Tag Archives: Opioid

What We Are Reading This Wee

Much thanks to the American Health Lawyer’s Association (AHLA), for compiling today’s news for us:

Trump Opioid Plan Explicitly Favors Alkermes’ Vivitrol Over Other Addiction Medications.

In covering the White House’s recent national strategy to address the opioid epidemic, STAT (3/26, Facher) reports that when Alkermes CEO Richard Pops testified before a White House commission on the opioid crisis in September, he “stressed the importance of increasing insurance coverage for Vivitrol [naltrexone], but added that patients should be made aware of all available treatment options.” Administration health officials “themselves expressed doubts about the approach,” but a White House spokesman later confirmed that the strategy document referred specifically to naltrexone in its injectable form, which is made only by Alkermes and marketed as Vivitrol.

Draft Legislation Would Bolster FDA’s Powers In Opioid Fight.

The Hill (3/26, Roubein) reports Senate Health Committee Chairman Lamar Alexander (R-TN) on Monday released draft legislation “aimed at bolstering the Food and Drug Administration’s (FDA) capacity to respond to the opioid crisis.” One of the draft bills “would let the FDA require drug manufacturers to package certain opioids in set doses, known as ‘blister packs,’” that would reduce the volume of opioids prescribed and be easier to dispose of. The Hill reports other draft legislation “would ensure the FDA can spend the $94 million included in the spending bill passed last week to upgrade equipment at the border, boost laboratory capacity and improve the infrastructure to better seize illegal drugs at the border,” including fentanyl.

The Washington Times (3/26, Howell) reports Alexander also said that the FDA should use the new funding to improve its coordination with US Customs and Borders Protection.

American Dental Association Backs Seven-Day Limits On Opioid Prescriptions.

CBS News (3/26, Strickler) reports on its website that according to new research (PDF) published Monday in the Journal of the American Dental Association, dental prescriptions for opioids have been rising while opioid prescriptions have been declining nationwide. The American Dental Association “has now released a new policy saying they now support statutory limits of seven days for dental opioid prescriptions,” limits not currently embraced by the American Medical Association, “which has so far resisted opioid prescription limits.”

The Hill (3/26, Roubein) reports the new research “shows that 6.4 percent of all opioid prescriptions were written by dentists in 2012, but that rates increased slightly from 2010 to 2015.” ADA president Joseph Crowley said in a press release, “This new policy demonstrates ADA’s firm commitment to help fight the country’s opioid epidemic while continuing to help patients manage dental pain.”

The AP (3/26, Tanner) reports dental opioid prescriptions grew slightly “despite evidence that ibuprofen and acetaminophen work just as well for most dental pain.” The AP reports that according to a study published in the same journal, dentists “are the leading prescribers of opioids for U.S. teens and the largest increase in dental prescriptions from 2010 to 2015 occurred in 11- to 18-year-olds.”

The Washington Examiner (3/26, Leonard) also reports.

Legal Action Center’s Response to President’s “Initiative to Stop Opioid Abuse and Reduce Drug Supply and Demand”

Yesterday in New Hampshire, President Trump outlined his administration’s three-pronged plan for addressing the opioid epidemic. While the strategy includes certain components critical to expanding access to evidence-based addiction care, it lacks specificity on health approaches and falls well short of the comprehensive public health response needed to address a crisis that is currently claiming the lives of over 175 Americans each day. Further, the plan’s emphasis on the failed punitive policies is out of step with what we know from decades of public health and public policy data.

One stated goal of the President’s “Initiative to Stop Opioid Abuse and Reduce Drug Supply” is to “expand access to evidence-based addiction treatment in every State, particularly MAT for opioid addiction”, a critical need which we strongly endorse. The Legal Action Center supports certain additional tactics outlined in the President’s plan to “increase availability of the life-saving overdose reversal drug Naloxone, to expand access to residential SUD treatment and to improve treatment options for people within the criminal justice system, and looks forward to hearing the details of their operationalization.

However, the President’s proposal does not sufficiently address the reality that bringing an end to the opioid epidemic is dependent on a significant federal investment to strengthen and expand the national system of care for all substance use disorders. Many communities, especially in rural areas, have a complete dearth of qualified addiction treatment providers. Strengthening the existing addiction care workforce and developing expertise in the rest of the healthcare system to help prevent and treat addiction also is critically needed. Addressing this gap in coverage will require both short and long term investments and policies that align with the goal of expanded access to effective community-based prevention, treatment and recovery supports. The 2010 Affordable Care Act, for the first time in history, included coverage of substance use disorders as an Essential Health Benefit, and the 2008 Mental Health Parity and Addiction Equity Act requires insurers to cover mental health and addiction services at a level that is equal to coverage of medical and surgical services. The federal government should be working with States to enforce the Parity Act, and to ensure that all insurers, including Medicaid, Medicare and commercial plans, are covering all evidence-based services – including all three FDA approved addiction medications – at par with other health conditions.

