Policy News Roundup: September 28, 2023

Key reads

Settlement funds at risk of going toward ineffective prevention efforts

Some opioid settlement money is going to school-based prevention programs, either through direct payments to school districts or state/local governments allocations for school-based initiatives. Research shows that D.A.R.E. and “just say no” messages do not work. The most promising prevention programs teach kids how to manage emotions, communicate with others, be resilient and build healthy relationships. Partnership to End Addiction’s Senior Vice President of Prevention Research and Analysis Linda Richter explains the challenge of convincing parents that these are the effective approaches. Experts worry that familiar programs like D.A.R.E. will be the go-to for officials deciding how to use funds. At least a half dozen states have already allocated at least $120,000 to D.A.R.E. Some localities, however, are directing funds to more evidence-based prevention, including trainings for school staff, proven programs that teach students about resilience and build social support, increasing the number of student assistance counselors in schools, and mentoring programs for at-risk youth. Some officials say they are not getting enough money to do anything inventive, leading them to put it toward existing D.A.R.E. programs.

Source: Officials Agree: Use Settlement Funds to Curb Youth Addiction. But the ‘How’ Gets Hairy. (KFF Health News)

SAMHSA releases data on recovery

The Substance Abuse and Mental Health Services Administration released a report on National Survey on Drug Use and Health data on recovery. In 2021, 70 million adults 18+ perceived that they ever had a substance use and/or mental health problem, 72.1% of whom considered themselves to be in recovery or have recovered. Recovery differed by age, family income, education, marital status and importance of religious beliefs. Adults who participated in at least one government assistance program, had a lower level of education or had a lower family income relative to the federal poverty level tended to have a higher prevalence of substance use recovery, but lower prevalence of mental health recovery. The percentage of adults in mental health recovery tended to be higher among those who were insured, had better overall health, were heterosexual or were never arrested. The percentage of adults in recovery tended to be lower among those with past-year serious psychological distress, substance use disorder, co-occurring mental and substance use disorders, alcohol use, marijuana use or cocaine use. Recovery was more prevalent among adults who received treatment.

Source: Recovery from Substance Use and Mental Health Problems Among Adults in the United States (Substance Abuse and Mental Health Services Administration)

Bipartisan Mental Health and Substance Use Disorder Task Force hosts recovery events

The Bipartisan Mental Health and Substance Use Disorder Task Force hosted a press conference with mental health professionals and recovery advocates to highlight their 2023 Legislative Agenda, which includes bills related to prevention, treatment, interdiction, workforce, public safety, youth and families, school supports, service members, health care access, prescribing, parity, recovery, prison and reentry and task force efforts. They also held a roundtable discussion to connect members with experts in the field to talk about the changing nature of the opioid crisis, the federal role in directing opioid spending and how to more efficiently use resources to respond to rising overdoses.

Source: Bipartisan Mental Health and Substance Use Disorder Task Force Highlights 2023 Legislative Agenda, Outlines Path Forward (Congressman David Trone)

SAMHSA announces funding for CCBHCs and youth behavioral health

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced $127.7 million to expand certified community behavioral health clinics (CCBHCs). The awards will work with the Bipartisan Safer Communities Act, through which up to 10 additional states will create state CCBHC programs under Medicaid every two years starting in 2024. The funding announced includes 128 grants to health clinics in 40 states and Puerto Rico. Each grantee will receive up to $1 million per year for four years. About half of the grants will help establish and implement new CCBHC programs, while half enhance and support existing ones. SAMHSA also announced $131.7 million in grant programs that connect youth and families to behavioral health services. This includes funding for tribal behavioral health care, trauma support and mental health services for students, services to support child development, services for transition-aged youth and young adults, drug court treatment and diversion programs, promoting youth awareness of risks associated with fentanyl, medications for opioid use disorder for adolescents/young adults and LGBTQI+ support programs.

Source: Approaching 60th Anniversary of Community Mental Health Act of 1963, the Biden-Harris Administration Awards Nearly $130 Million to Expand Certified Community Behavioral Health Clinics Across US; The Biden-Harris Administration Awards $131.7 Million to Support At-risk Youth and Families (Substance Abuse and Mental Health Services Administration)

ONDCP hosts National Recovery Month Summit

The Office of National Drug Control Policy (ONDCP) hosted a National Recovery Month Summit last week to discuss how Americans can work together to build a more recovery-ready nation. At the summit, ONDCP Director Rahul Gupta highlighted key actions the administration has taken to expand treatment access, prevent addiction and support Americans in recovery. Sen. Shaheen (D-NH) and Rep. Tonko (D-NY) also spoke. During the first panel, Supporting Youth in Recovery, the head of the Substance Abuse and Mental Health Services Administration moderated a conversation on the importance of prevention efforts and distinct challenges faced by youth and resources for young people in recovery with leaders of the Association of Recovery Schools and Chesterfield Recovery Academy, as well as students. The second panel, Strengthening Recovery-Ready Workplaces, featured a discussion with executives from across the country on the critical need for recovery-ready workplaces to help support Americans in recovery and strengthen our economy.

