Around the Agencies

• CMCS and HRSA release informational bulletin on maternal, infant, and early childhood home visiting services coverage
• CDC and Governors seek stricter limits on painkiller prescribing
• CDC releases new Prevention Status Report
• NIAAA study finds significant increase in marijuana use and marijuana use disorders between 2001-2002 and 2012-2013

In the News

• NDCI releases prescription drug misuse fact sheet
• Society for Adolescent Health and Medicine releases substance use resources for parents and adolescents

News from NASADAD

• NASADAD requests comments on 42 CFR Part 2 Proposed Rulemaking

Around the Agencies

CMCS and HRSA release informational bulletin on maternal, infant, and early childhood home visiting services coverage
The Center for Medicaid & CHIP Services (CMCS) and the Health Resources and Services Administration (HRSA) released an informational bulletin describing best practices for the development of evidence-based home visiting programs for maternal, infant, and early childhood services last week. The bulletin aims to help States design benefit packages for pregnant women and families. The Affordable Care Act created the first national Maternal, Infant, and Early Childhood Home Visiting program, allowing States, tribal organizations, and non-profit organizations to apply for federal grants assisting evidence-based home services. Services include child and adult screening for mental health and substance use disorders, case management, and caregiver training. The program has more than doubled in size since its creation, and is now implemented in 26 percent of counties across the United States as of July 2015.

Read the full bulletin here.

CDC and Governors seek stricter limits on painkiller prescribing
The Centers for Disease Control and Prevention (CDC) along with the National Governors Association (NGA) are seeking stricter limits on painkiller prescribing, as reported by the Pew Charitable Trusts. The CDC recently issued a draft proposal that would change prescribing guidelines to encourage doctors to utilize drug-free treatment options and non-opioid pain relievers for chronic pain and related conditions before prescribing opioid pain medication. The NGA unanimously approved the CDC initiative, with Governor Peter Shumlin of Vermont noting that opioid pain medication presents the biggest drug control problem currently facing the United States. The CDC’s proposed guidelines advise prescribing three days’ worth of pain medication instead of the commonly prescribed 30-day supply in order to prevent diversion of extra pills.

Read the full article here.

CDC releases new Prevention Status Report
Last week the Centers for Disease Control and Prevention (CDC) released a new Prevention Status Report for all 50 States and Washington, DC. The CDC’s Prevention Status Report outlines the current status of public health policies as well as best practices for dealing with notable public health problems. This Prevention Status Report contains information on alcohol-related harms, prescription drug overdose, and tobacco use. The reports for each State compare State-level data versus national averages and provide ratings on the regulations surrounding each State’s prescription drug monitoring programs (PDMP).

Access the new Prevention Status Report here.

NIAAA study finds significant increase in marijuana use and marijuana use disorders between 2001-2002 and 2012-2013
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has published a study finding a significant increase in both marijuana use and marijuana use disorders between 2001-2002 and 2012-2013. Past-year prevalence of marijuana use was 4.1 percent in 2001-2002 compared to 9.5 percent in 2012-2013. Past-year prevalence of marijuana use disorders experienced a similar increase, with 1.5 percent past-year incidence in 2001-2002 compared to 2.9 percent in 2012-2013. Both increases were found to be statistically significant. The study asserts that “nearly 3 of 10 marijuana users manifested a marijuana use disorder in 2012-2013.” This increase was attributed to the growing prevalence of marijuana use among adults.

Read the full study here.

In the News

NDCI releases prescription drug misuse fact sheet
The National Drug Court Institute (NDCI) has released a new fact sheet on prescription drug misuse. The fact sheet, titled “Understanding and Detecting Prescription Drug Misuse and Misuse Disorders” outlines the characteristics of the most commonly misused prescription drugs and their associated symptoms of misuse. The NDCI fact sheet also includes treatment suggestions, including medication assisted treatment (MAT), for individuals who may have developed a substance use disorder.

Read the full fact sheet here.

