WISAM On-Demand Recordings
Wisconsin Health News
Wisconsin saw a 27.4 percent increase in drug overdose deaths last year, according to provisional federal data released this week.
There were 1,539 predicted drug overdose deaths in Wisconsin last year, compared to 1,208 the prior year, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics. The total number is likely underreported due to incomplete data, per the center.
Nationally, drug overdose deaths rose over 29 percent, the largest single-year increase recorded. A total of 93,331 predicted deaths were reported in 2020, compared to 72,151 the prior year.
Overdose deaths rose in all but two states last year, with only South Dakota and New Hampshire seeing a decrease.
The Wisconsin Medical Society (Society) warned state legislators this week about a proposal that would remove two compounds from the state’s list of controlled substances that are found in leaves of the kratom tree and can have psychotropic effects. The proposal from State Assembly Representative David Murphy (R-Greenville) would also create a state regulatory system that would enable companies to sell kratom as a therapeutic product, including the ostensible ability to help people “alleviate their opioid dependency.”
Working with physician members of the Wisconsin Society of Addiction Medicine (WISAM), the Society sent a message to all 132 State Assembly Representatives and State Senators asking that they not co-author the proposal. The message from the Society included:
The proposal is spearheaded by the American Kratom Association, which has unsuccessfully lobbied the state’s Controlled Substances Board to remove the compounds from the state’s list of illegal substances. Once the proposal has circulated for legislative cosponsors, it will likely be officially introduced and assigned to a legislative committee.
Contact Society Chief Policy and Advocacy Officer Mark Grapentine, JD for more information.
Wisconsin could see more than $65 million for opioid abatement efforts through a settlement with the Sackler family and their company Purdue Pharma that’s pending approval before a bankruptcy court.
Attorney General Josh Kaul said the plan maximizes the amount Wisconsin will be able to recover. Kaul filed suit against the company two years ago.
“We’ve fought to get every dollar we can from Purdue and the Sacklers to help with the fight against the opioid epidemic,” Kaul said in a statement. “We opposed Purdue’s original bankruptcy plan, and we joined other states in negotiating for more resources to address the epidemic. Because of that multistate effort, the bankruptcy plan has improved.”
Kaul said the process has also revealed a need to reform the bankruptcy system. “It’s shameful that the Sackler family is using that process to limit their liability and that billions more can’t be recovered from them,” he added.
The state’s share of funding is around 1.8 percent of the $4.3 billion that would be paid over the next nine years. Thousands of victims would also receive compensation.
The plan permanently bans the Sacklers from the opioid business, with Purdue being sold or wound down by the end of 2024.
The Sacklers would also have to relinquish control of family foundations holding $175 million in assets to trustees of a foundation dedicated to abating the opioid crisis.
They couldn’t request or permit any new naming rights in connection with charitable or similar donations or organizations for the next nine years.
Purdue and the Sacklers would have to make public more than 30 million documents, including attorney-client privileged communications about the federal approval of painkiller OxyContin and tactics used to promote opioids.
On June 8th the Health Resources and Services Administration released the Fiscal Year 2021 Application and Program Guidance for the Substance Use Disorder Treatment and Recovery (STAR) Loan Repayment Program (LRP). The STAR-LRP will provide repayment of education loans for individuals working in a full-time substance-use disorder (SUD) treatment job that involves direct patient care at a STAR LRP-approved facility located in either a Health Professional Shortage Area (HPSA) designated for Mental Health, or a county/municipality where the average drug overdose death rate exceeds the national average.
Gov. Tony Evers on Wednesday signed into law a bill setting up a framework for distributing funds from a settlement in a lawsuit brought by Wisconsin counties and others against opioid manufacturers, distributors and retailers.
The Republican-backed bill passed the Legislature last week mostly along party-line votes. It would require the attorney general to work with counties on the settlement and splits Wisconsin’s share of settlement funds 30-70 between the state and counties that are party to the litigation.
“It will help bring much-needed funds to communities throughout Wisconsin to address the opioid pandemic,” Evers said in a statement. “These funds will be used on opioid abatement and mitigation efforts.”
