Join us TODAY! CEPOP and MAPDA Launches Pandemic – Epidemic Webinar Series

At 3:00pm ET today, CEPOP and MAPDA will launch their webinar series set to address the confluence of the COVID-19 pandemic and opioid epidemic, covering policy and practice changes to date and implications on care for individuals with acute or chronic pain and substance use disorders. Following recent data from the Centers for Disease Control and Prevention that demonstrates a 4.7% uptick in drug overdose deaths in 2019, a coordinated national response to these pressing public health issues remains critical.

Today’s webinar will focus on the role of digital health and telemedicine in providing new  and more efficient methods of care coordination at a time when quarantines and self-isolation make for more difficult office-based treatment and care.

It’s not too late to register. For additional information or to register for the series, please visit the event page.

The forthcoming webinars will focus on the following topics:

Monday, July 20th (3:00pm – 4:00pm): Digital Health Interventions and Telemedicine
During the COVID-19 pandemic, new or revised authorities and technologies are being leveraged to help ensure continuity and availability of evidence-based care for the treatment of pain and substance use disorders. How is this being implemented throughout the nation? Today, you’ll hear from:

  • Randy Pate, JD, MPH,  Deputy Administrator and Director, Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services
  • Jeffrey Gudin, MD, Co-Editor-at-Large, Practical Pain Management
  • Samantha Holcombe, MPH, Senior Director, Practice Improvement and Consulting, National Council for Behavioral Health
  • Tania Malik, JD, Immediate-Past Chair, Special Interest Group on Telemental Health, American Telemedicine Association
  • Moderated by: Rich Hamburg, MPA, Executive Director, Safe States Alliance

Monday, July 27th (3:30pm – 4:30pm): Policy Changes to Medication-Assisted Treatment
To address stay-at-home and self-isolation policies, federal regulators have expanded take-home opportunities for MAT prescriptions as well as initiation of new treatment modalities. This webinar will explore the new framework and its active integration into the current care paradigm. Confirmed speakers for this session include:

  • The Honorable Paul Tonko (NY-20), U.S. House of Representatives
  • Claire Brennan, Section Chief, Liaison Section, and Anastasia Martin, Staff Coordinator, Policy Section, Diversion Control Division, Drug Enforcement Administration
  • Yuri Maricich, MD, MBA, Chief Medical Officer, Pear Therapeutics
  • Mark Parrino, MPA, President, American Association for the Treatment of Opioid Dependence
  • Samantha Arsenault, MA, Vice President, National Treatment Quality Initiatives, Shatterproof
  • Moderated by: Van Ingram, Executive Director, Kentucky Office of Drug Control Policy

Monday, August 10th (3:00pm – 4:00pm): Addressing Access and Utilization of Opioid Overdose Reversal Medications
Recognizing the changes in prescribing policy and availability for prescription opioids and medication-assisted treatment, there remains an increasingly important need for access to overdose reversal medications. The panel will discuss options for improving this condition and preventing unnecessary overdoses.

Monday, August 17th (3:00pm – 4:00pm): Addressing Excess Medications in the Home
With the primary point of care now being in the home, additional considerations should be given to addressing and mitigating the risk of excess controlled substances. How do SUPPORT Act and other authorities enable this element of the response?

Please reach out to Matt Rubin with any questions, follow-up or series speaker suggestions!

CDC Surveillance Finds 4.8% Increase in Drug Overdose Deaths, Erasing 2018 Gains

This week, the Centers for Disease Control and Prevention’s National Vital Statistics System released provisional drug overdose data for 2019, which largely indicates a resurgence of deaths to record highs nearing 72,000. While deaths related to prescription opioids and heroin have plateaued and dipped slightly since a peak in 2017, the United States has evidenced a precipitous rise in overdose deaths associated with synthetic opioids such as fentanyl as well as other illicit drugs like methamphetamine and cocaine.

What is most worrisome about this data is the complete erasure of the advances made in 2018 to reduce drug overdose deaths – a reduction by approximately 4.5% – prior to the declaration of a public health emergency for the COVID-19 pandemic. In the first quarter of this year alone, as the nation copes with the impacts of the COVID-19 pandemic and opioid epidemic, federal data indicates a double-digit percentage increase in drug overdose deaths.

Articles & Resources

CDC National Vital Statistics System – Provision Drug Overdose Death Counts (as of July 5, 2020)

New York Times – In Shadow of Pandemic, U.S. Drug Overdose Deaths Resurge to Record

POLITICO – Fatal Overdoses Climbed to Record High in 2019, Reversing Historic Progress

HHS Releases Final SUD Patient Record Confidentiality Rule

On Monday, the Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration (SAMHSA) released a final rule that addressed a longstanding policy priority for many patient and healthcare provider advocates in the addiction community in revising 42 CFR Part 2 and allowing for better integration of substance use disorder information into clinical practice. Further aligning substance use disorder patient records with that of the Health Insurance Portability and Accessibility Act (HIPAA), patients will now be able to better facilitate and coordinate care among a complex healthcare system while maintaining all necessary and available confidentiality protections under the law and efforts to discourage unauthorized disclosure or use of such information.

