Substance Abuse

When their son Michael passed away, Avi and Julie Israel of Buffalo, N.Y., were distraught. Michael had suffered from an addiction to painkillers and in the depths of misery, had taken his own life. Knowing they weren’t alone in grappling with this issue and compelled to respond, the Israels decided to act. They established an organization called Save the Michaels of the World to increase public awareness, especially among parents.

President Barack Obama recently announced new actions his administration will take to address the prescription opioid and heroin epidemic in the nation. In visits across the nation, the president heard from people dealing head on with how difficult it is to get treatment for addiction. “It comes down to the fact that lawmakers have traditionally blamed those with substance use disorders for their disorders. . . (Lawmakers) want to fix it but do not want to pay for the treatment. That is the bottom line,” said Debbie Plotnick, vice president of mental health and systems advocacy at Mental Health America. But policy efforts to address the epidemic aren’t limited to the federal level. States are looking to expand treatment access and attract more mental health professionals into treatment facilities.

From economic and workforce development, to infrastructure and education, any number of items could have dominated discussions during the winter meeting of the National Governors Association, or NGA, in February. Yet, as the governors began to immerse themselves in committee reports and assemble a list of priorities for their meeting with President Barack Obama at the White House, it was the issue of opioid abuse and overdose deaths that dominated the agenda.

The U.S. Food and Drug Administration announced yesterday it will require “black box” warnings on all immediate-release opioid pain medications. The target of the warning is prescribers.

CSG South

While the heroin epidemic largely has been concentrated in the Northeast, Appalachian, and Midwest regions of the country, substance abuse is an issue that crosses multiple areas of public policy, including behavioral and public health, criminal justice, and social services. As the South continues to lead the way in criminal justice reform, lessons from the plight of other regions allow SLC lawmakers to build on their efforts to combat prescription drug abuse and take a proactive stance in the heroin epidemic. In recent years, this awareness has led many SLC states to pass laws which expand availability and access to drugs that can help treat an opioid overdose and provide limited immunity from prosecution for individuals who seek medical assistance for themselves or another person experiencing an opioid overdose. This SLC Regional Resource examines what the SLC member states are doing to combat the heroin epidemic and what policies and/or practices can be implemented to mitigate its side effects and ensure a long-term solution.

Last week, the U.S. Senate passed a drug abuse prevention and treatment bill 94-1. The New York Times reported it is the biggest bill on the topic since 2008, when Congress mandated insurance coverage for addiction treatment.

The overwhelming bi-partisan support for the bill underlined the growing attention to the very real increase in overdose deaths due to prescription drug abuse and heroin use. Governors talked with President Obama about the same topic during the National Governors’ Association meeting in February. In a CSG analysis of 2016 governors' state of the state addresses, substance abuse and drug overdoses figured prominantly as key themes. 

A February 2016 CSG Capitol Research Brief provides the latest data on overdose deaths by state. Fourteen states had a statistically significant increase in overdose deaths from prescription drug abuse and heroin use from 2013 to 2014, according to the latest data from the Centers for Disease Control and Prevention. 

On Feb. 2, Obama unveiled a $1.1 billion funding proposal to help states fight the growing tide of drug abuse. The proposal includes $1 billion in new mandatory funding over two years to expand treatment access for substance abusers. More than 90 percent of the $1 billion will support cooperative agreements with states to expand medication-assisted treatment options or to make already existing services more affordable. Federal funding will be allocated to states based on the severity of the crisis and the feasibility of the states’ plans for responding to it.

In 2014, overdose deaths numbered 47,055, approximately one and a half times as many deaths as from motor vehicle crashes, according to data released by the Centers for Disease Control and Prevention in December 2015. For the nation, the 2014 death rate from drug overdoses is significantly higher than the rate in 2013 and since 2000 has more than doubled.

CSG Director of Health Policy Debra Miller outlines the top five issues in health policy for 2016, including Medicaid expansion, substance abuse and drug overdoses, cost containment, the graying of America, and population health. 

#1  Medicaid Expansion

Thirty states and the District of Columbia have expanded Medicaid eligibility to 138 percent of the federal poverty level as allowed by the Affordable Care Act, and they will be required to contribute matching funds beginning Jan. 1, 2017. This means that legislatures in those states will have to appropriate state funds during their budget sessions in 2016.  

The federal funding will decrease from covering 100 percent of the newly eligible...