The Big News

In Tennessee, a group is teaching kids as young as 6 how to administer Narcan, a nasal-spray medicine that can reverse an opioid overdose: “It’s just like a little squirt gun.” This story is generating a range of mixed reactions. One thought: if children are learning how to save a parent’s life, they should also probably get age-specific counseling and ongoing support. What are your thoughts on this?

Lawyers involved with the thousands of opioid lawsuits nationwide say they would like to reach a national agreement before the start of a New York trial next month. But the harsh reality emerging on all sides is that the payout from opioid companies probably won’t be as big as hoped—likely less than half of what Big Tobacco companies agreed to pay more than 20 years ago in a landmark settlement over costs associated with smoking-related deaths.

A new article in the New England Journal of Medicine provides an efficient, effective and objective public-health analysis of the youth vaping epidemic, the related severe-lung-illness epidemic, and changing attitudes, patterns and laws related to marijuana use. Of note, and an important consideration for policymakers: “The impact of these trends on public health has received minimal research attention to date.”

Meth is resurging and casting a dark shadow once again. Did you know it also played a sinister role in the Nazi war machine?

Wisconsin lawmakers are considering legislation to keep bars open until 4 a.m. from July 13-16, when 50,000 people are expected to visit the state for the Democratic National Convention in Milwaukee. “Let's show these people a good time — not only in Milwaukee but all over Wisconsin,” said the bill’s author. The state Assembly approved the idea last week, limiting the last-call extension to 14 counties, rather than statewide, in hopes of attracting more support from skeptical senators. In a letter to the editor, our own Nick Motu argued that public health and safety should be a higher priority than any economic jolt that may result from allowing bars to serve alcohol into the wee hours of the morning. Seeing bipartisan legislative time invested in such an effort, while policymakers nationwide simultaneously wrestle with the worst addiction crisis in American history—including, specifically, rising rates of alcohol-related deaths—gives us pause. It’s perhaps a sign that more advocacy is needed to help policymakers see the connections between opioid, alcohol, meth, marijuana, vaping and all substance use-related public health issues, and how they intersect with mental health issues as well.

This week’s featured media is the latest episode in our award-winning Let’s Talk podcast series. It is also relevant to our top story above, with host William C. Moyers talking to children’s advocate and clinician Jerry Moe about Sesame Street's newest Muppet, Karli, and other resources to help kids heal from the hurt of addiction. Watch, read or listen.

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Treatment Industry Issues and Reforms

We are among those encouraging Congress to support the expansion of telepsychiatry and to remove barriers to care for patients in remote and underserved areas. Learn more →

An analysis of residential treatment admissions nationwide says too few facilities are offering medications as part of their treatment for opioid use disorder. We began using medications in combination with psychosocial therapies and peer support in 2012, developing a comprehensive approach that has proven effective and challenged stigmas against both medications on the one extreme and Twelve Step peer support on the other extreme. We continue to consult others on the approach through our Professional Education Solutions team. 

Interesting Q&A about the emerging role of AI in behavioral healthcare and addiction treatment.

An advocate blames Philadelphia’s addiction-treatment smoking ban for his friend’s recent death.

For specialty addiction treatment providers (and the patients and families they serve), what does it mean to be a Center of Excellence (CoE)? Our own Pablo McCabe contributes to a discussion about the increasing role of CoE’s in health plan contracting.

ONDCP Director James Carroll will testify Thursday at a House Oversight and Reform Committee hearing about the recently released 2020 National Drug Control Strategy.

Cannabis

A reporter writes: “It’s an open secret in the California marijuana industry that since the state launched licensed adult-use sales in 2018, many—if not most—legal operators have done business illegally to some degree.” Learn more →

In Massachusetts, police leaders say they are unsure of their role when it comes to unlicensed marijuana sellers.

Although medical cannabis is legal in Missouri and any doctor licensed in Missouri can certify patients for use, the region’s physicians don’t agree on whether certifying patients is safe, legal or ethical.

The New York Daily News editorial board is supporting cannabis legalization on primarily economic and regulatory grounds, while our friends at Smart Approaches to Marijuana make the case against it, arguing that decriminalization without commercialization addresses disparities and is ultimately better for public health.

