Policy News Roundup: April 11, 2024

Key reads

SAMHSA releases guidance on core curriculum on SUD for health professional students

The Substance Abuse and Mental Health Services Administration announced a new report with core curriculum content for integration of substance use disorder (SUD) treatment for early-career graduate health care education programs. The report is designed to provide students in medical and health professional programs with training on SUD early in their academic careers to ensure they have basic knowledge of strategies to identify, assess and treat addiction and support recovery. The guidance is applicable to medical, physician assistant, nurse practitioner, nurse, social work, public health and counseling academic programs to provide training about SUD and how to address stigma; education that SUD is a chronic, treatable disease; and training needed to increase access to SUD screening, assessments and services for those with SUD. Core curriculum topics include general and historical context; overview of SUD; screening and assessment; treatment; pain management and intentional substance misuse; and inter-professional education and practice.

Source: SAMHSA Announces New Report Describing Key Elements of a Core Curriculum for Substance Use Disorder (Substance Abuse and Mental Health Services Administration)

NIDA Director discusses teen substance use trends

In an interview with The New York Times, National Institute on Drug Abuse Director Nora Volkow discusses the decrease in substance use among teens. She said contributing factors include education and prevention campaigns, as well as enacting and enforcing policies such as making the legal age for alcohol and tobacco 21. Social media may also play a role. As evident during COVID, not physically being with other teens can reduce the likelihood of substance use. The decline in teen substance use is good because earlier substance use increases the risk of addiction and because it lowers the risk that substances will interfere with teens’ mental health, general health, ability to complete education, future job opportunities, etc. But the drug supply is more dangerous, leading to increased overdose deaths. Vaping products appeal to teens because of the flavors, but vaping and nicotine addiction are harmful. Preventing new trends in substance use among teens, like marijuana or psychedelics, requires different strategies than those used for alcohol and nicotine.

Source: Teen Drug Use Habits Are Changing, For the Good. With Caveats. (The New York Times)

Senate Finance Committee holds hearing on improving SUD care in Medicare and Medicaid

The Senate Finance Committee Subcommittee on Health Care held a hearing this week on opportunities to improve addiction care in the federal health programs. Witnesses discussed ensuring Medicare and Medicaid cover treatment aligned with best practices and clinical standards and throughout the continuum of care, eliminating gaps and limitations in coverage and restrictive practices like prior authorization, and ensuring adequate provider networks. They also discussed providing care within various systems and expanding integration, incentivizing quality care, combatting stigma, addressing addiction as a chronic medical condition, improving reimbursement and combatting other workforce challenges, addressing barriers to treatment for youth, supporting family and peer support and using approaches such as Medicaid waivers to improve addiction care.

Source: Closing Gaps in the Care Continuum: Opportunities to Improve Substance Use Disorder Care in the Federal Health Programs (United States Senate Committee on Finance)

FTC issues report on e-cigarette sales and advertising in 2021

The Federal Trade Commission issued a report on e-cigarette sales and advertising. The combined sales of cartridge-based and disposable e-cigarette products to U.S. consumers by nine leading manufacturers increased by approximately $370 million between 2020 and 2021, while the total topped $2.67 billion. E-cigarette companies spent $90.6 million more on advertising/promotion in 2021 than 2020. In 2021, 69.2% of e-cigarette cartridges sold or given away contained menthol-flavored e-liquids, and the rest were tobacco-flavored. In 2021, “other” flavored devices made up 71% of all disposable vapes sold/given away, with the most popular being fruit- and menthol/mint-flavored, making up more than half of all disposable-cigarette devices sold/given away. The three largest spending categories among expenditures for advertising/promotion were price discounts, promotional allowances paid to wholesalers and point-of-sale advertising, accounting for almost two-thirds of expenditures. To deter or prevent underage consumers from visiting their websites, signing up for mailing lists and loyalty programs or buying e-cigarettes online, companies used online age self-certification and followed state laws requiring adult signature upon delivery of e-cigarette products.

Source: FTC Issues Third Report on E-Cigarette Advertising and Sales in the U.S. (Federal Trade Commission)

FDA issues warning letters to retailers for underage ZYN sales

The Food and Drug Administration (FDA) issued 119 warning letters to, and filed 41 civil money penalty complaints against, brick and mortar retailers that engaged in the underage sale of various ZYN nicotine pouches between Oct. 2023 and Feb. 2024. The FDA has also issued warning letters to three online retailers for the sale of unauthorized, flavored ZYN nicotine pouches. To date, the FDA has authorized four oral tobacco products. The FDA has not authorized any ZYN product for sale in the U.S.

