The Big News

Happy New Year!

Our alcohol-free New Year’s Eve bash in Minneapolis was a successful hoot! More than 200 joined us and our partners for top-flight comedy and music, tasty non-alcoholic beverages, and celebration. We called it Resolution 2020: A Zero Proof New Year’s Eve. Big thanks to our music headliners  HALEY and Lydia Liza (shown here, L to R) and comedian Moe Yaqub.

If you weren’t there, we hope you rang in the new year and decade in similar style. Looking at the biggest celebrations around the world, L.A.’s 7^th annual gathering of 50,000 in Grand Park stood out because it also was alcohol-free!

Now, we find ourselves in Dry January. The UK tradition of sobering up after the holidays has caught on worldwide and spawned similar campaigns like Dry July, Sober September, and Go Sober for October. Some say it’s part of the burgeoning sober-curious movement, which is creating stigma-free opportunities for people to experiment with sobriety and re-examine their relationship with alcohol, while simultaneously creating new social options for anyone interested in experiences outside of the drinking culture.

We welcome that positive trend. But as Americans reflect on the past decade, the much more defining story, of course, was the opioid crisis, which fueled an unprecedented overdose epidemic that has barely begun to abate. Drug overdoses claimed a mind-boggling half-million lives in the 2010s and devastated countless others, while exposing the inadequacy of our nation’s overall approach and commitment to preventing and treating addiction, and supporting long-term recovery.

Amid the tragedy, we saw the beginning of positive change in addiction-related public attitudes, perceptions, policies, practices and systems. Hazelden Betty Ford has helped lead the way with many changes of its own. We began using opioid-addiction-treatment medications in 2012, and became a strong advocate for comprehensive care that includes medication options, psychosocial therapies and peer support. We emerged as a leading voice for breaking down barriers between the medical and Twelve Step communities.

Hazelden Betty Ford also transitioned to an insurance model so more people could access our care; evolved away from the 28-day residential standard to a more individualized approach that enables people to stay engaged longer over multiple levels of care; launched a new era of aggressive collaboration with the broader healthcare field; made the evidence-based therapy “motivational interviewing” core to a more patient-centered clinical approach; initiated a new, innovative system for capturing and acting upon patient feedback throughout the treatment experience; developed new recovery coaching options; and much more. In addition, we spoke up vigorously about the need for ethical and quality standards in our field, and continue to support related industry reform efforts. It was a decade of big change for us, and we will likely evolve a great deal more in the 2020s, as we have consistently done since 1949.

Broader changes to the many systems that affect people with addiction are coming more slowly, but we seem to be pointed in the direction of progress. Here’s one commentator’s take on how the past decade opened the door to understanding and treating the pain of drug use rather than applying brute force to try to stop it. He’s referring to an overdue move away from the so-called War on Drugs.

Indeed, most of us want addiction prevented and treated, rather than stigmatized and criminalized. The question arises, though: Does that mean it is wise to fully legalize and commercialize more addictive substances? Or are there policies and approaches in between that promote public health better than either extreme?

In the new decade, marijuana will be a case study and likely a defining story. From our perspective, the experiment with full legalization looks troubling so far. State-level data from the National Survey on Drug Use and Health finds that marijuana use in “legal” states among youth, young adults, and the general population continued its multi-year upward trend in several categories. New data and studies come in weekly, it seems—consistently showing cause for greater public health concerns. One of our 2020 resolutions is to help ensure the facts about marijuana and the risks of expanded use get more attention.

One big concern, for example, is that marijuana vaping by teens surged in 2019, signaling that more adolescents are using the drug and consuming highly potent vape oils, according to new government data and drug-use researchers.

Federal regulators are paying attention. They shut down 44 websites advertising illicit THC vaping cartridges, part of a crackdown on suppliers amid a nationwide spate of lung injuries tied to black-market cannabis vaping products.

The outbreak of severe lung injuries may have peaked, but cases are still surfacing, and the agency is urging doctors to monitor people closely after hospitalization, due to the risk of continued vaping.