Frequent users of marijuana showed a greater tendency toward high risk-taking than non-users in a study conducted at Oregon State.

A spike in the number of job applicants disqualified by California state agencies after failing tests for marijuana use has spawned calls for new legislation and debate over whether employment rules should be relaxed.

Massachusetts Gov. Charlie Baker’s bill seeking to crack down on stoned driving has failed.

Opioids

At a Walgreens in Massachusetts, a pharmacy worker allegedly refused to give Narcan to a man who was overdosing in the store, due to the medicine’s cost. Learn more →

The CDC has identified 220 counties as being at risk of drug-fueled HIV outbreaks, but less than a third of them have working syringe exchanges.

Roughly one in four opioid poisonings involve children and adolescents, and such poisonings have become more severe and life-threatening in recent years, according to a large analysis conducted by Emory University researchers. With half of those poisonings due to accidental injestions and youth exposure to medication often the result of parents carrying loose pills, it’s a stark reminder to always store and dispose of unused opioids safely.

About half of the opioid prescriptions written by dentists in the United States exceed the three-day supply recommended by the CDC.

James thought he was going to jail when he got arrested buying heroin last summer. He remembers his astonishment when the officer told him: “You don’t look like the type who belongs here. I am going to do you a favor and park your truck legally and not tow it. There’s a program at the station, and when you get there, just say you want treatment.” James is one of more than 250 people who have agreed to participate in the Chicago Police Department’s “narcotics arrest diversion program,” which was launched in 2018 and is expanding in 2020.

Tom Vilsack, a former Iowa governor and U.S agriculture secretary, will monitor Purdue Pharma as part of its federal bankruptcy proceedings to ensure the OxyContin maker does not revive an aggressive marketing effort. Vilsack worked on rural opioid issues as agriculture secretary under former President Barack Obama.

Forbes looks at the opioid crisis and its financial impact on black Americans.

In a Q&A with MedPage Today, AMA President Patrice Harris, MD, discusses diversity, belonging, and addressing the opioid crisis.

A prevention expert says one key to ending the opioid crisis may be to invest in preventing mental health disorders.

The federal government is investigating how marketers may be obtaining seniors' personal Medicare information.

Diaries show the disastrous extent of the Anne of Green Gables author’s addiction to prescription drugs, as well as parallels to our modern-day opioid crisis.

Listen as a homeless camp comes together to save the life of someone overdosing.

Reminder: the deadline for Americans affected by the opioid crisis to file individual claims against Purdue Pharma is June 30.

Alcohol Shopping centers, malls and major chains such as Nordstrom are increasingly allowing—even encouraging—customers to drink alcohol while they browse in hopes they stay longer and spend more freely.

“I don’t know why it took us so long to put drinking and shoes together, but it’s a great combination,” said one executive. Learn more →

Doctors are seeing more people in their 20s and 30s with symptoms of acute liver disease related to alcohol consumption.

We have shared recently about new research showing a significant rise in alcohol-related mortality in the U.S., with deaths rising fastest among women. JAMA (the Journal of the American Medical Association) published the research on Friday as a free, open-source article, along with an audio discussion between two editors (start listening at the 5:50 mark) and commentaries on the trends for American Indians and Alaska Natives as well as African Americans.

Researchers are studying Canada’s Managed Alcohol Programs, sometimes known as “wet shelters.”

Health Care Reform and Parity

The National Academy for State Health Policy is tracking governors’ 2020 State-of-the-State addresses and has compiled interesting data on their references to health care. Mental health and addiction issues have been the most frequently mentioned issues so far. Learn more →

The National Council for Behavioral Health created a new toolkit for providers handling potential parity violations and the resulting appeals process.

A county in rural Kansas is jailing people over unpaid medical debt.

Unions across the country are at odds over Medicare for All.

In a recent monologue, John Oliver makes a case for Medicare for All.

An estimated 50 million Americans have donated to crowdfunding campaigns to help others pay for medical bills, according to a new study.

Six in 10 Nevada caucus-goers supported replacing private insurance with a single government plan for everyone.