Source: ICYMI: White House Hosts Summit on National Recovery Month (Office of National Drug Control Policy)

McKinsey reaches settlement with local governments and school districts

McKinsey has agreed to pay $230 million to resolve lawsuits by hundreds of U.S. local governments and school districts alleging it fueled the opioid crisis through its work for Purdue and other drug companies. The settlements require a judge’s approval. The money is on top of $641.5 million McKinsey already paid to resolve claims by state attorneys general. McKinsey will pay $206 million to resolve claims by counties and municipalities, and another $23 million to resolve claims by public school districts. McKinsey has not admitted wrongdoing.

Source: Consulting firm McKinsey to pay $230 million in latest US opioid settlements (Reuters)

New Mexico orders insurance companies to expand timely access to behavioral health care

New Mexico’s insurance regulator ordered health insurance companies to expand timely access to behavioral health services in response to the governor recently declaring a public health emergency over gun violence in the state’s largest metro area. Governor Lujan Grisham initially sought to ban people from the open and concealed carry of firearms in Albuquerque and Bernalillo County, but a federal judge put that effort on hold pending the outcome of legal challenges. Other provisions of the order remain in place, however, including mandates for public health officials to address mental health and substance use disorders. The Superintendent of Insurance’s emergency order mandates that major health insurers cover out-of-network behavioral health services at in-network rates. The order applies to all fully insured individual, small and large group health plans, including those sold through the state marketplace.

Source: New Mexico official orders insurance companies to expand timely access to behavioral health services (Associated Press)

NYC establishes guidelines for overdose prevention centers

The New York City Health Department established guidelines for entities currently providing or seeking to provide overdose prevention center (OPC) services in New York City, given the absence of federal and state regulations. The guidelines promote OPC services in New York City that are high-quality and responsive to community needs and delivered in a way that ensures the safety of participants, staff and local residents. The department strongly encourages OPCs operating in New York City to comply with the guidelines. The guidelines offer standards for program eligibility, space, equipment, staffing, training, overdose prevention services, wraparound services, community engagement, safety and security, data management and reporting, funding and policies and procedures.

Source: Guidelines for Overdose Prevention Centers in New York City (NYC Health)

San Francisco mayor proposes requiring SUD screening/treatment as condition for cash assistance

San Francisco Mayor London Breed announced a proposal to require individuals with substance use disorder (SUD) to be enrolled in treatment to access cash assistance. Under the proposal, as a condition of eligibility to receive County Adult Assistance Programs (CAAP), individuals with suspected SUD would be required to participate in screenings or treatment programs, which would include a range of interventions including residential treatment, medical detox, medication treatment, outpatient options and abstinence-based treatment, among others based on the needs of the client. Individuals who refuse or do not successfully engage in treatment would not be eligible to receive cash assistance and their application would be denied, or they would be discontinued from receiving assistance. Progressive critics compared the proposal to Republican-style welfare mandates. The proposal from the Democratic mayor of the ultra-liberal city reflects the depth of frustration with the fentanyl crisis. Breed is taking more drastic measures around substance use, homelessness and mental health to show voters she is serious about the concerns. Breed faces a tough road getting the progressive-leaning Board of Supervisors to support the proposal.

Source: Mayor London Breed Announces New Initiative to Require Screening and Treatment for Substance Use Disorder in Order to Receive County-Funded Cash Assistance (SF.gov); San Francisco’s mayor wants drug testing for welfare recipients (Politico)

Massachusetts funds Massachusetts Overdose Prevention Helpline

Massachusetts Governor Maura Healy announced a partnership with Boston Medical Center and RIZE Massachusetts to fund and expand the Massachusetts Overdose Prevention Helpline. With the $350,000 investment, Massachusetts becomes the first state to fund an overdose prevention helpline, an easily accessible and life-saving overdose detection resource for people who use substances. The helpline uses a spotting model to prevent fatal overdoses. Trained helpline operators stay on the line while people use substances, alerting authorities if the caller becomes unresponsive. Previously a volunteer effort, this investment will enable the helpline to hire paid staff, resulting in stronger statewide coverage and shorter wait times. The funding will also support promotional efforts to increase awareness of the helpline’s services among individuals at risk of overdose.

Source: Healey-Driscoll administration announces first-of-its-kind investment in overdose prevention helpline (Massachusetts Department of Public Health)

Online marijuana dispensaries have inadequate age verification

A study on age verification procedures and potential youth access to online marijuana dispensaries found that most online marijuana dispensaries lacked adequate age verification features and most accepted nontraceable payment methods, enabling youth to hide their transactions. Of the online dispensaries identified, 27.5% had delivery options across state lines, and nearly all delivered to states with differing marijuana laws. Products included e-cigarettes (92.5%), edibles (93.8%), and medical formulations (55%). The study found 67% of dispensaries offering edibles used colorful packaging that could be attractive to minors. On entry, 70% of the websites prompted users to click yes to confirm they were of legal age, and 3.8% asked for a specific birthdate. None required verified age documentation to enter the website. Researchers found 66.3% required users to verify age when completing a purchase or on receipt of a product; 66.3% offered pickup and 67.5% offered delivery, while 42.5% offered warnings or disclaimers regarding the safety of marijuana products. The study found 67.5% listed policies regarding sale to minors; 83.8% accepted nontraceable payment methods (i.e., cash, prepaid cards, cryptocurrency); 18.8% offered first-time buyer discounts, 5% student discounts and 2.5% discounts for using cryptocurrency.

Source: Access to Marijuana by Minors Via Online Dispensaries (JAMA)