One Harvard graduate student writes, “I nearly died from vaping THC, and you could too.”

Marijuana and vaping are both among the issues coming up on the campaign trail, and recent polling released by the National Council for Behavioral Health shows strong bipartisan agreement among registered voters in New Hampshire that the federal government is not doing enough to address mental health and addiction in America. Mental Health for US, a coalition trying to raise more awareness in the campaign, held a recent forum in New Hampshire. Watch the livestream replay.

In Washington, the White House hosted a summit of its own on efforts to deliver mental health treatment to people experiencing homelessness, violence and substance use disorder. Watch Part 1 of the event, Part 2, and the President’s remarks.

The Administration also issued its long-awaited vaping policy last week, with the FDA banning fruit, mint and dessert-flavored vaping cartridges but continuing to allow menthol- and tobacco-flavored cartridges as well as all flavored e-cigarette liquids. Many worry the guidelines don't go far enough.

Since our last update, the President also signed a $1.4 trillion spending package passed by Congress, averting a government shutdown. The package maintains funding levels for most areas relevant to our field, with modest increases in a few SAMHSA grants as well as at the CDC and at the National Institutes of Health. Most notably, the legislation gives states more flexibility in spending State Opioid Response (SOR) grant funds; specifically, they’ll now be able to use the money to also address the growing problems associated with addiction to meth, cocaine and other stimulants. Here’s a thorough overview from our friends at the National Association of State Alcohol and Drug Abuse Directors.

This week’s featured media is the latest episode in our award-winning Let’s Talk Addiction & Recovery podcast series, with host William C. Moyers talking to Kristen Schmidt, MD, about the use of trauma-informed practices in addiction treatment that account for the different ways patients experience trauma symptoms. Watch, listen or read.

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Treatment Industry Issues and Reforms

If passed, the Opioid Workforce Act would provide an additional 1,000 graduate medical education slots over current levels to qualifying hospitals with approved residency programs in addiction medicine, addiction psychiatry, pain medicine, and corresponding prerequisite programs. Learn more →

Face It Together has gone public with the much-anticipated Recovery Capital Index it has been developing for the past several years. It is now available for licensing.

Recovery advocate Bill Stauffer makes a case we often do—for our systems and policies to be focused widely and comprehensively.

Interesting take here on who and what should be driving the needed integration of behavioral health care and primary care.

Vox reporter German Lopez continues to crowdsource a months-long series on addiction treatment. In this piece, he recaps his stories so far, after having heard from more than 1,000 people.

Cannabis Recreational marijuana sales began Jan. 1 in Illinois, the 11th state to launch its own public health experiment by dramatically expanding access to high-potency cannabis. Our colleague Zach Levin talked to WGN-TV, cautioning that legalization is not an indication of safety. Learn more →

After just two days, legal marijuana sales in Illinois topped $5.4 million, with some dispensaries running out of inventory.

Health experts agree Illinois should expect a rise in pot-related ER visits.

Cannabis-related psychosis is a very real and scary thing, but it’s just now getting more attention in the press. 

Pot smoking is gaining on booze as teens' favorite mood- and mind-altering substance.

Did a mom’s marijuana use contribute to her newborn’s death? Experts say … probably.

The U.S. Senate blocked some House attempts to push through pro-cannabis legislation late in the year.

A study of tens of thousands of tweets related to marijuana found more than half were generated by bots, with many of them spreading false information.

California’s legal marijuana industry isn’t panning out as planned.

Opioids

A new analysis of overdose data shows when and where the three waves of the opioid crisis took hold. Learn more →

The TODAY show traveled to Portsmouth, Ohio, to see how military veterans are helping revitalize a town devastated by the opioid crisis—through CrossFit, rebuilding businesses and collaborating with a counseling center.

New research looks at how auto factory closures may have helped fuel the opioid crisis. Some say it’s more complicated than that.

Hospital costs for treating newborns in opioid withdrawal jumped to $573 million in 2016, almost double what they were in 2012.

