Controlled Substances

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. ...

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....

The Coordinated Opioid Recovery (CORE) Network, overseen by the Florida Department of Health, the Florida Department of Children and Families, and the Florida Agency for Health Care Administration establishes a system of care for individuals suffering from substance use disorder (SUD). CORE provides a state-supported, coordinated system of addiction care for individuals with SUD and has provided approximately 550,000 services to support patients since its inception in 2022....

The first U.S. reports of counterfeit pills containing fentanyl emerged in a handful of jurisdictions in 2015 and by October 2019, all U.S. jurisdictions reported them. One reason for the proliferation is the ease with which drug traffickers can enter this market. With only a few thousand dollars, a person can purchase a pill press, pill molds, and dies that mimic trademarked pharmaceuticals and enough illicitly imported fentanyl to generate $5 to $20 million in sellable counterfeit pills. Given the simple manufacturing process and low startup costs, counterfeiting is an attractive area for drug traffickers, albeit one that creates substantial health risks to consumers. Despite this, however, there are relatively few federal or state laws governing access to pill press machines, and those that exist do not provide for substantial oversight or assessment. In this fact sheet, the Legislative Analysis and Public Policy Association reviews: (1) what pill presses are and how people obtain them; (2) why fentanyl is an often-used drug in counterfeit pills and the health concerns this poses; and (3) the limited, currently-in-force, applicable state and federal laws....

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances 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 xylazine, a powerful veterinary sedative increasingly appearing as an adulterant in heroin and fentanyl mixtures in the U.S., particularly since 2020. Xylazine has a chemical structure similar to compounds called phenothiazines and operates by decreasing the release of norepinephrine and dopamine in the central nervous system, resulting in analgesia, sedation, and muscle relaxation. Xylazine intoxication can result in central nervous system depression, low blood pressure, and slow heart rate. Respiratory depression can also occur, which increases the risk of overdose when combined with opioid-induced respiratory depression. ...

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....

The Legislative Analysis and Public Policy Association is monitoring the emergence of novel psychoactive substances 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 bromazolam, a novel benzodiazepine that is structurally related to alprazolam (Xanax), which has been a Schedule IV controlled substance in the U.S. since November 1981. Bromazolam is typically found in tablet or powder form and sold mainly via online drug markets under its own name or as “XLI-268.” It has been found mixed with opioids, including fentanyl, and in counterfeit Xanax pills. There is not much information about the illicit use of bromazolam and its effects on the human body in scientific literature, so most of the information currently available about the substance is anecdotal. ...

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....