Policy News Roundup: September 8, 2022

Key reads

Juul settles with states to end investigation of its marketing to youth

Juul has agreed to pay $438.5 million over 6 to 10 years to settle a 2-year investigation by 33 states into the marketing of its products, which have been blamed for the youth vaping crisis. The investigation found that Juul marketed its e-cigarettes to underage teens with launch parties, product giveaways and ads and social media posts using youthful models. Although Juul already stopped many of its marketing practices after it came under scrutiny several years ago, the settlement includes restrictions on how Juul can market its products, including prohibiting using cartoons, paying social media influencers, depicting people under 35, advertising on billboards and public transportation and placing ads in any outlets unless 85% of the audience is adults. It also includes restrictions on where Juul products may be placed in stores, age verification and limits to online and retail sales. The settlement will be finalized in the next several weeks.

Source: Juul to pay nearly $440M to settle states’ teen vaping probe (Associated Press)

SAMHSA announces over $79 million in grants to address the overdose crisis

The Substance Abuse and Mental Health Services Administration announced $79.1 million in overdose prevention grants. This includes $14.5 million for grants to provide resources to first responders and others to train, carry and administer naloxone; $7.1 million for grants to help rural areas recruit and train emergency medical services personnel to address mental health and substance use disorder; and $8.2 million for grants to implement harm reduction, treatment and/or recovery support services to support an under-resourced population or unmet need. The grants also include $1.5 million to train graduate-level students in treating opioid use disorder; $12.1 million for residential and outpatient treatment and recovery support services for pregnant and postpartum women and their children and families; $3 million for states/territories/tribes to target prescription misuse; and $32.7 million to help expand and enhance access to medications for opioid use disorder and decrease opioid use.

Source: On International Overdose Awareness Day, HHS Announces Awarding of $79.1 Million in Overdose Prevention Grants (Substance Abuse and Mental Health Services Administration)

ONDCP director and Second Gentleman host Overdose Awareness Day event

On International Overdose Awareness Day, Second Gentleman Doug Emhoff and Office of National Drug Control Policy Director Rahul Gupta hosted a meeting at the White House with family members from across the country who lost loved ones to overdose. Family members shared their personal experiences and raised awareness about accessing treatment and support, including for those with co-occurring mental health and substance use disorder. They also spoke about bringing attention to the dangers of illicit fentanyl being added to fake prescription pills and other substances, as well as the importance of effective prevention programs and making sure harm reduction tools like naloxone are readily available. They also discussed the need to eliminate stigma and the administration’s efforts to address the overdose crisis.

Source: Readout of White House Meeting with Second Gentleman, ONDCP Director Dr. Gupta, and Families on Overdose Awareness Day (Office of National Drug Control Policy)

NIDA highlights need for implementation of proven strategies to address addiction

National Institute on Drug Abuse (NIDA) Director Nora Volkow explains in a blog that there are things that science has shown conclusively to be effective for addressing the overdose crisis. Rather than continuing to ask if they work, we must overcome barriers to implementation. Naloxone is not available over the counter, doctors do not always prescribe it to patients who need it, pharmacies do not always stock it, the price can be prohibitive and people do not know about standing orders. NIDA is supporting research to expand use and develop new overdose reversal methods. Medications for addiction treatment are effective, but we must overcome attitudinal barriers and increase implementation, research strategies to improve retention, research which medications work best for whom and develop treatments for other substances. Contingency management is effective for stimulant use disorder, but anti-fraud regulations have limited rewards to non-effective amounts and providers have legal concerns. Greater clarity is needed for more providers to implement it. Syringe service programs mitigate harms, but we must build evidence for other harm reduction approaches. Proven prevention interventions are seldom adopted due to lack of investment in long-term solutions and challenges in scaling up interventions.

Source: Five Areas Where “More Research” Isn’t Needed to Curb the Overdose Crisis (National Institute on Drug Abuse)

DOJ settles opioid use disorder discrimination case with Indiana State Nursing Board

The Department of Justice entered into a settlement agreement with the Indiana State Board of Nursing to resolve claims it violated the Americans with Disabilities Act. The settlement ensures that nurses who take medications for opioid use disorder (MOUD) can remain on their medication when participating in the Indiana State Nursing Assistance Program, which assists in rehabilitating and monitoring nurses with substance use disorder, and is often required for nurses to maintain an active license or have one reinstated. The Nursing Board will also revise its written policies to ensure nurses taking MOUD are not subjected to discriminatory conditions or terms, pay $70,000 in damages to the complainant and report on its compliance.