SAMHSA head, Dr. Elinore McCance-Katz, noted “The adoption of this rule means Americans will be better able to receive integrated and coordinated care in the treatment of their substance use disorders…Modernizing 42 CFR Part 2 will strengthen the nation’s efforts to reduce opioid misuse and abuse and to support patients and their families confronting substance use disorders. The rule will make it easier for primary care clinicians to treat individuals with substance use disorders.” Dr. McCance-Katz continued saying that, “We must do all we can to ensure the greatest access and availability to care for individuals living with substance use disorders. Although well-intentioned, the non-disclosure of critical, lifesaving information the previous rule permitted is itself stigmatizing.”

The final rule goes into effect as of August 14, 2020.

Articles & Resources

Federal Register – Confidentiality of Substance Use Disorder Patient Records

HHS Newsroom – Health Privacy Rule 42 CFR Part 2 Is Revised, Modernizing Care Coordination for Americans Seeking Treatment for Substance Use Disorders

HHS Newsroom – Fact Sheet: SAMHSA 42 CFR Part 2 Revised Rule

CDC Data Analysis Surveys Opioid Use by Pregnant Women

In the most recent Morbidity and Mortality Weekly Report issued by the Centers for Disease Control and Prevention, researchers outline the findings associated with self-reported opioid use during pregnancy. Utilizing the 2019 dataset within the Pregnancy Risk Assessment Monitoring System (PRAMS) across 32 jurisdictions, the research analyzed findings from more than 21,000 respondents finding that 1,405 (6.6%) had reported prescription opioid use during pregnancy. Within those that have identified previous prescription opioid use:

  • 91.3% received opioid from a healthcare provider and 8.9% from alternate sources.
  • 88.8% reported use due to acute and chronic pain.
  • More than 1-in-5 indicated prescription opioid misuse during pregnancy (21.2%) and more than a quarter (27.1%) indicating a desire to cut down or cease opioid use.
  • Nearly 32% noted that they did not receive counseling or additional information around opioid use and potential affects on an infant from a healthcare provider.

Articles & Resources

CDC Morbidity and Mortality Weekly Report – Vital Signs: Prescription Opioid Pain Reliever Use During Pregnancy — 34 U.S. Jurisdictions, 2019

What We Read Last Week

Several articles were published last week pertaining to the opioid epidemic, covering a variety of different components of the issue. Links to relevant articles are provided below.

Articles & Resources

STAT News – Opioid Overdoses Have Skyrocketed Amid the Coronavirus, But States Are Nevertheless Slashing Addiction Treatment Program Budgets

NPR – Doctors And Dentists Still Flooding U.S. With Opioid Prescriptions

Journal of the American Medical Association – Association of State Policies Allowing Medical Cannabis for Opioid Use Disorder With Dispensary Marketing for This Indication

WBUR – 29% of Mass. Nursing Homes Refused Patients Who’ve Used Opioid, Study Finds

American Journal of Managed Care – The Escalation of the Opioid Epidemic Due to COVID-19 and Resulting Lessons About Treatment Alternatives

JAMA Psychiatry – Comparison of Driving Times to Opioid Treatment Programs and Pharmacies in the US

JAMA Psychiatry – Methadone for Opioid Use Disorder—Decades of Effectiveness but Still Miles Away in the US

JAMA Pediatrics – Association of State-Level Opioid-Reduction Policies with Pediatric Opioid Poisoning

ProPublica – Opioid Overdoses Keep Surging in Chicago, Killing Black People on the West Side

FDA Newsroom – Darknet Vendor and Pharmacist Plead Guilty to Firebomb Attack Plot

HHS Office of Inspector General – Ohio Did Not Ensure the Accuracy and Completeness of Psychotropic and Opioid Medication Information Recorded in Its Child Welfare Information System for Children in Foster Care

U.S. Attorney for the Western District of Louisiana – Former VA Pharmacist to Serve Time in Federal Prison for Stealing Controlled Drugs from Veterans’ Prescriptions

U.S. Attorney for the Western District of Michigan – Traverse City Physician Assistant Surrenders DEA Registration and Agrees to Life-Time Ban on Prescribing Controlled Substances

This Week’s Calendar

The House and Senate are set to return to Washington this week for a series of breakneck discussions headed in the August recess. Both chambers plan to begin discussions around Phase 5 of a COVID-19  relief package as well as continue dialogue around FY21 appropriations and reauthorization of the NDAA. Beyond those efforts, there are no relevant hearings or markups scheduled at this time. In the instance that there are any changes to the schedule for this week, we will make additional information available.

  • CDC Board of Scientific Counselors – National Center for Injury Prevention and Control
    Thirty-Third Meeting of the Opioid Work Group
    Wednesday, July 22, 10:00am, (800) 369-3110 // 7563795
  • Affiliated Monitors, Inc. (a CEPOP Participant)
    Navigating the Risks of Prescribing Opioids for Chronic Pain in the COVID-19 Era
    Wednesday, July 22, 12:00pm ET; Register HERE
  • The Brookings Institution
    The Opioid Crisis in America: Vulnerable Groups, Law Enforcement, and International Supply
    Wednesday, July 22, 3:00pm – 4:00pm, Register for Webcast

Questions about the above content can be directed to [email protected].