol and Drug Addiction Recovery Month
The Office of National Drug Control Policy (ONDCP) has announced an online event to be held at the White House in celebration of National Alcohol and Drug Addiction Recovery Month (Recovery Month). The event will be held on September 17, 2015 from 7:00-8:00PM EST and will target youth currently in recovery from substance use disorders. A panel of leaders working within youth recovery will speak at the event to educate and inform viewers on the benefits of seeking recovery. The panel will take questions from Twitter during the event using the hashtag #Recovery atWH prior to or during the event. The event will be broadcasted on the White House’s website here.

Please contact Nataki MacMurray at recovery@ondcp.eop.gov or (202) 395-5510 with any questions.

Medicaid Innovation Accelerator Program announces webinar on incorporating substance use disorder services into Medicaid managed care contracts
The Medicaid Innovation Accelerator Program (IAP) has announced a webinar on the incorporation of substance use disorder services into Medicaid managed care contracts. The webinar will be held on Monday, September 14 from 3:30-5:00PM ES as part of IAP’s new Targeted Learning Opportunities (TLOs) initiative. The webinar will highlight several State models for the incorporation of substance use disorder services including carve-ins and carve-outs, in addition to discussing the key factors for merging substance use disorder services into managed care. Representatives from Arizona will speak on their new “integrated physical and behavioral health managed care program,” and Beacon Health Options will provide the health plan perspective of working with States transitioning to managed care models for substance use disorder services.

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 the States

• Governor Ricketts announces Sheri Dawson as Director for Nebraska’s Division of Behavioral Health
• Illinois Consortium on Drug Policy publishes study on State’s heroin crisis

Around the Agencies

• AHRQ releases brief on newborn and maternal hospitalizations related to substance abuse
• GAO report recommends that additional State reporting may help CMS oversee prescription drug fraud
• NIH report finds that most American adults have experienced some level of pain
• NIH-funded study shows possible link between e-cigarettes and initiation of tobacco use
• CDC report finds 7 million fewer uninsured this year than in 2014
• CMS releases 2015 Health Insurance Marketplace Special Enrollment Period Report
• AHRQ releases Medical Expenditure Panel Survey Insurance Component Chartbook
• CMS report shows cost savings among Accountable Care Organizations
• CBO report finds that eliminating sequestration could result in 1.4 million more jobs

In the News

• States collected $32 billion from “sin taxes” in fiscal year 2014
• Largest insurers in the Health Insurance Marketplace raised premiums an average 75% more than smaller insurers in past year

 

News from the States

Governor Ricketts announces Sheri Dawson as Director for Nebraska’s Division of Behavioral Health
Governor Pete Ricketts announced the appointment of Sheri Dawson, R.N. as Director for the Division of Behavioral Health for the Nebraska Department of Health and Human Services (DHHS). Ms. Dawson has served as the acting director of the Division of Behavioral Health since earlier this year. Prior to serving as acting director, she held different roles within the department including Deputy Director of Community-Based Services, QI and Managed Care Administrator, Program Specialist, and Nurse Surveyor/Consultant. Additionally, Ms. Dawson served as Associate Director of Nursing for the Nebraska Department of Public Institutions.

Illinois Consortium on Drug Policy publishes study on heroin crisis
The Illinois Consortium on Drug Policy at Roosevelt University released a report on the State’s continuing heroin problem. The study found that 25 percent of State-funded treatment admissions were for heroin, significantly higher than the 16 percent of heroin admissions for the nation. The report suggests improving treatment for prescription opioid drugs, increasing access to naloxone, implementing medication-assisted treatment programs in jails and prisons, and ensuring that drug courts follow evidence-based practices.

