Substance Abuse Newsletter January 2018

The following is a compendium of news reports over the past month that may be of interest to our AG offices who are dealing with substance abuse issues. Neither the National Association of Attorneys General nor the National Attorneys General Training & Research Institute expresses a view as to the accuracy of news accounts, nor as to the position expounded by the authors of the hyperlinked articles.

Opioids

Attorney General Jeff Sessions announced that the Department of Justice has created a new senior level position - Director of Opioid Enforcement and Prevention Efforts (Director). The Director will be responsible for assisting the Attorney General, Deputy Attorney General, and Department components in formulating and implementing department initiatives, policies, grants, and programs relating to opioids, and coordinating these efforts with law enforcement.

The Drug Enforcement Administration (DEA) announced that China’s Ministry of Public Security announced scheduling controls on two fentanyl precursor chemicals – NPP and 4ANPP, substances that can be used to make illicit drugs. The scheduling controls will take effect on February 1, 2018 and is the result of the ongoing collaboration between the DEA and the Government of China and their shared commitment to countering illicit fentanyl-class substances. The Chinese Government previously controlled four fentanyl-class substances – carfentanil, furanyl fentanyl, valeryl fentanyl, and acryl fentanyl – which took effect on March 1, 2017, and another four new psychoactive substances/fentanyl-class substances - U-47700, MT-45, PMMA, and 4,4’ DMAR – which took effect on July 1, 2017.

The Center for Disease Control (CDC) has issued a letter to clarify its Guideline for Prescribing Opioids for Chronic Pain--2016 (Guideline). The letter stated that “the dosage thresholds in the Guideline were not meant to and should not apply to dosing of opioid agonists/partial agonists used for the treatment of opioid use disorder. “ The full letter describing the clarification may be accessed here.

West Virginia Attorney General Patrick Morrisey will travel to Logan County to continue a faith-based initiative titled “Combating Addiction with Grace” which is aimed at empowering religious groups across the Mountain State in the fight against substance abuse. It follows successful conferences already held in Martinsburg, Parkersburg, Fairmont, Wheeling, and Beckley. The initiative connects faith leaders with law enforcement, first responders, and residential treatment and local substance abuse groups, among others. Attendees will receive resources to help those suffering from opioid abuse and addiction, while expanding their understanding of the statewide impact. The goal is to form an action plan which includes ideas of how to combat the drug epidemic in each community represented.

Netflix has released a 39-minute documentary titled “Heroin (e)” which chronicles the activities of three women, a judge, a fire chief, and a worker with Brown Bag Ministries, who are doing their part to combat the opioid crisis in the Huntington, West Virginia, area.

Medical/Marijuana/Synthetics

For the first time, a U.S. state has legalized marijuana with the stroke of a pen, not a vote at the ballot box. Vermont Gov. Phil Scott signed into law HB 511, which legalizes the possession of up to one ounce of cannabis and removes penalties for possession of up to two mature marijuana plants and up to four immature plants. The legislation says nothing about creating a state market for recreational marijuana. The new law will go into effect in July 2018. Vermont legalized medical marijuana in 2004 and is currently among nearly 30 states, plus the territories of Guam and Puerto Rico and the District of Columbia, with such programs in place.

The Department of Veterans Affairs; Veterans Health Administration has issued VHA DIRECTIVE 1315 titled ”Access to VHA Clinical Programs for Veterans Participating in State-Approved Marijuana Programs” which provides policy on access to VHA clinical programs for veterans participating in a state-approved marijuana program. The directive may be accessed here.

New York Attorney General Eric T. Schneiderman announced that a consent order and judgment has been entered in his contempt case against Kenneth Wayne Hamm, who owns and operates a head shop in Watertown, NY called Trip on the Wild Side II. The Attorney General brought a contempt case against the business in August 2017 after discovering that the business was unlawfully selling mislabeled and misbranded drugs in violation of a 2012 court order that explicitly prohibited such illegal sales. This settlement specifies that Trip on the Wild Side II is further barred from selling misbranded and mislabeled kratom and Cannabidiol (CBD). Additionally, the company must pay a penalty of $10,000 to the state and turn over to the Attorney General’s office all revenue from the sales of those drugs, $1,838.

PDMP

Georgia’s recently enacted legislation (HB 249) now requires anyone able to write a prescription for opioids in the state to register with the PDMP program. Failing to sign up for the PDMP, or maintain records, could mean losing a medical license. "They're not going to be held criminally responsible for this, but the Georgia State Board will be the ones responsible for administratively dealing with physicians that don't follow the letter of the law," stated Dr. David Gaskin, a practicing physician in Savannah. "We'll have to query this PDMP every time we write narcotics, or people on chronic medications for pain," Gaskin said. "We'll have to query it every 90 days. The patients will be quite aware of us doing this. And they will also be signing a form for us to know that they're coming to us only and not going to any other physicians. It's a patient pain medication agreement."

Other

SAMHSA announced it has appointed Christopher M. Jones, PharmD, M.P.H. as its first Director of the National Mental Health and Substance Use Policy Laboratory. The Policy Lab was created as part of the 21st Century Cures Act and promotes innovation and the dissemination and adoption of evidence-based practices and service delivery models related to mental health and substance use, including through the evaluation of models that would benefit from further development and through expanding, replicating, or scaling evidence-based programs, policies, and practices. Prior to joining SAMHSA, Dr. Jones served as Acting Associate Deputy Assistant Secretary for Science and Data Policy and Director of the Division of Science Policy in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services (HHS).

The Center for Disease Control has released its Mortality in the United States, 2016 report. This report presents final 2016 U.S. mortality data on deaths and death rates by demographic and medical characteristics. These data provide information on mortality patterns among U.S. residents by variables such as sex, race and ethnicity, and cause of death. Life expectancy estimates, age-specific death rates, age-adjusted death rates by race and ethnicity and sex, the 10 leading causes of death, and 10 leading causes of infant death were analyzed by comparing 2016 and 2015 final data.

The Institute for the Advancement of Behavioral Healthcare has announced it will host a National Cocaine, Meth & Stimulant Summit on November 12-14, 2018 in Ft. Lauderdale, Florida. The Institute engages 200,000+ professionals in the addiction treatment and behavioral healthcare community. The Stimulant Summit is a sister conference to the country’s largest annual gathering on the opioid crisis, the National Rx Drug Abuse & Heroin Summit. For more details, contact Judi Beshella at jbeshella@iabhc.com

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, recently published a new report which states the rate of alcohol-related visits to U.S. emergency departments (ED) increased by nearly 50 percent between 2006 and 2014, especially among females and drinkers who are middle-aged or older. “In just nine years, the number of people transported to the ED annually for medical emergencies caused or exacerbated by alcohol increased from about 3 million to 5 million,” said NIAAA Director George F. Koob, Ph.D. “These findings are indicative of the detrimental effects that acute and chronic alcohol misuse have on public health, and the significant burden they place on our healthcare system.” The study findings are available online in the journal Alcoholism: Clinical and Experimental Research.


Joanne Thomka is the Editor of Substance Abuse News and may be reached at 202-326-6269. Substance Abuse News is a publication of the National Association of Attorneys General. Any use and/or copies of this newsletter in whole or part must include the customary bibliographic citation. NAAG retains copyright and all other intellectual property rights in the material presented in this publication. For content submissions or to contact the editor directly, please e-mail jthomka@naag.org.

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