Substance Misuse

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 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...

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....

April 9, 2024 | Emergency Departments, First Responders, Innovative Initiatives, Medication Assisted Treatment (MAT), Opioids, Public Health, Recovery, Substance Misuse, Treatments

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....

March 18, 2024 | Fact Sheets, Novel Psychoactive Substances, Opioids, Public Safety, Stimulants, Substance Misuse, Synthetic Drugs

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. ...

January 16, 2024 | Controlled Substances, Harm Reduction, Reports & Studies, Stimulants, Substance Misuse, Treatments

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....