The Latest Advocacy News

Headlines on Addiction, Treatment and Recovery Policy, curated by our Institute for Recovery Advocacy

 TOP NEWS 

Amazing, isn’t it, that there is a national holiday centered on the recovery principle of gratitude? We are grateful for many things this Thanksgiving week, with a major one the release of the first-ever Surgeon General’s report on substance use disorders!

This historic document was launched at an exciting event in Los Angeles, with our own William Moyers chairing a panel on the report, which lays out the comprehensive context of where America is and needs to go to address the public health crisis of addiction in America.

The report received quite a bit of media coverage, including this excellent piece in the New York Times that talks about the unfortunate fact that few people who need substance use treatment actually receive it.

The venue for the release of the report – Hollywood – is also significant, as noted by Jeremiah Gardner in the blog above. As he further points out in this thoughtful exposition on music star Macklemore, “thanks to the Surgeon General’s report and a growing collection of cultural influencers (like Macklemore), I think we are much closer … to winning hearts and minds.”

Our colleague Kiersten Hewitt points out the report’s notable emphasis on prevention, an oft-neglected piece of the policy puzzle. It was nice to see a significant chapter on recovery supports as well.

Now, more than ever, advocates like us need to speak out about the promise and possibility of prevention, treatment and recovery. As we think about ways we can do that, here is an inspiring look at a speaker series called the Awareness Hour that has been helping smash stigma for 40 years! It’s long, but worth a read.

And, of course, a lot has been happening on the public policy front. On Capitol Hill, the U.S. Senate reconvenes on Monday, Nov. 28, with the House back in session the next day. A spending bill to extend government funding past Dec. 9 is expected, with the likelihood high for a so-called “continuing resolution” that would fund the government through March. Besides funding, House Democrats are slated to vote on Nov. 30 to select their leaders in the next Congress. And House members say they are close to being ready to vote on a medical innovation bill known as the 21st Century Cures Act, likely in early December. That measure is expected to include mental health care reform and funding to address the opioid crisis.

Our friends at Faces & Voices of Recovery are promoting national “call-in days” today, Nov. 25, and Nov. 28, urging advocates to call Congressional members and urge $1 billion in funding to address the opioid epidemic. Look up the contact information for your House and Senate members here.

On election night Nov. 8, pro-recreational marijuana measures passed in California, Massachusetts, Nevada and Maine; Arizona is the only state that defeated it. Four other states—Florida, North Dakota, Arkansas and Montana—passed medical marijuana initiatives. That means a majority of states have now passed medical marijuana laws, while eight states and the District of Columbia have approved recreational use measures.

The new Congress will be officially sworn in early this January, and the presidential inauguration takes place Jan. 20. Republicans hold a 45-seat lead (238-194) in the U.S. House and a five-seat lead in the Senate (52-48). Much of what we will see come January remains up in the air, of course, but this article points out we might see shifting coalitions in the Senate on some issues.

With the uncertainty of change created by the election, we are monitoring a number of issues very closely. The three main ones are health care reform, opioids and marijuana. And obviously there will be major changes to federal agencies and their personnel, including at “our agencies” – ONDCP, SAMHSA, NIDA and NIAAA.

There is a lot on the plate of Congress, but one of its first orders of business is likely to be reconsideration of the Affordable Care Act (ACA). Several articles have hazarded guesses as to what might happen. Here is one, pointing out the complexity of repeal.

While all is conjecture at this point, here are a few other things we do know:

  • The ACA is not likely to continue in its present form. But as this Q&A about health care under the new president points out, the government has never undone a major benefits program after it has taken effect, and lawmakers don’t know exactly how they'll replace it.

  • Senate Democrats will likely filibuster attempts to repeal the law, requiring 60 votes to overcome their objections. Therefore, Republicans, with 52 members, would need to use fast-track budget authority (“budget reconciliation”) to make any major changes to the law – this requires only a simple majority to pass. The President-elect, once-inaugurated, also could use executive power to make some changes on his own.

  • Replacement of the law would take time, and the most effective and sustainable reforms tend to be those that are bipartisan. Sen. Lamar Alexander, chair of the Senate Health, Education, Labor and Pensions Committee, offers some interesting insights and notes that a consensus will be required.

  • Some of the ACA’s popular consumer protections will most likely remain in place, like requiring that insurers cover everyone regardless of their health, prohibiting against charging sick people higher premiums, and allowing children up to age 26 to stay on their parents’ plans (which has resulted in roughly a million people gaining coverage).

