Improving Treatment for Black Patients, Congressional Testimony, Recent Publications, and more.
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INSIDE: Article published in the American Journal of Public Health on Improving Treatment for Black Patients, testimony before House Ways and Means Committee.
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Improving Addiction Treatment Quality and Access for Black Patients
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The American Journal of Public Health published an editorial from Addiction Policy Forum Founder Jessica Hulsey, which urges researchers, clinicians, and policymakers to employ an “all-hands-on-deck approach” to advance public health response to the Black community.
People from racial and ethnic minority groups have experienced disproportionately negative health outcomes resulting from long-standing inequities. Over the past two years, Black Americans have been at the epicenter of colliding epidemics, pandemics, and mental health stressors. White and Black people do not differ significantly in their use of drugs, yet the legal consequences, access to quality treatment, and levels of stigma are very different.
“As a patient advocacy organization, the Addiction Policy Forum focuses on safety net services for patients and families nationwide and has been specifically concerned about Black patients and families in our network since the start of the pandemic. In addition to more frequent punitive approaches versus medical responses to addiction that Black patients receive, the disruption of necessary services experienced during COVID-19 shutdowns and social distancing has had a negative effect on many patients in both treatment and recovery and those with active use disorders.”
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Addiction Policy Forum Testimony Before the House Ways and Means Committee
Jessica Hulsey Presented the U.S. House of Representatives Ways and Means Committee with Recommendations for Improving Our Country’s Opioid Overdose Response
On March 2nd, Addiction Policy Forum Founder and Executive Director Jessica Hulsey spoke before the U.S. House of Representatives’ Ways and Means Committee and urged Congress to take steps to address the country’s opioid epidemic during a hearing titled Substance Use, Suicide Risk, and the American Health System.
Jessica’s testimony before the committee stressed the importance of input from individuals with substance use disorders and their families when searching for ways to end our nation’s opioid crisis, and also shared how the COVID-19 pandemic, mental health stressors, and the emergence of fentanyl have collided to increase the rate at which individuals are dying from opioid overdoses. Provisional data from the CDC shows that there were over 104,000 fatal overdoses from September 2020 through September 2021 - a staggering 285 people each day. To honor those we have lost, she shared stories written by the loved ones of five individuals who lost their lives to substance use disorder.
She highlighted several evidence-based strategies for combating opioid overdose, including addressing the 17-year research-to-practice gap, building the addiction workforce, going upstream to prevent substance use disorders through prevention, early intervention, and expansion of programs for children impacted by parental addiction.
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States Policies to Expand Access to Substance Use Disorder Treatment during COVID-19
The Prescription Drug Abuse Policy System (PDAPS) is an online resource, developed by researchers at JCOIN’s Brown University Clinical Research Center, that provides data and information on state policies and laws aimed at responding to substance use disorders, including topics related to justice-involved populations, naloxone access, medication for opioid use disorder (MOUD), prescription drug monitoring programs, and more
PDAPS has recently published datasets that capture state responses to expand access to MOUD during the COVID-19 pandemic in correctional facilities, through telehealth, and by utilizing Medicaid Waivers to remove prior authorization barriers.
The new datasets and key findings include:
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COVID-19 Mitigation Laws at State Correctional Facilities Relating to Opioid Use Disorder Treatment: Before COVID-19, 18 states had existing policies to provide MOUD in correctional facilities, and of those, eight states continued treatment during release. During the pandemic, 11 states adjusted their policies to provide MOUD during release, primarily due to the early release orders.
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COVID-19 State Medicaid Waivers for Substance Use Disorder Treatment: States can use three Medicaid Waivers to modify Medicaid programs to increase flexibility, support, and access to health care services during emergency situations. These include Section 1115 Waivers, Section 1135 Waivers, and Section 1915(c), Appendix K Modifications which allow states to remove prior authorization barriers to substance use disorder treatment and increase the availability of telehealth services. During COVID-19, 17 states adopted all three waivers, but only five states utilized the Section 1115 Waiver specifically for substance use disorder services.
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Increasing Access to Buprenorphine and Methadone During COVID-19: Throughout the pandemic, federal guidance was issued that allowed states to lessen telehealth requirements, extend take-home doses of MOUD, and co-prescribe naloxone. However, only a handful of states implemented these measures to increase MOUD availability. Six states removed in-person requirements to initiate MOUD, only two states permanently removed prior authorization, and four states extended take-home doses of MOUD during the pandemic.
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Methamphetamine Response Act (S.854) Passes the House of Representatives
The Methamphetamine Response Act passed the House of Representatives by voice vote on February 28, 2022, and is now under review by President Biden. Addiction Policy Forum endorsed this bill in 2020.
The Methamphetamine Response Act, sponsored by Senator Dianne Feinstein (D-CA) and co-sponsored by Senators Chuck Grassley (R-IA) and Joni Ernst (R-IA), requires the Office of National Drug Control Policy (ONDCP) to declare methamphetamine an emerging drug threat. This timely legislation is in response to the alarming rise in the number of overdoses related to psychostimulants, such as methamphetamine. In 2019, the number of methamphetamine-related overdose deaths rose by 27 percent, highlighting the importance of federal assistance to combat this crisis.
This legislation will help improve access to evidence-based prevention and treatment programs for those struggling with a methamphetamine use disorder.
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Social Determinants of Mental Health - Recommendations for Research, Training, Practice, and Policy
This Viewpoint published by the JAMA Network addresses the need to expand the concept of social determinants of health to include mental health and provides recommendations for research, training, and clinical practice within individual-level health care, community-level health care, and policy.
Sex Trafficking and Substance Use - Identifying High-Priority Needs Within the Criminal Justice System
In this report, researchers describe an online panel in which participants discussed how SUDs and sex trafficking complicate the identification and screening of victims and victims' ability to access treatment and legal remedies.
Overdose Prevention and Response in Community Corrections
The National Council for Mental Wellbeing, with support from the Centers for Disease Control and Prevention, conducted an environmental scan to determine how overdose prevention and response efforts are currently implemented in community corrections. This effort included a literature review, 19 key informant interviews and a roundtable discussion with a diverse group of individuals with experience in community corrections, overdose prevention or harm reduction.
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