Around the Agencies

AHRQ releases brief on newborn and maternal hospitalizations related to substance abuse
The Agency for Healthcare Research and Quality released a brief on Neonatal and Maternal Hospital Stays Related to Substance Use. From 2006 to 2012, the rate of neonatal hospitalizations related to substance use increased by 71 percent, and the rate of maternal hospitalizations related to substance use increased by 33 percent. The costs for neonatal hospitalizations rose by 135 percent, from $253 to $595 million, from 2006 to 2012. For maternal hospitalizations, costs rose by 35 percent, from $258 to $349 million. The rate of maternal hospital stays for opioid use rose by 134.7 percent. Of the newborns hospitalized because of substance use-related issues, 20 percent had low birth weight, compared with 7 percent of all other neonatal stays. There was a rise in hospital stays for neonatal abstinence syndrome, from 7,240 in 2006 to 18,968 in 2012.

GAO report recommends that additional State reporting may help CMS oversee prescription drug fraud
A new Government Accountability Office (GAO) report has recommended that the Centers for Medicare & Medicaid Services (CMS) require States to report on two controls that are not currently included in CMS’s reporting requirements: lock-in programs for abusers of non-controlled substances, and prohibitions on automatic refills.

Currently, lock-in programs address doctor shopping by restricting beneficiaries who have abused the Medicaid program to only receiving controlled substance prescriptions from a single provider and pharmacy. A lock-in program for those with non-controlled substance prescriptions could also help address potential fraud and abuse. However, CMS does not currently collect information about lock-in programs for non-controlled substances. Similarly, CMS does not collect data on automatic refill prohibitions, even though such data could reduce the potential for medication stockpiling, continued fill of discontinued medications, and waste of prescription medications. According to the report, requiring States to report on these controls could help CMS oversee prescription drug fraud, and CMS has stated that it will consider the GAO’s recommendations.

NIH report finds that most American adults have experienced some level of pain
The National Center for Complementary and Integrative Health, a branch of the National Institutes of Health, recently analyzed data from the 2012 National Health Interview Survey (NHIS) and found that most American adults have experienced some level of pain. The severity of pain varied among survey respondents, with an estimated 25.3 million adults (11.2 percent) experiencing some level of pain every day for the preceding 3 months. There were associations between pain severity and race, ethnicity, language preference, gender, and age. Those with high levels of pain were more likely to have worse health status, use healthcare services, and suffer from disability.

NIH-funded study shows possible link between e-cigarettes and initiation of tobacco use
A study on electronic cigarette use and subsequent tobacco use by adolescents, published in the Journal of the American Medical Association, found that students who have used e-cigarettes by the time they start ninth grade are more likely than others to start smoking traditional cigarettes and other combustible tobacco products within the next year.  E-cigarettes could increase tobacco initiation rates among youth who would not have otherwise smoked cigarettes; youth who try e-cigarettes and subsequently become addicted to nicotine might transition to conventional cigarettes. While the study authors cannot conclude that e-cigarette use directly leads to smoking, this study raises concerns that increases in youth e-cigarette use could increase the prevalence of smoking-related illness.

CDC report finds 7 million fewer uninsured this year than in 2014
According to a report by the CDC’s National Center for Health Statistics, an estimated 29 million U.S. residents of all ages lacked health insurance in the first three months of 2015, which is 7 million fewer than in 2014. The uninsured rate for adults under age 65 fell by 7.8 percent in Medicaid expansion States, compared with 5.9 percent in non-expansion States. Among adults aged 18–64, the percentage of uninsured individuals decreased from 16.3 percent in 2014 to 13.0 percent in 2015, with a corresponding increase in private coverage, from 67.3 percent to 70.4 percent. The report analyzes insurance trends by age, poverty status, and race and ethnicity. It also presents estimates of public and private coverage, coverage through exchanges, and enrollment in high deductible health plans (HDHPs) and consumer directed health plans (CDHPs).

CMS releases 2015 Health Insurance Marketplace Special Enrollment Period Report
Although the next open enrollment period for Health Insurance Marketplace coverage doesn’t begin until November 1^st, some individuals qualify for a special early enrollment period. A consumer can qualify for a special enrollment period (SEP) if they have lost health coverage, lost Medicaid eligibility, or had a change in family status.