  • Repeal with no replacement would mean about 22 million Americans would lose insurance.  It’s also important to note that some 10 million people bought coverage last year through the state insurance “exchanges.”  

  • It will be important to us to maintain expanded and fair coverage for healthcare related to mental health and substance use disorders.

On opioids, the President-elect said recently he would focus on border control, law enforcement, prescription drug regulations and treatment to address this epidemic.

  • On the regulation front, he criticized regulations that “make it even harder” for individuals to receive treatment. He stated the Food and Drug Administration (FDA) needs to approve more abuse-deterrent drugs while also making the approved treatment drugs more available and less restrictive for authorized prescribers. He expressed support for increasing the cap on the number of patients a doctor can treat with medications like buprenorphine. He also called on the Drug Enforcement Administration (DEA) to reduce the amount of Schedule II opioid drugs released to the market.

  • On the treatment front, he praised passage of the Comprehensive Addiction and Recovery Act (CARA). He called for expanded incentives for states to use drug courts and said he would dramatically expand access to drug treatment; alter Medicaid policies that obstruct inpatient treatment, such as the Institutions for Mental Diseases (IMD) exclusion; and improve availability of the opioid overdose antidote Narcan to first responders.

  • A wild card that could drive action: some of the states that have been hit hardest by the opioid crisis—Pennsylvania, Kentucky, Ohio and Indiana, among others—were election battleground states and would benefit mightily from more action by the federal government.

Concerning marijuana, even with the number of states legalizing it, it is important to remember this drug remains illegal under federal law. The current Administration has chosen, for the most part, not to enforce the federal law. This could change, or not, under the new Administration—it’s entirely unclear. Some background on the topic: in 1970, Congress passed the Controlled Substances Act (CSA) as part of the Comprehensive Drug Abuse Prevention and Control Act. It created five schedules to classify substances. Marijuana was placed in Schedule I (having a high potential for abuse, no currently accepted medical use, and a lack of accepted safety for use of the drug). Schedule I classification of marijuana has not changed to this day, despite many unsuccessful legal efforts to do so.

On a separate note, while public support for marijuana legalization appears strong given the success of the state ballot initiatives, there has been some backlash. Several localities in Florida have banned retail sales, and the group “Smart Approaches to Marijuana” says it raised $1M in pledges in one day for a new Marijuana Accountability Project that promises to keep state officials and the industry accountable. In trying to ascertain what the new Administration will do on this issue, one area to look at is incoming personnel, like Attorney General nominee Senator Jeff Sessions.

Stay tuned to this space for regular updates, as we will closely monitor and speak into these and other important recovery-related issues.

The Surgeon General's Report on Alcohol, Drugs and Health

A full recording of "Facing Addiction in America: A National Summit with the Surgeon General," held in Los Angeles to amplify the release of Dr. Vivek Murthy's long-awaited, groundbreaking report on addiction. Our own William Moyers is introduced at the 2:25:20 mark.

A Tradition of Healing and Hope

The Betty Ford Center's Awareness Hour is an engaging public forum with a four-decade legacy of providing inspiration, information and education on addiction and recovery. Emulated widely across the country, the Awareness Hour has featured the best and brightest speakers in the field, providing recovery wisdom and strength to friends, family, fellow travelers, professionals, and the interested public.

Musical Activism

Popular hip hop artist Macklemore, a person in long-term recovery, has generated a lot of conversation with his new song Drug Dealer, which is a blunt takedown of Big Pharma. 

Dr. Joseph Lee Speaks at White House Symposium

The Medical Director for our Youth Continuum speaks at a White House symposium entitled "Medicine Responds to Addiction II." Among other topics, he spoke about the importance of all physicians in training getting the opportunity to see and experience the redemptive process of recovery.

The System We Need: Quality Transparency

This video, part of a series that premiered at the Kennedy Forum's 2016 State of the Union on Mental Health and Addiction, illustrates why communication between primary care physicians and behavioral health specialists is so crucial.


Opioids. In other opioid news, nurse practitioners and physician assistants can begin the 24 hours of required training to prescribe buprenorphine—a medication used in the treatment of opioid use disorders, the Department of Health and Human Services announced. More on the training and a waiver application will be available soon at www.samhsa.gov/medication-assisted-treatment.

  • Mass. General in Boston is one of the first hospitals in the U.S. to embed recovery coaches on care teams.
  • According to The Washington Post, the DEA slowed enforcement while the opioid epidemic grew out of control.