Purdue Pharma, the embattled opioid maker, has quietly split ways with PhRMA,the powerful lobbying organization charged with representing the drug industry in Washington.

The Sackler family, owners of Purdue Pharma, withdrew $10.7 billion from the company over the last dozen years, placing the money in trusts and overseas holding companies, according to an audit commissioned by Purdue and filed in bankruptcy court.

Life-threatening breathing difficulties can occur in patients who use gabapentin or pregabalin with opioids or other drugs that depress the central nervous system, as well as those with underlying respiratory impairment and the elderly, the FDA said in new public warning.

Older teens appeared, in a recent study, to have similar risk factors for prescription opioid overdose as adults. That’s why it’s so nice to see the latest Monitoring the Future survey results indicating that prescription opioid misuse among high schoolers is at a historic low nationally.

Good news about declining opioid prescriptions in Minnesota.

Some people with sickle cell disease say the opioid crisis has made it too hard to get the pain medication they sometimes need in the ER.

The opioid crisis tripled deaths among Philly’s homeless population in the last decade.

A new study published in Health Affairs found that, since 2016, access to lifesaving addiction treatment medications in rural areas has increased by 111%. The study credits the Comprehensive Addiction and Recovery Act for enabling nurse practitioners and physician assistants to obtain the waivers needed to prescribe buprenorphine.

In 2011, the FDA began asking the makers of OxyContin and other addictive long-acting opioids to pay for safety training for more than half the physicians prescribing the drugs, and to track the effectiveness of the training and other measures in reducing addiction, overdoses and deaths. But the FDA was never able to determine whether the program worked, researchers at the Johns Hopkins Bloomberg School of Public Health found in a new review.

According to another report, the FDA also struggled—perhaps understandably so—with managing what’s called the “Aggregate Production Quota” for oxycodone and hydrocodone.

Racism in pain care ironically shields black Americans from an even worse opioid overdose crisis.

The U.S. Supreme Court declined to hear a case by Arizona seeking to recover billions of dollars that the state has says members of the Sackler family funneled out of Purdue Pharma before the company filed for bankruptcy in September.

An Ohio doctor charged with killing 25 patients by overprescribing pain medication is now suing the hospital for defamation.

Alcohol

In the UK, where Dry January originated, more people than ever report they are no longer drinking year-round. Learn more →

Some say Dry January is killing bars. Others say brewers are embracing it by developing new no- and low-alcohol options.

Of course, Dry January is not for everyone. Some drinkers need professional help to stop. Others may be trying Dry-ish January.

Heavy drinking may damage heart tissue, researchers warn.

For people with atrial fibrillation, abstinence from alcohol may make the heart beat better.

A newborn baby reportedly died after being given a sip of alcohol by his grandfather in China.  

A former member of Norway’s royal family who died by suicide on Christmas Day had been open about his struggles with alcohol use.

In Ireland, an ad stating alcohol is a drug was blocked as “too political.”

Health Care Reform and Parity With policymakers in Washington likely to be mired in partisan gridlock this year, look for health care policy news to come out of state capitols. Learn more →

In Kansas, a bipartisan group of lawmakers wants a stronger parity law.

A new year means pharmaceutical price hikes, including for OxyContin.

A federal appeals court upheld a lower-court ruling that the Affordable Care Act's individual mandate is unconstitutional, but told the judge in the case to look again at whether other parts of the law can still stand. A lower court now must reconsider the fate of the law, likely pushing off a Supreme Court showdown past the November presidential election.

More than 1 million people have joined alternative “cost-sharing” health-care associations, which offer lower premiums than traditional insurers but no guarantees they will actually provide coverage. These nonprofits, often affiliated with religious groups, are growing due to demand from consumers. But, as the New York Times reports, several states are now working to ban them, alleging they mislead consumers.

In a world where systems, software and data are ever more connected, figuring out how to keep health data in the right hands has become an increasingly arduous task—throughout health care.

STAT’s newest health tech wizard, Erin Brodwin, unpacks the startups at the heart of Apple’s digital health strategy.