CMS released a snapshot of information about consumers who selected a plan from the February 23 to June 30, 2015 SEP through the HealthCare.gov platform. Nearly 950,000 new consumers selected a plan through the SEP. Of enrollments during the SEP, 50 percent of plan selections occurred because of health coverage loss, and 19 percent occurred because of Medicaid ineligibility.

AHRQ releases Medical Expenditure Panel Survey Insurance Component Chartbook
The Agency for Healthcare Research and Quality (AHRQ) released its 2014 Medical Expenditure Panel Survey Insurance Component (MEPS-IC). The MEPS-IC is an annual survey of private employers and State and local governments. The MEPS-IC produces national- and State-level estimates of employer-sponsored insurance, including offered plans, costs, employee eligibility, and number of enrollees. The Chartbook, which looks at changes in employer-sponsored insurance before and after ACA implementation, provides both single- and multi-year trend analyses using data from 2003 to 2014.

CMS report shows cost savings among Accountable Care Organizations
The Centers for Medicare & Medicaid Services Medicare released quality and financial performance results showing that Accountable Care Organizations (ACOs) are improving the quality of care that Medicare beneficiaries receive while saving money. ACOs created cost savings amounting $422 million in 2014. Compared to Medicare Shared Shavings Program (MSSP) ACOs, Pioneer ACOs are early adopters of coordinated care and tend to be more experienced. Pioneer ACOs also have an established care coordination infrastructure, and assume greater performance-based financial risk. In 2014 there were 20 Pioneer ACOs and 333 MSSP ACOs. Eleven Pioneer ACOs earned $82 million in shared savings, and 92 MSSP ACOs earned $341 million in shared savings. ACOs with three years of experience in the program were more likely to earn savings than those with only one or two years of experience.

CBO report finds that eliminating sequestration could result in 1.4 million more jobs
In response to a request from Senator Bernie Sanders (VT), the Congressional Budget Office (CBO) released a report on the macroeconomic effects of eliminating automatic reductions to discretionary spending caps. The Budget Control Act of 2011 created caps on discretionary budget authority for each year through 2021, with automatic reductions in those caps that would be triggered under certain conditions. According to the CBO, eliminating the automatic reductions for fiscal years 2016 and 2017 would allow for an increase in appropriations of $90 billion in 2016 and $91 billion in 2017. The changes in spending could increase full-time employment by 0.2 million to 0.8 million in 2016, and 0.1 million to 0.6 million in 2017; 1.4 million jobs could be created over two years without automatic reductions in budget caps.

In the News

States collected $32 billion from “sin taxes” in fiscal year 2014
According to a recent article in Governing Magazine, States collectively took in approximately $32 billion in “sin taxes”—taxes on tobacco, alcohol, and gambling—in fiscal year 2014. The most common sin tax-related practice among State legislatures is passing cigarette tax hikes. Since 2000, States enacted a total of 111 tax increases on tobacco products, and another 23 on alcohol. States rely on sin taxes to varying degrees. Delaware, New Hampshire, Nevada, Rhode Island, and West Virginia accounted for the largest share of total sin tax revenues in 2014.

Largest insurers in the Health Insurance Marketplace raised premiums an average of 75% more than smaller insurers in past year
A new study in the Harvard Journal of Technology Science looks at changes in health insurance premiums made by individual health insurance issuers in 34 federally facilitated and State partnership health insurance exchanges. The study found that the largest insurance issuers in the Health Insurance Marketplace raised premium rates by an average 23.9 percent while the other issuers raised rates by an average 13.7 percent. One suggested reason for this discrepancy is that larger and more broadly recognized issuers are more appealing to older enrollees who have a larger burden of health problems, while younger and healthier individuals may be more receptive to smaller and newer issuers.