Evers signed the bill over the objections of Attorney General Josh Kaul, who said the bill shouldn’t become law.
Kaul said in a statement last week that the bill would “unconstitutionally” give the Joint Finance Committee significant authority over opioid-related settlements and that the bill creates no process for legislative review of confidential materials. And he noted the bill doesn’t cap attorney's fees for opioid-related settlements.
Evers acknowledged Kaul’s concerns about the committee’s oversight.
“Despite these serious concerns, I am not willing to risk our ability to maximize the amount of settlement dollars available to Wisconsin by vetoing this bill in its entirety,” Evers said in a statement.
“I agree with the Governor that aspects of this legislation are unconstitutional,” Kaul said in a Wednesday statement. “It’s unfortunate that this new law misses the opportunity to help maximize the resources that will go toward fighting the opioid crisis in Wisconsin.”
The Wisconsin Counties Association applauded the signing.
“Without this legislation, the state and counties could have lost vital opioid abatement funds," Lance Pliml, chair of the board of the association, said in a statement. "We are grateful for Gov. Evers’ leadership in acting in the best interest of Wisconsin to get this money quickly to our local communities for mitigation and abatement efforts.
Today, the final rule for Registration Requirements for Narcotic Treatment Programs (NTPs) with Mobile Components was published. These regulations will allow the operation of a mobile component associated with a DEA-registered NTP to be considered a coincident activity permitted under the NTP’s registration. Based on these revisions, NTP registrants that operate or wish to operate mobile components (in the State in which the registrant is registered) to dispense narcotic drugs in schedules II-V at remote location(s) for the purpose of maintenance or detoxification treatment do not need a separate registration for such mobile component. This final rule waives the requirement of a separate registration at each principal place of business or professional practice where controlled substances are dispensed for those NTPs with mobile components that fully comply with the requirements of this rule. These revisions to the regulations are intended to make maintenance or detoxification treatments more widely available, while ensuring that safeguards are in place to reduce the likelihood of diversion.
This final rule will be effective 30 days after publication and can be found at: https://www.federalregister.gov/public-inspection/2021-13519/registration-requirements-for-narcotic-treatment-programs-with-mobile-components. Back in April 2020, ASAM wrote this letter urging final rule publication.
State lawmakers are moving quickly on a plan that would create a framework for distributing settlement proceeds from a challenge filed by state and local governments against opioid makers, distributors and retailers.
The full Assembly is set to consider the measure Tuesday, after the Assembly Committee on State Affairs approved the measure last week on a 7-4 vote. All Democrats were opposed to the plan.
The Senate Committee on Health signed off on the measure 3-2 in a similar party-line vote Thursday, after holding a public hearing on the plan last Tuesday.
The bill would require the attorney general to work with counties on the settlement, with 70 percent of the settlement funds going toward local governments that are party to the litigation and 30 percent to the state. The Joint Finance Committee would have to sign off on the proposed settlement agreement.
The state’s share would go to the Department of Health Services, which would annually report to the Joint Finance Committee a proposal for spending the money in the next year. The committee would sign off on the plan through its passive review process.
Seventy-one of Wisconsin’s 72 counties have signed on to the lawsuit, and counties have borne the cost of the epidemic, said Senate Committee on Health Chair Patrick Testin, R-Stevens Point.
“This is common-sense legislation,” Testin said at the Tuesday public hearing. He said the bill would require that all funds be used for abatement purposes, rather than other government functions or to fill budget holes.
The Wisconsin Counties Association supports the measure.
“We should not wait even one minute longer than we have to to utilize the funds,” Executive Director Mark O’Connell said.
“This bill is the right bill for counties to be able to serve our citizens who have been affected by this crisis,” Racine County Executive Jonathan Delagrave said. “We are on the front lines.”
Attorney General Josh Kaul opposes the measure. In testimony submitted to the committee, he said it would be beneficial to set up a structure for distributing funds, but the bill is “fundamentally flawed.”
Kaul questioned the measure’s constitutionality, saying it would grant a legislative committee oversight for something that is the responsibility of the executive branch. He said legislative review of potential resolutions of opioid matters is not practical.
