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CEO Update | 23

Senate Expected to Vote on Opioid Package Next Week The Senate has agreed on a bipartisan opioids package to address the nation’s public health crisis, according to Senate Majority Leader Mitch McConnell’s (R-Ky.) office this week. Sen. Rob Portman (R-Ohio)—whose opioid-related bills are included in the package—said in a statement that a Senate floor vote is likely next week. The Senate package is similar in scope to the SUPPORT for Patients and Communities Act, or H.R. 6, which the House passed in June and includes many provisions that NABH supports. The Senate version includes new funding for states for a variety of opioid-related issues and would provide $500 million a year through the year 2021 to address substance use disorder (SUD) through grants that the 21st Century Cures Act established. The Senate’s legislation would also provide expanded access to MAT; increase the use of telemedicine for SUD; allow the CMS Innovation Center to test incentive payments for providers to adopt behavioral health electronic health records; and reauthorize the Office of National Drug Control Policy (ONDCP). This opioid package does not include NABH-supported initiatives on the Institutions for Mental Diseases (IMD) exclusion and reforms to 42 CFR Part 2, both of which the House has passed. After the Senate passes its legislative package, the House and Senate will settle differences between their respective bills through a conference committee. NABH staff will continue to consult with House and Senate leaders and their staff to address NABH’s interests throughout the conference committee process.   GAO Examines How Federal Agencies Use Grants to Address Adolescent and Young Adult Substance Use A new Government Accountability Office (GAO) study has found there are too few studies about drug addiction treatment for adolescents, too few providers to treat these patients, and too few services to sustain their recovery. The study examined how federal agencies, through grants, are addressing substance use prevention, treatment, and recovery among adolescents and young adults. According to the study, about 16 percent of adolescents and 38 percent of young adults used illicit substances in 2016, and most young adults who develop substance use disorders start using during adolescence. GAO researchers interviewed officials from four federal agencies—HHS, ONDCP, the Justice Department, and the Education Department—and 20 stakeholder groups (including advocacy groups, research organizations, and state agencies) about gaps in services or research, and agency efforts to address them. GAO identified 12 federal grant programs within three federal agencies that funded substance use prevention, treatment, and recovery services in 2017 and targeted adolescents’ and young adults’ use of illicit substances such as marijuana and non-medical use of prescription opioids. HHS’ National Institute on Drug Abuse (NIDA), the agency that is the primary funder of research on illicit substance use, had 186 active grant-funded research projects that received a total of about $61 million from NIDA in 2017. “There are federal grants that fund drug addiction treatment for adolescents and young adults,” the GAO noted in a brief summary of the report. “But most of the stakeholders we talked to believed that there are too few studies about drug addiction treatment for adolescents, too few providers to treat these patients, and too few services to sustain their recovery.” NIH Study Finds Daily Use of Marijuana Among Non-College Students at All-Time High Daily, or near daily, marijuana use among non-college young adults has reached its highest level, according to the Monitoring the Future (MTF) survey results released this week from NIDA at the National Institutes of Health (NIH). As a result, daily, or near daily, marijuana use is now nearly three times as high among non-college young adults as among college students. In 2017—for the first time— the MTF included questions about vaping marijuana. According to the results, past month use appears to be higher among non-college young adults than amount college students (7.8 percent versus 5.2 percent). More data and an infographic are available on NIDA’s College-Age & Young Adults webpage, which also includes links to statistics and trends, and a list of more than 400 college programs in addiction science, information about the Addiction Medicine Subspecialty, and other materials, including a toolkit for those hosting events during National Drug & Alcohol Facts Week ® early next year. Separately this week, a study published in Nature Neuroscience found that some of the same genes associated with the use of cannabis are also associated with certain personality types and psychiatric conditions.   The Lancet Study Finds Alcohol Use a Leading Risk Factor for Global Disease Burden Alcohol use is a leading risk factor for global disease burden and causes substantial health loss, according to results in the The Lancet’s Global Burden of Diseases, Injuries, and Risk Factors Study 2016. Researchers found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimizes health loss is zero. “These results suggest that alcohol control policies might need to be revised worldwide,” the study noted, “refocusing on efforts to lower overall population-level consumption.” Duke-Margolis Center for Health Policy Workshop Will Explore Therapies to Treat OUD The Duke-Margolis Center for Health Policy will host a workshop at the National Press Club in Washington next week to generate a discussion with providers and stakeholders about therapies to treat opioid use disorder (OUD). Sarah Wattenberg, NABH’s director of quality and addiction services, will present at that the workshop, which will also examine current barriers to using these medications appropriately and opportunities to further reduce stigma and expand access to effective pharmacotherapies as part of an evidence-based approach to OUD treatment. The U.S. Food and Drug Administration’s Center for Drug Evaluation and Research provided funding for this workshop, and Janet Woodcock, M.D., the center’s director, will serve as the workshop’s first speaker.   Save the Date for the NABH 2019 Annual Meeting! Please save the date and plan to join us at the Mandarin Oriental Washington, D.C. fromMarch 18-20, 2019 for the 2019 NABH Annual Meeting. NABH will provide additional information in upcoming editions of CEO Update. For questions or comments about CEO Update, please contact Jessica Zigmond.