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

• NASADAD attends Congressional briefing on introduction of the Mental Health Reform Act of 2015
• NASADAD attends Alliance for Health Reform briefing on the intersection of health and housing

News from the States

• Ohio encourages Medicaid sign-ups for inmates
• Ohio State University Office of Student Life pilots MAT program for students
• New Jersey Division of Mental Health and Addiction Services announces Valerie L. Mielke as new Assistant Commissioner

Around the Agencies

• CDC report examines alcohol-impaired driving among adults in 2012

In the News

• Senator Kelly Ayotte (R-NH) delivers speech on heroin problem

Upcoming Events

• Institute for Research, Education & Training in Addictions (IRETA) announces SBIRT webinar
• SAMHSA announces webinar on strategies for referral to specialty mental health and substance use disorder services
• College of Psychiatric and Neurologic Pharmacists announces webinar on increasing pharmacy access to naloxone

News from NASADAD

NASADAD attends Congressional briefing on the Mental Health Reform Act of 2015

Brian Denten, Public Policy Intern, attended the briefing held on Tuesday, August 4^th. The briefing served as the announcement of the “Mental Health Reform Act of 2015,”new legislation introduced by Senators Bill Cassidy (R-LA) and Chris Murphy (D-CT). The bill aims to increase access to treatment, improve treatment delivery, and expand treatment to underserved populations. Specifically, the legislation authorizes new grant programs for the integration of primary care and mental health, early intervention programs, designates a new Assistant Secretary for Mental Health and Substance Use within the U.S. Department of Health and Human Services (HHS), establishes a Serious Mental Illness (SMI) Coordination Committee under the Assistant Secretary, and contains provisions regarding mental health parity and the IMD exclusion. The legislation includes language regarding HIPAA as well. NASADAD will work to develop and release a “Section-by-Section” overview of the bill in the coming weeks.

Read Senator Murphy’s press release about the legislation here: http://www.murphy.senate.gov/newsroom/press-releases/cassidy-murphy-introduce-comprehensive-overhaul-of-mental-health-system

 

NASADAD attends Alliance for Health Reform briefing on the intersection of health and housing

Brian Denten, Public Policy Intern, attended the briefing held on Friday, August 7^th. The briefing included several speakers working with non-profit organizations, State agencies, and federal agencies that aim to improve healthcare outcomes by increasing access to safe housing for underserved populations. Several speakers noted the cycle between poor health and homelessness, as mental health and substance use disorders are often further aggravated by a lack of housing. Panelists advocated for increased funding for supportive housing initiatives and enhanced communication between Medicaid and agencies working with populations dealing with a lack of housing.

Panelists:

• Barbara DiPietro; National Health Care for the Homeless Council
• Jennifer Ho;S. Department of Housing and Urban Development
• Gretchen Hammer; Colorado Department of Health Care Policy & Financing
• Sister Adele O’Sullivan; Circle the City, Arizona

 

News from the States

Ohio encourages Medicaid sign-ups for inmates

Three State agencies in Ohio have started a program to enroll inmates in Medicaid following their release from the criminal justice system. 21,000 inmates are released in Ohio each year, yet many face difficulty continuing treatment for mental health or substance use disorders due to long processes at the county level. With the State’s expansion of Medicaid, inmates are able to begin signing up for Medicaid up to 90 days before leaving prison. Obtaining a Medicaid card will allow ex-offenders to continue receiving treatment as soon as they are released. Prisons Chief Gary Mohr stated to the Columbus Dispatch that the program is part of a broader mission to reduce recidivism throughout Ohio. A separate initiative in Ohio’s criminal justice system is working to double the 4,600 inmates currently enrolled in substance use disorder treatment programs in an additional effort to reduce recidivism. Officials hope to complete preliminary sign-up programs at all State prisons by the end of 2015.

