Policy News Roundup: June 13, 2024

Key reads

White House holds meetings to expand naloxone access

The White House held meetings last week to promote wider access to naloxone. Officials met with drug manufacturers who make overdose reversal medications. The manufacturers announced they are building capacity to produce an additional 25 million doses in 2025, and some announced they will donate funds to expand the Real Deal on Fentanyl youth awareness campaign. Officials also met with city, county, and private sector leaders, who highlighted their efforts. Major League Baseball announced that emergency medical procedures now require that naloxone be stored in multiple locations at ballparks, and Certified Athletic Trainers are required to travel with naloxone. MLB will train employees and promote awareness to fans. The Los Angeles County Unified School District has naloxone in all K-12 schools, early education centers and adult education centers. The Chicago Department of Aviation committed to having naloxone available in AED cabinets at pre- and post-security locations at O’Hare and Midway International Airports.

Source: White House Convenes City, County, and Private Sector Leaders to Discuss Saving Lives from Overdose; Readout of White House Meeting with Overdose Reversal Medication Manufacturers (Office of National Drug Control Policy)

New report outlines state policies to support effective crisis response

A new Inseparable report on crisis support features effective policy solutions states can adopt to ensure that everyone in a mental health crisis receives the right services at the right time and has a supportive, recovery-oriented experience of care; youth in mental health crisis and their families receive developmentally appropriate services and supports; and law enforcement involvement in a mental health crisis is the exception, not the rule. The report includes recommendations for states to establish sustainable financing, ensure system accountability, build system infrastructure, develop workforce capacity and promote a culture of service. The report includes state snapshots capturing each state’s crisis call center capacity and mobile response and stabilization needs, as well as an overview of the state’s progress in adopting financing and accountability-related policies.

Source: A Better Response: Policies to Improve America’s Mental Health Crisis System (Inseparable)

FDA reverses ban on Juul products

The Food and Drug Administration (FDA) reversed a ban on Juul e-cigarette products. The decision will not immediately affect consumers, as Juul products have remained on store shelves as the company appealed the FDA’s June 2022 decision to ban the products. FDA said the move to rescind the ban was made in light of court cases involving the vaping industry and because the agency has since “gained more experience” with scientific issues involving e-cigarette products. FDA stressed that the move was not an approval of Juul’s requests to market products but instead returns those applications to the status of pending review. The move comes as the Supreme Court is scheduled on June 20 to discuss whether to weigh in on conflicting lower-court decisions involving FDA regulation of e-cigarette products for other companies. The Campaign for Tobacco-Free Kids criticized FDA’s recent decision, urging the agency to “finish its review and again deny marketing applications for all Juul products.”

Source: FDA reverses ban on Juul products as Supreme Court may weigh in on vapes (Washington Post)

FDA and DOJ announce task force to combat illegal e-cigarette sales

The Department of Justice (DOJ) and Food and Drug Administration (FDA) announced a federal multi-agency task force to combat the illegal distribution and sale of e-cigarettes. The task force will also include the Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF), the U.S. Marshals Service, the U.S. Postal Inspection Service (USPIS) and the Federal Trade Commission. It will focus on topics including investigating and prosecuting new criminal, civil, seizure and forfeiture actions. The U.S. Marshals Service will help FDA and DOJ effectuate seizures of unauthorized e-cigarettes. DOJ is collaborating with ATF and USPIS on potential criminal and civil enforcement under the PACT Act, which requires online sellers of e-cigarettes to register with ATF and to verify age of purchasers at points of sale and delivery. The task force will support these actions and coordinate enforcement strategies FDA and DOJ are working on. FTC will support the activities of the task force by sharing its knowledge about the marketplace for vaping products.

Source: Justice Department and FDA Announce Federal Multi-Agency Task Force to Curb the Distribution and Sale of Illegal E-Cigarettes (Food and Drug Administration)

CDC study finds mental and behavioral disorders are leading cause of ER visits by people experiencing homelessness

A Centers for Disease Control and Prevention report found that approximately 981,000 and 460,000 emergency department (ED) visits were made annually by males and females experiencing homelessness, respectively, 2016-2021. The most frequent major diagnosis categories at visits by people experiencing homelessness were mental, behavioral and neurodevelopmental disorders (28.8%), followed by symptoms, signs and abnormal clinical findings (21.4%), injury (9.8%), diseases of the musculoskeletal system (7.5%) and diseases of the skin and subcutaneous tissue (4.5%). The most frequent for those not experiencing homelessness were symptoms, signs and abnormal clinical findings, injury, diseases of the respiratory system, diseases of the musculoskeletal system and diseases of the digestive system. Only 3.6% of visits by those not experiencing homelessness were for mental, behavioral or neurodevelopmental disorders. Intentional substance misuse (41.5%), intentional alcohol misuse (28.1%) and depression (27%) were the most frequently documented chronic conditions at ED visits by people experiencing homelessness and were more common than among visits by people not experiencing homelessness.

