Controlled Substances

January 30, 2025 | Controlled Substances, First Responders, Legal & Legislative Research, Naloxone, Opioid Antagonists, Opioid Antagonists, Opioids, Overdose Reversal Agent, Public Health, Public Safety, Substance Misuse

In an effort to save lives, states have implemented laws to make it easier for first responders and the general public to obtain overdose reversal agents, 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 overdose reversal agents, 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 overdose reversal agent access laws throughout the United States, including the District of Columbia and all U.S. territories. As of January 2025, all 50 states and the District of Columbia have some form of an overdose reversal agent access law....

January 6, 2025 | Controlled Substances, Insurance, Model Laws, Public Health, Recovery, Substance Misuse, Treatments

The Mental Health and Substance Use Disorder Parity Act aims to empower effective enforcement of mental health and substance use disorder (SUD) parity standards at the state level. This model legislation requires: (1) health benefit plans to provide mental health and SUD benefits on terms no more restrictive than those for medical/surgical benefits; and (2) health insurers to demonstrate compliance with the Mental Health Parity and Addiction Equity Act for all state-regulated health benefit plans subject to the parameters of this legislation. The overarching purpose of this Act is to save lives and improve health and quality of life by expanding access to mental health and SUD treatment....

December 3, 2024 | Controlled Substances, Model Laws, Peer Support and Recoery Services, Public Health, Recovery, Substance Misuse, Workforce Development

Drafted in collaboration with the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center, the purpose of the Model Building the Substance Use Disorder Workforce of the Future Act is to address the current and projected shortage of professions for the substance use disorder workforce, including psychiatrists, psychologists, physicians who are certified in addiction medicine, addiction counselors, social workers, nursing professionals, peer support professionals, and others. This legislation guides states in adopting a strategy that supports and advances immediate, intermediate, and long-term measures to build and sustain an SUD workforce....

November 5, 2024 | Controlled Substances, Medication Assisted Treatment (MAT), Opioids, Recovery, Reports & Studies, Treatments

The Heller School for Social Policy and Management at Brandeis University and the Legislative Analysis and Public Policy Association, together published a report that includes a comprehensive review of the laws and regulations that apply to methadone for opioid use disorder (OUD) to determine which laws and regulations would need to be amended in order to support pharmacy-based methadone treatment for OUD. This analysis (1) includes a discussion of the agencies involved in governing methadone for OUD treatment; (2) explains the provision in federal Controlled Substances Act that creates the regulatory scheme for methadone treatment; (3) describes DEA regulations governing Narcotic Treatment Programs; and (4) summarizes the general types of state laws and regulations that place additional restrictions on methadone for OUD treatment....

October 7, 2024 | Controlled Substances, Fact Sheets, Fentanyl, Novel Psychoactive Substances, Opioids, Substance Misuse

“Tusi” is the name given to a new synthetic drug combination that first emerged in the 2010s in Latin America and Europe and is becoming increasingly popular in the United States. The name is a play on “2C,” a group of psychedelic drugs common among clubgoers, which tusi is rarely found to contain. Also called “pink cocaine,” though it usually does not contain cocaine, it is a powder that is dyed with pink food coloring that smells of strawberries. It is typically snorted, pressed into pill form, or mixed with water (called “happy water”). Because tusi is new on the drug scene, not much is currently known about the effects of the drug on those who use it. People who use drugs should be aware of the dangers of using tusi due to confusion regarding the names by which it is known as well as the different drugs used to make it and should use harm reduction practices to prevent adverse effects from its use....

July 12, 2024 | Fact Sheets, Medication Assisted Treatment (MAT), Novel Psychoactive Substances, Opioids, Recovery, Substance Misuse, Treatments

Methadone is one of the three medications approved by the U.S. Food and Drug Administration used for the treatment of opioid use disorder (OUD). Evidence shows that for patients who suffer a nonfatal overdose, subsequent methadone treatment reduces the likelihood of a future fatal opioid overdose by over 50 percent. In 2024, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued the first substantive changes to its federal methadone regulations in over 20 years. This final rule updated and modified several aspects of existing regulations with the goal of expanding the use of methadone for OUD treatment. As part of the revisions, SAMHSA clarified that a hospital, long-term care entity, or correctional facility, if appropriately registered with the Drug Enforcement Administration, can provide and initiate methadone as a treatment for OUD to those with a primary diagnosis other than substance withdrawal or OUD. In this fact sheet the Legislative Analysis and Public Policy Association details changes to the definition of "primary diagnosis" other than OUD regulation. The fact sheet also covers the federal regulatory scheme for methadone to treat OUD and explains what led SAMHSA to revise its regulations. ...

June 28, 2024 | Fact Sheets, Novel Psychoactive Substances, Opioids, Stimulants, Substance Misuse, Synthetic Drugs

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances (NPS) appearing on the illicit drug market in the United States. The term “novel” does not denote a new, never-before-seen substance but rather a substance that is newly available in the drug market. This fact sheet examines medetomidine, a powerful veterinary sedative that has been appearing as an adulterant in fentanyl mixtures in the U.S. Medetomidine is a synthetic alpha-2 agonist that is used as a sedative in veterinary medicine and sold under the brand name Domitor®. Medetomidine belongs to the same drug class as xylazine, but its potency is 200 times greater, and has a longer duration of action, than xylazine. The U.S. Food and Drug Administration has only approved medetomidine for use in veterinary medicine, and information about the use of the substance in humans is limited. The effects of medetomidine on humans are not well understood but include prolonged sedation, slow heart rate, slowed breathing, and low blood pressure. Similar to xylazine, the combination of medetomidine with other substances, like fentanyl, can enhance or prolong the effects of the substance and place the individual at a higher risk of overdose than from...

June 28, 2024 | Controlled Substances, Fetal and Infant Health, Legal & Legislative Research, Maternal Health, Opioids, Prescription Drugs, Substance Misuse, Treatments

In this document, the Legislative Analysis and Public Policy Association (LAPPA) examines state-level statutes and regulations related to substance use during pregnancy and whether such use during pregnancy is considered child abuse or neglect in the jurisdiction. ...

May 12, 2024 | Emergency Departments, First Responders, Harm Reduction, Innovative Initiatives, Medication Assisted Treatment (MAT), Opioid Antagonists, Opioid Antagonists, Opioids, Public Health, Recovery, Substance Misuse, Treatments

Paramedics in the State of New Jersey are permitted to carry and administer buprenorphine to treat acute withdrawal symptoms after having had an opioid overdose reversed with naloxone. The directive, via Executive Order from the State Health Commissioner, simply added buprenorphine to the list of medications available to paramedics in the MICUs and required officials in each county to train paramedics on the protocol. ...

April 11, 2024 | Controlled Substances, Criminal Justice, Harm Reduction, Medication Assisted Treatment (MAT), Naloxone, Opioid Antagonists, Opioids, Prescription Drugs, Public Health, Public Safety, Recovery, Reports & Studies, Substance Misuse, Treatments

The Addiction and Public Policy Initiative at the O’Neill Institute for National and Global Health Law was established in 2018 through a generous grant from Arnold Ventures. Housed at Georgetown Law, the Addiction and Public Policy Initiative works at the intersection of public health and the law to advance a public health approach to substance use disorder and the overdose epidemic through legal and policy strategies that promote evidence-based treatment, harm reduction, and recovery. This reports highlights O'Neill's accomplishments over the last five years....