Read more about this story here: http://www.dispatch.com/content/stories/local/2015/07/27/medicaid-prison-signups.html

 

Ohio State University Office of Student Life pilots MAT program for students

The Ohio State University Office of Student Life will now offer comprehensive therapeutic and Medication-Assisted Treatment (MAT) services for students in or seeking substance use disorder recovery through a pilot program beginning this fall. NASADAD spoke with Sarah Nerad, Program Manager of the Collegiate Recovery Community, about some of the University’s current and future plans to improve recovery services for OSU students.

The Ohio State University currently has a Collegiate Recovery Community (CRC) that supports all students in or seeking recovery. The CRC provides specific programming in addition to a supportive network of peers to aid the recovery process. The CRC maintains a 28 bed residence hall and has two full-time employees dedicated to running the program. A separate 2,000 square foot space exists as the dedicated CRC location for weekly meetings, recreational activities, and a place to find peer-to-peer support. The program offers scholarships, individualized recovery plans, and professional and leadership development for students. Students signing up as official members of the CRC receive eligibility for scholarship funding, priority course registration, and access to special events. The program has primarily grown through word-of-mouth among students, although academic advisors and other university staff have begun referring students to the program.

Since the inception of the CRC in 2013, the Ohio State Office of Student Life has worked on implementing a Good Samaritan policy; is establishing screening, brief intervention, and referral to treatment (SBIRT) initiatives across campus; and has taken steps  to provide comprehensive therapeutic MAT services for students with substance use disorders. Starting this fall, a pilot program will offer full MAT services to eligible students. This is a partnership between three Student Life departments: Student Health Services, Counseling and Consultation Services, and the Collegiate Recovery Community. The program will include access to a variety of FDA-approved medications complemented by weekly counseling, random drug testing, and other evidence-based MAT practices. Students eligible to apply for the program will need to be on a stable dose of their medication for at least one year. The pilot program will begin with a handful of students before gradually increasing capacity over the next several years.

OSU’s CRC is a partner of the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery (HECAOD). They are hosting the 2015 National Meeting from August 4-6, 2015 in Columbus, Ohio. The conference will focus on AOD prevention, prescription drug misuse, and collegiate recovery. HECAOD is a national organization that helps colleges provide and manage prevention and recovery programs. Recently, HECAOD has focused on increasing the prevalence of SBIRT models in universities across the country.

Read more about the OSU CRC here: http://go.osu.edu/recovery

Read more about HECAOD and their upcoming conference here: http://hecaod.osu.edu/events/national-meeting/

New Jersey Division of Mental Health and Addiction Services announces Valerie L. Mielke as new Assistant Commissioner

Valerie L. Mielke, MSW, has been appointed Assistant Commissioner of the New Jersey Division of Mental Health and Addiction Services, effective August 1^st. Previously, Lynn Kovich had been Assistant Commissioner since 2011. NASADAD recognizes Ms. Kovich for her contributions to the Association in a number of areas.

Read a letter from Ms. Kovich discussing her time as Assistant Commissioner here: http://www.mhanj.org/lynn-kovichs-letter-to-stakeholders/

 

Around the Agencies

CDC report examines alcohol-impaired driving among adults in 2012

The Centers for Disease Control and Prevention (CDC) released a new report this week examining rates of alcohol-impaired driving throughout the United States in 2012. Using data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS), the report finds that “an estimated 4.2 million U.S. adults reported driving while impaired by alcohol at least once in the preceding 30 days, resulting in an estimated 121 million alcohol-impaired driving episodes annually, and a national rate of 505 episodes per 1,000 population.” The report finds substantial variation in alcohol-impaired driving rates between States – attributing this variation to differences between alcohol consumption and State prevention campaigns.