Source: Emergency Department Visits by Homeless Status and Sex: United States, 2016–2021 (Centers for Disease Control and Prevention)

Hunter Biden trial spotlights America's addiction crisis

Hunter Biden’s trial on charges that he illegally purchased and possessed a gun while intentionally misusing or being addicted to drugs put a spotlight on the American addiction crisis. Questions used in winnowing down the group of prospective jurors included, “Have you, a family member or a close friend ever suffered from drug or alcohol abuse, or been addicted to drugs or alcohol in any way?” Another question probed whether potential jurors or their close associates had ever sought treatment for drug use. Many prospective jurors described how drug use had afflicted people they knew. Following the verdict finding Hunter Biden guilty, President Biden issued a statement that said, “Jill and I love our son, and we are so proud of the man he is today. So many families who have had loved ones battle addiction understand the feeling of pride seeing someone you love come out the other side and be so strong and resilient in recovery.” In his own statement, Hunter Biden also spoke to family ties and the process of recovery.

Source: Hunter Biden trial puts America’s addiction crisis back into focus (CNN); President offers love and pride for his son’s addiction recovery after Hunter Biden’s guilty verdict (Associated Press)

Baltimore City Council will hold hearings on overdose crisis

Baltimore City Council members said they would hold a series of hearings on the city government’s response to its overdose epidemic, following the New York Times examination finding a faltering response in recent years. The public safety and health committees announced they would meet at least four times on the topic in coming months, starting in July. The chair of the public safety committee also said he would explore changing the city’s budget to put more money into overdose prevention, though he said it was not clear how feasible such changes would be. In the three weeks since the examination was published, city officials have been repeatedly questioned during City Council committee meetings about their response to overdoses. They have pointed to several steps they are taking, including the plan to create an opioid coordination office to manage the settlement money and an “opioid stat” database to track overdose deaths.

Source: Baltimore City Council to Hold Hearings on Drug Overdoses (New York Times)

Miami's IDEA Exchange demonstrates success of harm reduction

Despite data supporting harm reduction, politicians have been hesitant to embrace it. Miami’s story illustrates that the policy can work even in a red state. In 2008, while he was a medical student in Miami, IDEA Exchange founder Dr. Hansel Tookes started fighting for syringe exchanges to reduce the spread of AIDS, but Florida resisted. By 2015, Miami had one of the worst HIV epidemics in the U.S. For his capstone project, Tookes compared the number of dirty syringes found on the street in Miami, which did not have an exchange program, to that in San Francisco, which did, to combat the common argument that exchanges increase needle litter. There were eight times as many syringes on Miami streets. Tookes and the University of Miami persuaded the legislature to authorize the syringe exchange. To persuade Republicans, he focused on an economic argument that preventing just one case of HIV saves some $500,000 in health costs, as well as a “pro-life” argument. IDEA was able to win over the Miami Police Department by emphasizing that officers would be safer because suspects would not be trying to hide dirty needles. Since 2022, Tookes and his staff have been entrusted by the state with training others to replicate their work. Florida now has eight authorized needle exchange programs.

Source: Why Miami’s Approach to Addiction Is Working (New York Times)

Resources for families who have lost loved ones to overdose remain lacking amid pervasive stigma

Despite the fact that as many as 125 million Americans know someone who fatally overdosed, the family and friends of those who have died are often confronted by stigma, shame and blame from strangers and neighbors alike. They may be told that their loved one’s death was self-inflicted or through some fault of their own. Nationwide, established support group networks exist for people with a parent, child, or sibling who is struggling with substance use as they seek treatment and recovery, but the same is not true for those who have witnessed that struggle end in an overdose death. Researchers are looking to expand the bereavement resources that do exist in a way that is sustainable and accessible.

Source: ‘The pain is so much.’ How stigma and shame over fatal overdose make grief more unbearable (PBS)

Four industries cause over a third of deaths per year globally

A WHO report found that tobacco, ultra-processed foods, fossil fuels and alcohol cause 19 million deaths per year globally, or 34% of all deaths, including around 2.7 million deaths in the WHO Europe region every year. The report explains how consolidation of these industry sectors and others, into a smaller number of powerful transnational corporations, has enabled them to wield significant power over the political and legal contexts in which they operate and to obstruct public interest regulations that could impact their profit margins. The sectors use near-identical tactics to shape structural, policy and information environments, with the goal of generating profit. Industry tactics include exploitation of vulnerable people through targeted marketing strategies, misleading consumers and making false claims about the benefits of their products. Policymakers should enforce stronger regulations related to marketing of health-harming products; monopolistic practices; transparency, lobbying, funding and conflicts of interest; taxation of multinational corporations; job security and labor conditions; exploitation of vulnerable populations; and funding and support for civil society organizations to ensure their independence.

Source: Just four industries cause 2.7 million deaths in the European Region every year (WHO Europe)