Society for Adolescent Health and Medicine releases substance use resources for parents and adolescents
The Society for Adolescent Health and Medicine (SAHM) has released new resources on substance use for parents and adolescents. The resources compile existing SAHM resources on substance use, support groups, and treatment service locators for both adolescents and their parents. Both resources also provide external links to other organizations working on issues related to substance use and substance use disorders.

Access the SAHM resource for adolescents here.

Access the SAHM resource for parents of adolescents here.

News from NASADAD

NASADAD requests comments on 42 CFR Part 2 Proposed Rulemaking
During last Monday’s NASADAD’s All States Public Policy call, guests from the Legal Action Center spoke about 42 CFR Part 2 and the Notice of Proposed Rulemaking by HHS, which was published in the Federal Register on February 9^th. During the call, it was suggested that NASADAD consider commenting on the proposed rule as an Association. Comments on the proposed rule are due by 5 pm on Monday, April 11^th.

In order for NASADAD to meet the deadline, we request that any comments for the Association’s consideration be submitted by COB Friday, March 18^th to swickramatilake@nasadad.org. Comments will then be summarized for the Board of Directors to review at their next meeting March 24^th-25^th. The Board may also review other groups’ statements that have been made available at that point. The Legal Action Center will be releasing a template for the field to use in crafting comments on the proposed rule. The template will likely be released in the next 2 weeks, and NASADAD will send it to membership as soon as possible.

More information about confidentiality can be found on the NASADAD website, including comments by other organizations regarding potential changes to 42 CFR Part 2.

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

• Marijuana legalization bill advances in Vermont State Senate
• Connecticut pediatricians support proposal allowing limited medical marijuana for minors with specific medical conditions

In the News

• AMA President Steven Stack calls for medical community to address opioid epidemic
• NGA and AMA release joint statement calling for response to opioid epidemic
• MaineGeneral Health CMO testifies at Senate hearing on opioid use among senior citizens

News from NASADAD

• NASADAD updates SAPT Block Grant and Prevention Set-Aside fact sheets
• NASADAD attends National Association of Counties briefing on criminal justice reform

News from the States

Marijuana legalization bill advances in Vermont State Senate
A bill that would legalize recreational marijuana for adults 21 or older advanced in the Vermont State Senate last week. The proposed legislation would create retail licenses for businesses to sell marijuana products. The bill passed the Senate with a 17-12 vote, with opposition from both Democrats and Republicans; some Senators think the bill goes too far in increasing access to marijuana, and others think that the bill should allow Vermonters to grow small amounts of marijuana on their own. The legislation, which has support from Governor Peter Shumlin, will next move to the Vermont House of Representatives.

Read more about this story here.

Connecticut pediatricians support proposal allowing limited medical marijuana for minors with specific medical conditions
The Connecticut Chapter of the American Academy of Pediatrics announced their support for a proposed bill that would provide access to non-smokable medical marijuana to minors with specific medical conditions, including epilepsy and terminal illnesses requiring end-of-life hospital care.  The Connecticut Chapter opposed a similar measure last year, but changed policies after a hearing featuring testimony from pediatric neurologists and parents of children affected by seizure disorders and terminal illnesses. Minors would be required to receive approval from their parents, primary care providers, and healthcare specialists before being granted access to medical marijuana.

Read more about this story here.

In the News

AMA President Steven Stack calls for medical community to address opioid epidemic
American Medical Association President Steven Stack released a press release calling for the medical community to address the opioid epidemic earlier this month. Mr. Stack notes that over the past 15 years the United States has experienced over 250,000 fatal overdoses, with 30,000 in the last year alone. The press release outlines five specific steps for medical professionals to take in addressing the epidemic, including: 1) registration for State prescription drug monitoring programs (PDMPs); 2) the enhancement of education and training surrounding safe prescribing practices; 3) the co-prescription of naloxone to patients at risk of an overdose; 4) the expansion of medication-assisted treatment (MAT) related training programs; and 5) speaking out against mental health and substance use disorder stigma. The AMA has previously convened a taskforce comprised of State and specialty associations, the American Osteopathic Association, and the American Dental Association to identify and implement opioid-related best practices.