Read the full report here: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a2.htm?s_cid=mm6430a2_e

 

In the News

Senator Kelly Ayotte (R-NH) delivers speech on Senate floor discussing heroin epidemic

Senator Kelly Ayotte (R-NH) delivered a speech on the Senate floor discussing the heroin epidemic in New Hampshire along with her proposed legislation to increase access to naloxone and prescription drug monitoring programs this past week. Sen. Ayotte highlighted her participation in ride-alongs with the Manchester Fire Department, during which she observed first responders using naloxone to reverse heroin overdoses. Sen. Ayotte and several other Senators have introduced legislation aiming to combat the opioid epidemic through increased access to treatment and reform of current prescribing practices. The Comprehensive Addiction and Recovery Act would increase the availability of naloxone to first responders and law enforcement, in addition to enhancing treatment options for incarcerated individuals with substance use disorders. The Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act reauthorizes prescription drug monitoring programs and creates an interagency task force to determine best practices for prescribing opioid pain medication.

Read more about Sen. Ayotte’s speech, and watch a video here: https://www.ayotte.senate.gov/?p=press_release&id=2119

Read a NASADAD overview of the Comprehensive Addiction and Recovery Act here: http://nasadad.org/2015/03/comprehensive-addiction-and-recovery-act-of-2015-s-524h-r-953-a-section-by-section-analysis/

 

Upcoming Events

Institute for Research, Education & Training in Addictions (IRETA) announces SBIRT webinar

The Institute for Research, Education & Training in Addictions has announced a new webinar discussing screening, brief intervention, and referral to treatment (SBIRT) best practices. The webinar will evaluate the efficacy of various SBIRT programs and examine the evidence behind utilizing SBIRT as a mechanism for treatment. The webinar will be hosted by Richard Brown, MD, MPH, a professor in the Department of Family Medicine, School of Medicine, and Public Health at the University of Wisconsin. In addition to conducting NIH-funded research, Dr. Brown currently serves as the Director for the Wisconsin Initiative to Promote Health Lifestyles and worked as the President of the Association for Medical Education and Research in Substance Abuse (AMERSA) from 1997 to 1999. The webinar will be held on Wednesday, August 26, 2015 from 1-2:30 PM EST.

Read more, and register for the webinar here: http://ireta.org/improve-practice/addiction-professionals/webinars/?utm_source=iContact&utm_medium=email&utm_campaign=IRETA&utm_content=

 

SAMHSA announces webinar on strategies for referral to specialty mental health and substance use disorder services

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced a new webinar on best practices for referring patients to specialty mental health and substance use disorder services. This webinar will discuss best practices for referring patients from primary care to specialty mental health and substance use disorder services, particularly as they relate to Patient-Centered Medical Homes and providers adopting screening, brief intervention, and referral to treatment (SBIRT).  The webinar will be held on Wednesday, August 19, 2015 at 2:30 PM EST.

Read more, and register for the webinar here: https://goto.webcasts.com/starthere.jsp?ei=1072566

 

College of Psychiatric and Neurologic Pharmacists announces webinar on increasing pharmacy access to naloxone

The College of Psychiatric and Neurologic Pharmacists (CPNP) announced an upcoming webinar discussing increasing pharmacy access to naloxone. As prescription opioid and heroin overdoses continue to rise across the country, many communities have demonstrated success in using naloxone to reverse overdoses and save lives. Because naloxone remains a prescription medication, pharmacists play an essential role in increasing access to naloxone across the country. This webinar will discuss the usage of Communities with Overdose Education and Naloxone Distribution (OEND) programs to improve opioid overdose prevention and treatment. Several speakers will comment on their personal experiences with implementing OEND programs in their respective areas. The webinar will be held Thursday, August 13, 2015 from 8-9 PM EST.

Read more, and register for the webinar here: https://cpnp.org/ed/university/course/putting-naloxone-action

News from NASADAD

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

News from the States

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

Around the Agencies

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

In the News

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

News from NASADAD

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

Panelists:

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

 

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

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

News from the States

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

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

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

Around the Agencies

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

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

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

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

In the News

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

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

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

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

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

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

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

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

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

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

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

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

View a NASADAD two pager on NAS here.

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

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

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

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

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

View the opening statement by Rep. Upton here.

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