States would be allowed to import certain FDA-approved medications from Canada in an attempt to drive down costs under a proposed rule issued by the Trump administration. U.S. and Canadian drugmakers, as well as Canada's government, oppose the plan, saying it won’t cut costs.

Advocate Spotlight Big announcement from Young People in Recovery: President & CEO Justin Luke Riley is transitioning to Chairman of the Board of Directors, and Danielle Tarino (pictured here with Justin) will become the new president and CEO.

Tarino is one of YPR’s founders and is well regarded throughout the national recovery advocacy community. Learn More →

May we all keep singing and dancing like recovery advocate Dick Van Dyke, who was on another stage Sunday at age 94.

After getting established in recovery, Nick Winings bought a taxi business in southern Minnesota. In just over a year, he has expanded from one taxi to 30 drivers and 18 cars, and all of the contractors are people in recovery.

Robert Upton from North Dakota used the #DecadeChallenge on social media to advocate for recovery.

Former Canadian radio host Erin Davis opens up on loss and sobriety.

Miscellaneous Musings We co-sponsored “Recovery Night at the Wild” on Sunday. A few hundred people in recovery showed up for fellowship, to hear from recovery speakers like former hockey star Kevin Stevens, and to see the Minneosta Wild take on the Calgary Flames.

Thanks to our friend Sol Ryan from The Retreat and Recovery Community Hockey for organizing the great event! Learn more →

• A Gambling Commission report in the UK shows how much the betting industry relies on people with gambling problems for its profits. As recovery advocate and researcher Austin McNeill Brown tweeted, “The alcohol industry, the gambling industry, and likely the cannabis industry all rely on a small amount of problematic users to sustain business.”
• The federal spending package mentioned in the Big News section also included a handful of other notable public health measures, including: 1) Repeal of health taxes designed to pay for the Affordable Care Act; 2) Raising of the age to buy tobacco products to 21; 3) Funding to begin a campaign to end the HIV epidemic by 2030; 4) A bill to encourage generic medication competition; 5) Increased funding for the national Suicide Prevention Lifeline; and 6) An extension of Medicaid funding for U.S. territories Guam, Puerto Rico and the Virgin Islands.
• If current trends continue, nearly half of U.S. adults will be obese 10 years from now, and almost one-quarter will be severely obese, researchers predict.
• Emotional health: why it's as important as physical health.
• It’s NFL playoff time, and this writer is rooting for the Vikings all the way! But we all should be rooting for Josh Gordon, the talented Seahawks receiver who, before the playoffs, was suspended indefinitely for violating the NFL’s substance use policies again—his eighth suspension in eight seasons.
• A new author got articles published recently in both the New York Times and TIME magazine, the first on “the Patriarchy of Alcoholics Anonymous” and the second on “why I stopped calling myself an alcoholic.” In an article that may or may not have been a reaction to her thoughtful views, the aforementioned recovery researcher Austin McNeill Brown offered some related perspectives, while also laying out the strong evidence supporting Twelve Step recovery. All of these articles are useful references.
• Congrats to our friend Susie Mullens, who has been hired as the project coordinator for the new Southern West Virginia Collegiate Peer Recovery Network.
• Minnesotans: Andy Gold and his Addicted to Comedy tour are coming to the Twin Cities on Jan. 13. The show will feature people in recovery performing for a sober crowd you can be part of!
• Vaping has more than health consequences, say those looking at the environmental impact of trashed cartridges and e-cigarettes.
• We shared previously about the Appalachian School of Luthiery supporting people new to recovery by getting them involved in making musical instruments. The New York Times took the baton from NPR, expanding on this interesting and inspiring story.
• William White remains on a break from his blog. If you haven’t yet taken us up on our plea to dive into his three lectures on recovery-oriented systems of care (ROSC), now is the time. We think lectures 1, 2 and 3 are must-sees for anyone working in addiction treatment and/or recovery.
• Thank you for reading. What do you think? Send us a note anytime, and have a great start to the new year!