Controlled Substances

Kratom is an herb derived from a leafy Southeast Asian tree and contains two psychoactive compounds that can bind to opioid receptors in the brain and produce a pharmacological response similar to effects produced by other opioid agonists, such as morphine. As of February 2024, 22 states and the District of Columbia regulate kratom. This document: (1) provides a singular resource for each jurisdiction’s laws; (2) allows for a comparison of these laws between jurisdictions; and (3) identifies and highlights interesting provisions. ...

These fact sheets provide guidance for overdose fatality review (OFR) teams, public safety and public health agencies utilizing the Overdose Detection Mapping Application Program (ODMAP), and law enforcement deflection partnership efforts on what can and cannot be legally shared regarding federal law (such as 42 Code of Federal Regulations [CFR] Part 2 and the Health Insurance Portability and Accountability Act [HIPAA]). ...

Given the increased emphasis in recent years on using harm reduction strategies to slow the overdose crisis, the hurdle posed by state drug paraphernalia laws to freely allowing drug checking services or establishing syringe services programs is not inconspicuous. Accordingly, in 2022, LAPPA first undertook an extensive research project to determine how drug paraphernalia laws throughout the 50 states, District of Columbia, and all U.S. territories treat drug checking equipment (including fentanyl test strips and other items) and needles/syringes. This January 2024 version, which sets forth a summary of state and territory laws as of December 2023, is an update to the original report. ...

Total abstinence has historically been the goal of treatment for substance use disorders; however, there is a growing recognition of the health benefits associated with reduced use as a harm reduction measure in stimulant use disorders treatment. The researchers and authors of this report aimed to assess the validity of reduced stimulant use as an outcome measure in randomized controlled trials of pharmacological interventions for stimulant use disorder....

In this survey, the Legislative Analysis and Public Policy Association (LAPPA) examines the policy response at the state level to the spread of pill presses used to create counterfeit drugs. There is relatively little policy in this area compared to federal law, and most innovation is relatively recent.  Findings are presented jurisdiction by jurisdiction for easy comparison among states and between current state- and federal law....

The Legislative Analysis and Public Policy Association (LAPPA) continues to monitor the emergence of novel psychoactive substances (NPS) appearing on the illicit drug market in the United States. The term “novel” does not denote a brand new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet, the sixth in a series highlighting these dangerous drugs, is an examination of bromazolam....

This fact sheet summarizes a recent increase in the use of contingency management, a behavioral therapy that reinforces or rewards positive behavioral change. Often, mental health professionals use contingency management alongside other methods of treatment. In the context of substance use disorder treatment, patients typically receive something of monetary value to incentivize abstinence from drug use. Contingency management is a well-studied and effective method for treating substance use disorder, but until recently, received little support....

In an effort to save lives, states have implemented laws to make it easier for first responders and the general public to obtain opioid antagonists, such as naloxone. Additionally, to encourage people to assist an individual who is or may be suffering an overdose, the majority of states also enacted laws which protect laypeople who administer opioid antagonists, in good faith, in an emergency from civil and/or criminal liability. The Legislative Analysis and Public Policy Association (LAPPA) undertook an extensive research project to determine the current status of opioid antagonist access laws throughout the United States, including the District of Columbia and all U.S. territories. As of August 2020, all 50 states and the District of Columbia have some form of an opioid antagonist access law. ...