Source: Justice Department Secures Settlement Agreement with the Indiana State Nursing Board Addressing Discrimination Against People with Opioid Use Disorder (Department of Justice)

New Hampshire reaches opioid settlement with J&J

New Hampshire settled opioid claims against Johnson & Johnson (J&J) for $40.5 million, of which $31.5 million will be used for opioid abatement purposes. The state alleged that J&J aggressively marketed opioids to prescribers and patients in the state and misrepresented that their opioids were safer than other alternatives. New Hampshire also alleged that J&J disseminated misleading statements about opioids, promoted the false concept of pseudo-addiction and misrepresented that their opioids were rarely addictive when used for chronic pain. The state alleged that J&J’s marketing targeted particularly vulnerable populations, such as the elderly, and that J&J’s activities were a substantial factor in creating a public nuisance in the state. The trial was scheduled to begin September 7. New Hampshire decided not to join the earlier national settlement. The terms of this agreement are better for the state.

Source: Attorney General Reaches $40.5 Million Settlement with Johnson & Johnson To Settle Opioid Claims (New Hampshire Department of Justice)

New Mexico's trial against pharmacies for opioid crisis begins

New Mexico’s trial against pharmacy operators Walgreens, Walmart and Kroger for their alleged role in the opioid crisis began this week. The state argued that the pharmacies were supposed to act as a “dam” against a flood of opioid prescriptions by refusing to fill prescriptions with “red flags.” The pharmacies countered that pharmacists must exercise their “professional judgement” rather than relying on “mechanical application of red flags” and that the state would not be able to prove that pharmacists “knowingly” filled any illegitimate prescriptions. New Mexico sued the pharmacies in 2017, accusing them of creating a public nuisance by failing to stop the diversion of opioids into illegal channels, and it is seeking to make them pay for anti-addiction programs to abate that nuisance.

Source: Pharmacy operators Walmart, Walgreens, Kroger begin opioid trial in New Mexico (Reuters)

New Jersey creates advisory council and online portal for stakeholder input on spending opioid settlement funds

New Jersey Governor Phil Murphy announced a new online portal and executive order to establish methods through which stakeholders can provide input on how to use opioid settlement funds. Executive Order No. 305 establishes an Opioid Recovery and Remediation Advisory Council to make recommendations on use of the funds. It will be chaired by the commissioner of the Department of Human Services and will include the attorney general, Department of Health, Department of Children and Families, people with lived experience and public health and policy experts. The online portal, launched in partnership with the Department of Human Services and the Office of Information Technology, will give any member of the public the opportunity to weigh in on how the funds should be spent. The portal will be open for an initial 60-day comment period and will re-open annually to facilitate ongoing input.

Source: Governor Murphy Announces Creation of Online Portal & Advisory Council to Receive Input from Members of Public, Stakeholders on Use of Opioid Settlement Funds (Governor Phil Murphy)

Bipartisan majorities favor spending on addiction treatment

A survey found that large majorities of both Democrats and Republicans support federal funding to expand substance use disorder (SUD) treatment to ensure all who need and want it are able to get it. When asked how high a priority that should be for the government, 80% said very or somewhat high (67% of Republicans, 94% of Democrats). The survey found 75% (58% of Republicans, 92% of Democrats) supported spending $10 billion to fund treatment for those who want but are unable to get it, by expanding the number of treatment centers, training and hiring more providers, subsidizing treatment for low-income earners and funding research. The survey also found 74% (61% of Republicans, 89% of Democrats) supported funding the expansion of treatment programs in prisons, and 74% favored providing funds to give police officers training and tools to divert non-violent criminal offenders with SUD into treatment rather than charge them with a crime. Six in ten favored funding harm reduction programs that provide naloxone, fentanyl test kits and clean needles.

Source: Large Bipartisan Majorities Favor Congress Funding Substance Abuse Treatment for All Who Want It (Program for Public Consultation)

Greater focus on harm reduction needed

Connecticut Harm Reduction Alliance Founder and Executive Director Mark Jenkins and Drug Policy Alliance Executive Director Kassandra Federique explain the need to focus on harm reduction. They outline the toll of the overdose crisis, as well as stigma and punitive policies that disproportionately harm people of color. They explain harm reduction and the evidence supporting it. Congress and the administration should provide resources for syringe services programs and related harm reduction programs nationwide; make naloxone readily available to people who use substances, their friends and family and communities most affected by the overdose crisis; and communicate often with directly impacted people and their families, harm reduction providers and community leaders to rapidly respond and implement solutions.

Source: As overdose crisis rages, we must prioritize saving lives with harm reduction (The Hill)