Policy News Roundup: July 18, 2024

Key reads

Lack of institutional support prevents physicians from treating addiction

A National Institute on Drug Abuse study identified top reasons why physicians may be reluctant to treat addiction. Institutional environment was the reason most frequently reported in studies reviewed (81%), followed by insufficient skill (74%), lack of cognitive capacity to manage a certain level of care (74%) and inadequate knowledge (72%). Around 66% of studies cited negative social influences (beliefs about public and community acceptance of addiction care), and 56% cited fear of harming the patient-physician relationship. Reimbursement concerns for the cost of delivering addiction interventions were observed. Findings point to the need for institution-wide changes to improve the adoption of evidence-based addiction treatment practices among physicians, including increasing organizational support, leadership and staff buy-in, and education and training. Factors that facilitate addiction treatment include community outreach efforts, educational materials for patients and families and public health campaigns that promote non-stigmatizing language.

Source: Doctors reluctant to treat addiction most commonly report “lack of institutional support” as barrier (National Institute on Drug Abuse)

Two years in, 988 has answered more than 10 million contacts

Since 988’s launch two years ago, counselors have answered more than 10 million calls, texts and chats. Of those, 1.7 million were texts, with 988 answering 51% more texts in the past 12 months than the year before. Almost 1.2 million of the 988 calls were answered by the Veterans Crisis Line through 988’s Press 1 option. In 2023, 988 added Spanish text and chat, specialized services for LGBTQI+ youth and young adults and videophone for ASL users. Since these expansions, 988 has answered about 20,000 Spanish-language chats and texts; more than 475,000 LGBTQI+ youth/young adult texts, calls and chats; and about 20,000 videophone contacts in ASL. Later this year, georouting technology is expected to start routing callers/texters based on their approximate location rather than area code. The Department of Health and Human Services has invested nearly $1.5 billion in 988, including nearly $370 million in grants for states, territories and tribes to hire crisis counselors and improve local response.

Source: Now in Its Second Year, 988 Lifeline Continues to Help Millions of People (Substance Abuse and Mental Health Services Administration)

FDA and FTC warn companies selling copycat delta-8 THC food products

The Food and Drug Administration (FDA) and the Federal Trade Commission (FTC) issued warning letters to five companies for illegally selling copycat food products containing delta-8 THC and introducing them into the marketplace in violation of the Federal Food, Drug, and Cosmetic Act. The warning letters were issued to Hippy Mood, Earthly Hemps, Shamrockshrooms.com, Mary Janes Bakery Co. LLC and Life Leaf Medical CBD Center. The FDA also issued a warning letter independently to GrowGod LLC for the same violations. Last year, the agencies warned six other companies for selling edible food products containing delta-8 THC in packaging that could easily be confused for foods sold by popular national brands, and all six of those companies no longer have such products in stock.

Source: FDA, FTC Continue Joint Effort to Protect Consumers Against Companies Illegally Selling Copycat Delta-8 THC Food Products (Food and Drug Administration)

HRSA provides funding to support social worker licensure compact

The Health Resources and Services Administration (HRSA) announced the first-ever Licensure Portability Grant Program investment in a multi-state social worker licensure compact. State licensure compacts allow providers to practice across state lines without having to apply for a license in each state. HRSA’s $2.5 million investment will support the work to launch a social worker compact, as well as ongoing support for building and sustaining primary care, psychology and podiatry compacts. The awards will support the Association of Social Work Boards, the Association of State and Provincial Psychology Boards, the Federation of State Medical Boards of the United States and the Federation of Podiatric Medical Boards in working with state licensing boards to develop and implement state policies that reduce barriers to telehealth and allow for practice across state lines.

Source: Biden-Harris Administration Launching Initiative to Build Multi-state Social Worker Licensure Compact to Increase Access to Mental Health and Substance Use Disorder Treatment and Address Workforce Shortages (Health Resources and Services Administration)

Much of California opioid settlement funds largely unspent or going to naloxone so far

California is set to receive more than $4 billion in opioid settlement funds. As of June 2023, the bulk of funds controlled by California cities and counties, more than $200 million, had yet to be spent. Los Angeles accounted for nearly one-fifth of that unspent total, nearly $39 million, though officials say that since the report was filed, they have started allocating money to recovery housing and programs to connect people who are homeless with residential addiction treatment. Among local governments that did use the money in the first year, naloxone was the most popular use, accounting for more than $2 million across 19 projects. Some cities that had plans to buy portable drug analyzers for law enforcement did not do so in the first fiscal year, after the Department of Health Care Services issued rules that settlement funds may not be used for certain law enforcement efforts, including such analyzers. Other localities spent funds on a wide range of measures including police officer wellness and support; D.A.R.E.; new heating and air conditioning for a treatment center; treatment for people in jail; and showcasing prevention art and videos made by middle schoolers.