Insurer-owned clinics are increasingly competing with hospitals and physicians for patients.

One in four rural hospitals is vulnerable to closure, a new report finds.

Advocate Spotlight In Ben Affleck’s new movie, “The Way Back,” his character’s struggles with alcohol mirror his own. Sober again, Affleck says: “One of the things about recovery that I think people sometimes overlook is the fact that it inculcates certain values. Be honest. Be accountable. Help other people. Apologize when you’re wrong.” Learn more →

Reality TV continues to be a venue for recovery advocacy. On last night’s American Idol, contestant Hannah Prestridge earned a ticket to Hollywood for her performance and congratulations for overcoming her opioid use disorder.

After years of addiction and prison time, Roy Kearse turned his life around with the power of poetry as a vital tool of physical and spiritual recovery.

Jenna Bush Hager recalled a conversation about alcohol in her early 20s that she had with her father, former President George W. Bush, that has stayed with her now that she is a parent herself.

Greg Smith, chair of the Husch Blackwell law firm, described his struggles with alcoholism at a recent partner retreat in an effort to bring others grappling with addiction and mental illness out of the shadows.

The “Fittest Man on Earth”—crossfit champion Mat Fraser—says sobriety is part of his ongoing mission to keep improving.

A doctor in recovery writes about the need for advocacy in his profession.

A sober-chef support group is partnering with the Alano Club of Portland for a series of free cooking classes for people in or seeking recovery, covering everything from grocery budgeting to meal planning.

On Friday, we’ll be supporting Minnesota Recovery Connection’s annual Recovery Advocacy Seminar by moderating a discussion with a new generation of advocates.

Celebrities are talking more about mental health and recovery, and it’s helping.

Miscellaneous Musings Watch or set your DVR to record episode three in the docuseries “What’s Eating America?”—from celebrity chef Andrew Zimmern—this Sunday, March 1.

The topic is addiction and recovery, and the show will include scenes with our own William C. Moyers at Day by Day Café and Hazelden Betty Ford in St. Paul. Learn more →

• Some 59% of Americans said in a national survey that they do not believe e-cigarette companies are working to “be part of the solution to reduce the health effects of smoking.”
• Massachusetts Attorney General Maura Healey is continuing her fight against vape-maker JUUL, alleging in a new lawsuit that documents obtained through an investigation prove the company intentionally targeted minors with advertising.
• When patients need weeks or months of IV antibiotic treatment, but otherwise don't need to be hospitalized, the standard protocol is to discharge them with a PICC line, and allow them to finish the medication at home. It saves money and is more convenient. But this arrangement is almost never offered to patients who have a known history of addiction, for fear they may be tempted to inject drugs like heroin, cocaine or meth through the PICC line. Here’s why some hospitals are challenging that thinking and allowing some patients to go home with a PICC line anyway.
• A new survey suggests problems of depression, anxiety and substance use disorder among lawyers and other legal professionals may be worse than realized. At the same time, more may be open to addressing those long-stigmatized conditions.
• North Dakota is close to supporting the development of Peer Support Specialists. Draft administrative rules for certification are available for public comment now through April 6.
• At one time, believe it or not, pinball machines were considered a form of gambling and illegal in many major cities. Check out this interesting photo of police confiscating a pinball machine from a Minneapolis beer parlor in 1954. The owner was charged with “maintaining a gambling device.”
• The good news continues: coffee is pretty good for us, though the kind and quantity matter.
• The FDA’s new “Every Try Counts” campaign reaches out to people who have tried to quit smoking and encourages them to “never quit quitting.”
• A Massachusetts state legislator has been arraigned on two dozen fraud charges that prosecutors say are connected to a gambling problem.
• You don’t see this too often … The Journal of the American Heart Association retracted a paper tying vaping to heart attacks.
• The latest from the CDC on vaping-related severe lung injuries: 2,758 reported cases and 64 deaths.
• William White remains on a break from his blog, so this week we simply encourage you to browse WilliamWhitePapers.com.
• Thank you for reading. What do you think? Send us a note anytime, and have a great week!