Good access to Medicaid is critical to achieving the goal of expanded access to substance use disorder care. This includes expanding – rather than restricting– Medicaid eligibility, which provides coverage for millions of Americans who struggle with substance use disorders. The Legal Action Center strongly supports and has long advocated for making residential substance use disorder care more accessible to people enrolled in Medicaid by repealing the IMD exclusion and CMS issuing waivers until Congress changes the law. At the same time, the initiative’s stated goal of expanding access to evidence based treatment cannot be achieved if the Administration continues to take regulatory actions to weaken the Medicaid program through severe funding cuts and enrollment restrictions such as work requirements and lockout provisions. The administration must stop taking actions to limit people’s ability to get Medicaid if it is serious about stemming the opioid crisis.

Similarly, the Legal Action Center strongly supports the need to link people struggling with addiction in the criminal justice system to the care they need, but this action must include people with all forms of substance use disorder, not just opioid use disorder as proposed by the President’s Initiative. We agree with, and have long advocated for, diverting as many people with addiction away from the criminal justice system and connecting them to treatment. We encourage the administration to support diversion as early in the process as possible and to consider use of other home and community-based settings. We also urge the Administration to ensure that there is good access to evidence-based harm reduction approaches, including syringe-exchanges and safe consumption facilities, as well as all three FDA-approved addiction medications and residential treatment.

The Legal Action Center strongly opposes several aspects of the President’s Initiative that focus on punitive approaches. Research has clearly and repeatedly shown that a heightened focus on enforcement does not work to either reduce drug supply or demand, and that the ‘War on Drugs’ disproportionately targeted low-income communities of color and fueled mass incarceration. There is wide agreement among the American public as well as on both sides of the aisle that we need to shift away from a punitive approach to drug policy to a much more effective and less costly approach of treating addiction and supporting effective re-entry policies. There is also robust evidence that the majority of those incarcerated have diagnosed substance use disorders, and that many of them have been incarcerated as a result of criminal activity arising directly from their addiction. This includes those who are convicted of low-level drug dealing to support their addiction. We strongly condemn the suggestion that the death penalty should be sought for drug trafficking, since all evidence shows that such a policy would not reduce drug use, would be very costly and would fall disproportionately on people of color and those without financial means.

While we appreciate the administration’s recognition of the need to develop a plan to address this critical public health emergency and some of its proposals, we urge the Administration to invest sufficient resources to successfully combat the opioid and other substance use epidemic; prioritize proven health responses including expanding health care coverage of substance use disorders and quality prevention, treatment services and medications, evidence-based harm reduction approaches, and recovery supports; and not return to failed punitive policies of the past that did great damage to our country without reducing drug misuse and addiction.

Navigating Passages to Recovery: Public Policy and the Law of Marketing Treatment Programs

Following their breakout sessions at the 2017 National Conference on Addiction Disorders in Baltimore, several experts spoke with Tom Valentino, senior editor of Addiction Professional and Behavioral Healthcare Executive, and shared key takeaways from their presentations.

Jeffrey Lynne, Esq., partner at Beighley, Myrick, Udelle & Lynne, on treatment center marketing:

Reference: https://vendome.swoogo.com/ncad-2018/NCAD2017-Videos

Teens Now Succumbing to the Opioid Epidemic in Record Numbers

A new report out from the CDC on Wednesday morning highlights the dramatic shifts in overdose deaths among teens ages 15 to 19.

After more than doubling between 1999 and 2007, the overdose death rate among that group dropped 26 percent between 2008 and 2014. But the rate dramatically rose in 2015.

Opioids — and specifically, heroin — were the primary cause of drug overdoses among adolescents in 2015.

Key findings from the National Vital Statistics System

  • The death rate due to drug overdose among adolescents aged 15–19 more than doubled from 1999 (1.6 per 100,000) to 2007 (4.2), declined by 26% from 2007 to 2014 (3.1), and then increased in 2015 (3.7).
  • The drug overdose death rate increased between 1999 and the mid-2000s for both males and females but only males had a subsequent decline between 2007 and 2014.
  • For both male and female adolescents, the majority of drug overdose deaths in 2015 were unintentional.
  • Death rates for drug overdoses among those aged 15–19 in 2015 were highest for opioids, specifically heroin.

Meanwhile, as the opioid epidemic rages on, the lawsuits against drug manufacturers and distributors continue to pile up. South Carolina’s attorney general just filed a lawsuit against OxyContin maker Purdue Pharma, alleging that the company used shady marketing tactics that contributed to the epidemic. And in Cincinnati, city officials are suing three major prescription drug distributors, alleging that they broke a federal law that requires them to report suspicious opioid orders.

At this juncture, we remain sadly pessimistic that the Trump Administration is not going to fulfill cornerstone campaign promises to tackle the epidemic head-on. The recent declaration of national health emergency did send an important message of acknowledgement, and hopefully will expedite access to resources and different tools to respond, those resources are often only available to the indigent and underserved areas. This could be used to staff up or train providers for medication-assisted treatment, which is considered the gold standard for opioid addiction care. Or it could be used to waive state licensing requirements for doctors, letting addiction specialists go into areas that currently don’t have enough access to such care.

But for the balance of the nation, it may not mean much.