In this fact sheet the Legislative Analysis and Public Policy Association details the effects of the substance ibogaine in humans, reviews its regulation on the state and federal level, and highlights research being conducted relative to renewed interest in the substance....
In 2014, several U.S. cities and counties filed lawsuits against drug manufacturers and distributors alleging that the companies’ aggressive marketing practices fueled a national opioid addiction epidemic that subsequently killed hundreds of thousands of people. Since then, over 3,000 state and local governments filed lawsuits of their own, seeking to recoup the billions of dollars that these entities spent—and continue to spend—on the fallout from the epidemic. The result of these legal efforts is a series of ongoing monetary settlements, greater than $56 billion to date. Payment of these settlements will last 18 years, and the decision-making authority for spending these funds differs between jurisdictions. Many have an appointed advisory board that disburses specified amounts each year for specified purposes. In this fact sheet, LAPPA details how opioid settlement proceeds are being disbursed to state and local governments, how those governments are choosing to spend those funds, and the obstacles that can prevent these funds from helping those who have been affected by the opioid epidemic....
The Medicaid Health Home State Plan Option, authorized by the Affordable Care Act in 2011, gives states the ability to create health home programs that provide comprehensive care coordination for Medicaid beneficiaries. Health home programs are required to “integrate and coordinate all primary, acute, behavioral health and long term services and supports” to treat the patient across his or her lifespan. Health home services must include all six of the following components: comprehensive case management; care coordination; health promotion; comprehensive transitional care/follow-up; patient and family support; and referral to community and social support services. This fact sheet provides an overview of Medicaid health homes, which are designed to assist beneficiaries in obtaining care for chronic conditions, including substance use disorder....
In mid 2024, community-based drug checking programs discovered the industrial chemical bis (2,2,6,6-tetramethyl-4-piperidyl) sebacate (BTMPS) in the illicit opioid supply in Portland, Oregon and Philadelphia, Pennsylvania. The substance appears as a white powder, and on industrial chemical websites, it is often referred to by its brand name, Tinuvin® 770. Used, among other things, as a protective coating on plastics to provide protection against ultraviolet rays, BTMPS belongs to a class of molecules called hindered amine light stabilizers. It is not approved for use in humans or animals, and it is not a scheduled or regulated substance in the U.S. This fact sheet provides an overview of the sudden increase in the presence of BTMPS in the illicit drug supply and its rapid proliferation across the country, which has left drug policy experts and harm reduction specialists puzzled as to why it is in the supply and how it will affect the individuals consuming it....
Collateral consequences are legal, regulatory, and policy barriers imposed against an individual arrested for, charged with, or convicted of a criminal offense that often have no connection to the criminal offense. These consequences include but are not limited to: (1) the loss of the rights to vote, serve on a jury, or possess a firearm; (2) barriers in obtaining housing, employment, higher education, professional licensure, and federal and state government benefits; and (3) barriers in obtaining credit and loans, including student loans. This fact sheet provides an overview of the collateral consequences of becoming involved in the criminal justice system....
“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....
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. ...
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...
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 (LAPPA) is monitoring the emergence of novel psychoactive substances (NPS) appearing on the streets of the United States. This fact sheet, which focuses on Xylazine, was originally the second in a series that highlights these dangerous drugs. This is an update to the original version....