Source: FDA Issues Warning Letters to and Files Civil Money Penalty Complaints Against Retailers for Underage Sales of ZYN Nicotine Pouches (Food and Drug Administration)

HRSA updates policy and announces funding to encourage health centers to provide care to individuals leaving incarceration

The Health Resources and Services Administration (HRSA) announced $51 million for the first-ever funding opportunity for HRSA-funded health centers to implement innovative approaches to support transitions in care for people leaving incarceration and, for the first time, explicitly supported the provision of health services (including mental health and addiction treatment) to individuals during the 90 days prior to release. HRSA’s updated policy makes clear that the health centers can provide services to incarcerated individuals expected to be released from a carceral setting within 90 days. For the funding opportunity, approximately 51 health centers will implement approaches that focus on reducing overdose risk, addressing mental health and substance use disorder treatment needs, managing chronic conditions and preventing, screening, diagnosing and treating hepatitis C, HIV, syphilis and other infectious diseases. Health centers can also use the funding to provide case management services that address key social drivers of health, such as housing and food insecurity, financial strain, access to transportation and intimate partner violence.

Source: During Second Chance Month, HRSA Takes Policy Action, Releases First-Ever Funding Opportunity for Health Centers to Support Transitions in Care for People Leaving Incarceration (Department of Health and Human Services)

Judge rules against Safehouse in latest bid to open a safe consumption site

A federal judge ruled that Safehouse does not have the right to operate a safe consumption site. The judge rejected the assertion from Safehouse that banning the centers violates its board members’ rights of religious freedom. He said that Safehouse does not qualify as a religious organization, highlighting that its articles of incorporation “do not set forth any religious mission or activity.” He said the noble intentions of Safehouse and its founders are evident, and that the public health crisis they seek to address continues unabated, but that their religious inspiration does not provide a shield against prosecution for violation of a criminal statute barring operation. The judge granted the Department of Justice’s request to dismiss Safehouse’s lawsuit, which sought to secure the right to operate a facility by arguing that Safehouse’s work is inspired by Judeo-Christian beliefs about saving lives and caring for the sick and that the possibility of prosecution chilled its exercise of religious rights.

Source: Philadelphia nonprofit loses latest bid to open supervised drug-use center (The Washington Post)

Minnesota opens its first safe consumption site

Minnesota opened its first supervised consumption site last week. The Minnesota Overdose Awareness resource hub provides sterile needles, fentanyl test strips and Narcan, allows people to shower, do laundry and cook a meal, and permits people to use substances on site, with staff trained to reverse overdoses. Last year, the state legislature legalized and funded “safe recovery” start-ups that include safe injection spaces, needle exchange and other health services. Before launching, Minnesota Overdose Awareness sought approval of the neighborhood association. While there was a lot of discussion, the board approved it.

Source: Drug use resource hub opens in north Minneapolis after state legalizes safe injection sites (Star Tribune)

DeSantis signs legislation to increase penalties for exposing law enforcement to fentanyl and to raise awareness about opioid overdose reversal

Florida Governor DeSantis signed legislation to increase penalties on individuals who expose law enforcement officers to fentanyl and to bring awareness to life-saving measures for someone experiencing an opioid overdose. DeSantis also announced an expansion of the Coordinated Opioid Response (CORE) network from 12 counties to 29. SB 718 creates a second-degree felony for any adult who, through unlawful possession of fentanyl, recklessly exposes any first responder to such fentanyl and that results in overdose or serious bodily injury. It expands protections from prosecution for individuals who seek help in good faith due to the belief that they or someone they know is experiencing an overdose. SB 66 designates June 6 as Revive Awareness Day and directs the state health department to raise awareness of the dangers of opioid overdose and the safe use of opioid counteractants.

Source: Governor Ron DeSantis Signs Legislation to Protect Law Enforcement Officers from Fentanyl Exposure; Expands CORE Network in Florida (Ron DeSantis)

States are scrambling to address youth mental health without clear evidence

State and local governments across the country are scrambling to find new strategies to slow the youth mental health crisis. It is not clear what is causing the crisis, but governments are forging ahead anyway, conducting a nationwide experiment in whatever ideas seem promising. Some who treat children worry the lack of evidence to support many of the approaches threatens to waste time and money, or could make matters worse. Initiatives like free online therapy for all teens in a region, new K-12 curricula on handling stress, investing in institutions that cultivate community, adding suicide hotline numbers to student IDs and taking social media companies to court are among the approaches being tried. Since 2020, over 100 state laws have been passed to address the mental health rates that policymakers feared would be exacerbated by the pandemic.

Source: The nationwide experiment in treating mentally ill kids (Politico)