Read the full press release here.

NGA and AMA release joint statement calling for response to opioid epidemic
The National Governors Association (NGA) and American Medical Association (AMA) released a joint statement calling for a coordinated response to the opioid epidemic. The statement outlines several priorities for addressing the opioid crisis, including: greater integration and funding of prescription drug monitoring programs (PDMPs), more effective education and training on substance use disorders and pain management in medical schools, increased workforce development, closing the of the substance use disorder treatment gap, and expanded naloxone access.

Read the full statement here.

MaineGeneral Health CMO testifies at Senate hearing on opioid use among senior citizens
MaineGeneral Health Chief Medical Officer (CMO) and Senior Vice President Steven Diaz, M.D. testified at a Senate Special Committee on Aging hearing last week. Mr. Diaz’s department witnessed ten patients aged 65 years or older experience opioid overdoses in the last year, more than double the average of past years. Mr. Diaz recommended that opioid pain medication should not be the default treatment for elderly patients suffering from chronic pain, instead suggesting that a combination of alternative treatment and therapy should be pursued. Mr. Diaz’s testimony also noted the shortage of substance use disorder specialists in rural areas throughout Maine and the rest of the country. This shortage further exacerbates the opioid epidemic as individuals in need of treatment are unable to access treatment services.

View the full Senate hearing here.

News from NASADAD

NASADAD updates SAPT Block Grant and Prevention Set-Aside fact sheets
NASADAD released updated versions of its Substance Abuse Prevention and Treatment (SAPT) Block Grant and SAPT Block Grant Prevention Set-Aside fact sheets last week. The new versions contain updated information on FY 2015 and FY 2016 SAPTBG funding levels and analysis of the most recent substance use trends across the country. Over the last 10 years, SAPTBG funding has not kept up with health care inflation, resulting in a 26 percent decrease in the real value of funding when adjusted for inflation as of FY 2015.

Read the updated SAPT Block Grant fact sheet here.

Read the updated SAPT Block Grant Prevention Set-Aside fact sheet here.

NASADAD attends National Association of Counties briefing on criminal justice reform
Brian Denten, Public Policy Intern, attended the briefing hosted by the National Association of Counties (NaCo) on Tuesday, February 23^rd. The briefing included several State and local officials who spoke about new approaches to criminal justice. Speakers highlighted the need for enhanced substance use disorder and mental health services, noting that many people with mental health and substance use conditions are placed in the criminal justice system due to a lack of alternatives. Supervisor Don Knabe of Los Angeles asserted that, as a result of California’s “re-alignment” strategy that has sent more incarcerated individuals to county and local jails to deal with the State’s prison overpopulation, Los Angeles county jails are now the largest psychiatric treatment facility in the country. Other speakers noted the need for equity in sentencing and greater investment in reentry services for those entering society following periods of incarceration.

Senator Al Franken (D-MN) spoke in support of the Comprehensive Justice and Mental Health Act of 2015 (S. 993), which recently passed the Senate and is waiting to be brought to the House floor. This legislation creates several Department of Justice administered grant programs targeting recidivism, expanding the mental health and substance use disorder workforce, and creating new treatment and prevention programs. NaCo concluded the briefing with an additional call for eliminating the restrictions surrounding Medicaid and Pell Grants for incarcerated individuals.

Speakers:

• Senator Al Franken (D- MN)
• Commissioner Sallie Clark, El Paso County, Colorado
• Chairman John Eaves, Fulton County, Georgia
• Commissioner Sally Heyman, Miami-Dade County, Florida
• Supervisor Don Knabe, Los Angeles County, California
• Mayor Mark Luttrell, Shelby county, Tennessee

Watch a video of the briefing here.

Read more about the Comprehensive Justice and Mental Health Act of 2015 here.

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