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.