Source: Lifesaving Drugs and Police Projects Mark First Use of Opioid Settlement Cash in California (KFF Health News)

NACo brief shows how counties are addressing behavioral health workforce shortages

The National Association of Counties issued a brief on how counties are addressing behavioral health workforce challenges. Strategies that have been implemented include increasing funding by raising Medicaid rates and repurposing tax funds to support workforce initiatives; expanding apprenticeship programs that offer on-the-job training and college credit; enhancing clinical training programs; partnering with local colleges/universities to establish trainings and degree programs; and establishing specialized training academies to equip crisis responders. Federal partners can implement policies to support initiatives that attract and adequately train new professionals in behavioral health; implement incentives to retain skilled workers, such as competitive salaries and professional development opportunities; create pathways for peer providers and other credentialed support workers; incentivize the expansion of telehealth; and ensure sustained financial and resource investments by intergovernmental partners.

Source: County Leadership in Mental Health: How Counties Are Leading the Way to Address Workforce Challenges (National Association of Counties)

States are pursuing legislation to support crisis response services

The National Alliance on Mental Illness (NAMI) released an issue brief highlighting state legislation passed in 2023 that works to reimagine the mental health crisis response system. States should establish a permanent funding source for the full crisis response continuum through monthly telecommunications fees and related appropriations, create/expand local mobile crisis teams and crisis stabilization options, enact policies to minimize police involvement and reduce use of force incidents in mental health emergencies, improve insurance coverage of mobile crisis team and crisis stabilization services and require ongoing evaluation of the state’s crisis care system. In 2023, three new states implemented a monthly 988 fee. Compared to 2022, there was more state legislative focus in 2023 on creating and funding the in-person elements of the crisis care continuum in addition to continuing funding for 988 call centers. Several states passed legislation in 2023 requiring insurance coverage of mobile crisis and crisis stabilization services.

Source: 2023 State Legislation Issue Brief Series: Trends in State Policy: 988 and Reimagining Crisis Response (National Alliance on Mental Illness)

Most Americans still unfamiliar with 988

A NAMI-Ipsos poll found that 63% of Americans say they are aware of 988, and 23% say they are at least somewhat familiar with it. When asked what would be most important if they needed to contact 988 for themselves or another person, the top three were being able to speak with a crisis counselor immediately, health care professionals arriving to the scene of the crisis first and not receiving a bill for contacting 988. The poll found 3% say they or a loved one have contacted 988, with Black, Hispanic and Asian American/Pacific Islander Americans more likely than white Americans. Among those who say they or a loved one contacted 988, 68% say they got the help they needed, up 13 percentage points from last year, while 82% trust they would receive the help they needed from 988 if they needed to contact it. The poll found 72% are comfortable contacting 988 during a crisis, but 51% are not sure when a situation is serious enough to contact 988. The poll found 83% support federal and state funding for 988 and crisis response services. After receiving messaging about monthly 911 phone bill fees, most were willing to pay a slightly higher fee to fund 988, and 86% say that when someone is in a mental health crisis, they should receive a mental health response, not a police response.

Source: Poll of Public Perspectives on 988 & Crisis Response (2024) (National Alliance on Mental Illness)

Addiction treatment programs could help treat hepatitis C

Utilizing all types of addiction treatment programs, withdrawal management and stabilization programs, outpatient programs, opioid treatment programs (OTPs), sober houses, residential programs, harm reduction centers, etc., could be effective in the nation’s effort to eliminate hepatitis C. Most new hepatitis C infections in the U.S. occur in people who inject substances. Stigma is a major barrier to increased prescription of hepatitis C treatment. Only 1-2% of people with hepatitis C who use substances receive treatment. Hepatitis C treatment is expensive, but the cost pales in comparison to that of liver transplantation, liver cancer treatment and hospitalizations for liver failure from untreated hepatitis. New York offers Medicaid reimbursement of hepatitis C treatment in some outpatient addiction treatment centers and OTPs, which should be replicated across the country. With proper training, institutional support and insurance coverage, medical professionals can treat people with hepatitis C. Peer navigation and telehealth can help in settings without onsite medical services.

Source: Addressing the dual epidemics of hepatitis C and opioid use (STAT)