“Reducing the complexity of these matters to an abbreviated legislative review, without an agreed-upon process for the review of confidential information that protects the interests of the state, is not consistent with meaningful consideration of the issues,” Kaul wrote.
Instead, the bill should provide that opioid matters be resolved at the sole discretion of the attorney general, he said.
The Department of Health Services strives to protect and promote the health and safety of all people of Wisconsin through the efforts of a dedicated and diverse workforce. DHS works to ensure access to individuals, families, and communities to achieve positive health outcomes in the areas of abuse prevention, mental health, public health, family care, long-term care, and much more.
The Division of Care and Treatment Services (DCTS) is recruiting for a Human Services Program Coordinator-Senior position, also known as the Women's Substance Use Treatment Coordinator, within the Bureau of Prevention, Treatment, and Recovery (BPTR) in Madison, WI.
Click here for more information.
Lawmakers are considering establishing a centralized database for opioid and methamphetamine statistics that could help boost the fight against the state’s drug epidemic.
The Assembly Committee on Substance Abuse and Prevention approved the bill unanimously last week, and the Senate Committee on Health signed off on the measure in February. The bill would provide $1.5 million in the second year of the 2021-23 biennium to implement the data system.
The bill would direct the Department of Administration to work with a vendor to collect and analyze data on overdoses, drug trafficking and other measures. The state agency would also be charged with submitting reports to the Joint Finance Committee on data trends.
Committee on Substance Abuse and Prevention Chair Rep. Jon Plumer, R-Lodi, said different state agencies already collect the information that would be put into the database, but it’s not easily accessible.
“We need to be able to access that information more easily than we are now,” Plumer said. “This goes from a paper map to a GPS system. That’s how dramatic this change would be.”
Plumer said the measure would help not only with treatment, but law enforcement. He said law enforcement officials are more “reactionary” now to when substances appear in their area. The database would give them a “heads up” of what’s happening in other areas of the state, allowing them to target resources.
In testimony on the bill, Senate Committee on Health Chair Patrick Testin, R-Stevens Point, noted the state has recently seen an increase in overdoses and drug-related deaths. He said the bill would help assess the effectiveness of state initiatives.
The Assembly approved the bill last session, but it didn’t make it into law after the Senate canceled its final session.
The Joint Finance Committee removed a provision in Gov. Tony Evers’ budget that was similar to the bill when it removed a series of policies in early May. Evers included funding for a similar program in a bill that would expand Medicaid, which Republicans declined to take up last week.
WISAM is looking for individuals who are interested in becoming more involved in the Public Policy Committee. Our current Chair, Dr. Elizabeth Salisbury-Afshar, is ready to help lead a team with a keen interest in public policy matters around issues that affect addiction medicine, the practice of addiction medicine, and public policies that may impact the social determinant of health for our patients. Please contact us via the link below in order to get connected and learn more about the opportunities we have available to get involved.
Elizabeth Salisbury-Afshar, MD, MPH is an Associate Professor in the Department of Family Medicine and Community Health and is core faculty for the Addiction Medicine Fellowship at the University of Wisconsin School of Medicine and Public Health in Madison Wisconsin. Dr. Salisbury-Afshar is board certified in family medicine, preventive medicine/public health and addiction medicine and her expertise lies at the intersection of these fields. Much of her work has focused on expanding access to evidence-based responses to the opioid overdose crisis. Past roles include serving as the Medical Director of Behavioral Health Systems Baltimore (a quasi-public entity that oversees all publicly funded addiction and mental health treatment), as the Medical Director of Behavioral Health at the Chicago Department of Public Health, the Director of the Center for Addiction Research and Effective Solutions at the American Institutes for Research, and Medical Director of Heartland Alliance Health (Chicago-based healthcare for the homeless provider). She has over ten years of experience working clinically in federally qualified health centers- providing direct patient care in both primary care and addiction medicine treatment. She currently serves as the Vice Chair of the ASAM Public Policy Committee and as the ASAM representative on the AMA Opioid Task Force.
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