  • A publication called Stateline features another article on the rising number of grandparents raising children due to parental opioid addiction.
  • The Centers for Medicare and Medicaid Services (CMS) announced the removal of the Pain Management dimension of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Questions regarding how patients’ pain was treated in the hospital remain part of the survey; however, their answers no longer have an impact on the hospital’s funding. Learn more about the Prospective Payment System changes here

Marijuana. Several states voted on legalized marijuana in this election. Before they did, Colorado’s governor John Hickenlooper urged caution based on his state’s experience and the lack of complete data on the consequences.

  • Cannabis use is a possible cause of psychosis.

  • And Kierstin Hewitt of our FCD prevention arm wrote this excellent op-ed in response to marijuana legalization in Massachusetts.

Legal reforms. President Obama grants clemency to 79 federal drug offenders, the Washington Post reports.

Recovery. Financial incentives prove effective in motivating patients to participate in recovery steps.

Parity. The current White House reports the Federal Parity Task Force is working to strengthen insurance coverage for substance use and mental health disorders. Our Institute for Recovery Advocacy recently signed on to a letter supporting the task force’s recommendations and urging additional actions.

  • The dean of health care reporters, Robert Pear of the New York Times, on parity.


 OTHER NEWS IN THE STATES 

Minnesota. A new report issued by Attorney General Lori Swanson makes a series of recommendations to address the opioid epidemic, including requiring doctors to review patients’ drug histories before prescribing opioids, reducing the duration of controlled substance prescriptions, and expanding access to drug treatment and emergency naloxone medication (aka Narcan) that can be administered to reverse the effects of an overdose.

  • The Star Tribune reports that municipal liquor outlets experienced a $3 million plunge in revenue last year.  

California. Interesting question – could legalizing pot here diminish the state’s gains against smoking?

Illinois. TASC announced that The Chicago Reporter and John Kaul Greene will receive its 2016 Leadership Awards.

  • Chicago will require pharmaceutical sales representatives to be licensed in an effort to cut down on the overprescribing of opioids. The city plans to use more than $1 million in licensing revenue to cover the cost of regulation and for educating doctors and others about opioids.

Oregon. The DEA wants an appeals court to overturn a judge's ruling that requires federal agents to get a search warrant to access information in an Oregon prescription database that tracks doctors and the narcotics they prescribe to patients.

Pennsylvania. State lawmakers in Pennsylvania passed legislation to help control opioid prescription and abuse.

New York. Gov. Andrew Cuomo announced funding for four clubhouses to help prevent addiction in students and support those in recovery

 MISCELLANEOUS MUSINGS 

  • We’ll be exhibiting at an upcoming event in Minneapolis called Dissonance Presents: Unhappy Holidays. The event will feature three professional creative people performing and discussing how to cope in a healthy way when what’s supposed to be the most wonderful time of the year is not. Our own David Campbell moderates.
  • Great piece about the recovery journey of a University of Oklahoma student, including a personal offer from him to help others on his campus!
  • The Vatican hosted a conference this week called "Workshop on Narcotics: Problems and Solutions of this Global Issue." Smart Approaches to Marijuana President Kevin Sabet, PhD, will address the Pontifical Academy on the subject of "The Social Impact of Drug Policy Change." Other U.S. representatives include Prof. Jeffrey Sachs, Dr. Nora Volkow, Dr. Robert DuPont, Dr. Jon Caulkins and Dr. Bertha Madras.
  • CNN reports on new mobile apps designed to help with a variety of mental health issues.
  • Listen to NPR’s The Pulse conversation with Hazelden Publishing author Dr. James Prochaska, author of Changing to Thrive, about how and why change for the better is possible.
  • A therapist talks about finding unexpected approaches to helping hurting people help themselves.
  • Watch this short video about why communication between primary care physicians and behavioral health specialists is so crucial for patients.
  • And finally, students at one Canadian college smashed pumpkins this past Halloween to symbolize smashing the stigma of mental illness


If you have questions or thoughts on the items above or on any other matters, please contact Dean Peterson at 651.213.4568 or dppeterson@hazeldenbettyford.org. If this was forwarded to you and you’d like to subscribe, you can do so here.

For those on Twitter, please follow us at @HBFinstitute for timely updates! And be sure to subscribe to us on Youtube, where we’re always adding new stigma-busting, policy-shaping educational videos.

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Macklemore Drug Dealer Song

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