CLAAD Center for Lawful Access and Abuse Deterrence 2014 ANNUAL REPORT About CLAAD The not-for-profit Center for Lawful Access and Abuse Deterrence (CLAAD) coordinates a comprehensive national effort to prevent prescription drug fraud, diversion, misuse, and abuse while advancing consumer access to high-quality health care. CLAAD enables health professionals, law enforcement, businesses, government officials, and others to share resources and work together to improve public health and safety. We foster collaboration among the multiple sectors of society that had previously been working concurrently, yet not in unison, to address the growing national concern for prescription drug abuse. CLAAD gathers information and research on prescription drug fraud, abuse, misuse, and diversion. We also coordinate grassroots activities among interested organizations and make policy recommendations on prescription drug abuse with the goal of improving the public health. CLAAD’s policy positions are established through a consensus process, in which at least 80 percent of the participants must represent not-for-profit organizations. This rule of governance ensures that the public interest drives CLAAD’s priorities, as opposed to the interests of individual stakeholders. Policy Leadership. Information and Analysis. Coalition Building. Since 2009, the Center for Lawful Access and Abuse Deterrence (CLAAD) and its diverse coalition of not-for-profit public health and safety and commercial organizations have encouraged a balanced approach to the prescription drug abuse epidemic. In 2014, our efforts resulted in progress, having witnessed the first decline in opioid-related overdose deaths in over a decade.1 While there is still much more to do, this Annual Report summarizes the work we did last year towards achieving our mission. As the prescription drug abuse epidemic continues to evolve, unintended consequences of well-intentioned policy approaches are beginning to emerge. Although efforts to reduce the supply of opioid medications available for abuse are proving to be successful, the pendulum has swung back, resulting in adverse effects. These include inadequate reduction in demand; increased misuse of heroin, buprenorphine, benzodiazepines, and stimulants; the proliferation of counterfeit and analog drugs; black market novel biologics; and fraud and abuse in testing for substance use. In 2015, through its National Prescription Drug Abuse Prevention Policy Meeting and National Prescription Drug Abuse Prevention Strategy, CLAAD and its coalition will continue to share perspectives, discuss policy, provide analysis, and build consensus, maximizing the use of limited resources by harmonizing efforts. Commercial coalition members that provided funding support to CLAAD in 2014 included 4Thought Products, AbbVie, Allergan, Egalet, Endo Pharmaceuticals, Grünenthal USA, Mallinckrodt Pharmaceuticals, Millennium Health, Otsuka, Purdue Pharma, Signature Therapeutics, Two Dreams, and Watauga Recovery Center. [1] Donna Leinwand Leger, Painkiller deaths drop for first time since 1999, USA TODAY (Oct. 15, 2014), http://www.usatoday.com/story/news/nation/2014/10/15/painkiller-deaths-drop-for-thefirst-time-since-1999/17262383/. Policy Leadership • Abuse-Deterrent Formulations (ADFs) Manuscript – Authored an original manuscript entitled Abuse-Deterrent Formulations: Transitioning the Pharmaceutical Market To Improve Patient and Public Health and Safety. The article assessed the pros and cons of abusedeterrent medications to reduce the attractiveness or drug-liking qualities of powerful controlled substances and called for the U.S. Food and Drug Administration and Congress to implement concrete strategies to transition the market to ADFs for all Schedule II and III controlled substances. • Differential Diagnosis Policy Paper – Authored policy document that discusses differential diagnosis of low back pain, misprescribing of an opioid pain medication when a non-opioid would be more appropriate, and the ensuing impact on patients. The document is currently being reviewed and considered for publication by health policy journals. • Pain Care Forum and Federal Legislative Recommendations – Authored draft legislation consisting of 12 sections that, if enacted, would effectively reduce prescription drug abuse. The proposal was presented in-person to U.S. Senate Health, Education, Labor, and Pensions Committee majority and minority staff in October. • Urine Drug Testing Policy Proposals – Through policy outreach to its coalition, CLAAD formulated principles for the application of urine drug testing to be applied to addiction treatment. CLAAD communicated these principles to state and federal policy makers throughout 2014: Where We’ve Been • Connect With CLAAD @CLAAD_Coalition http://goo.gl/qs8glP * [email protected] • o Comments to Oklahoma Health Care Authority (Nov. 10) o Letter to CLAAD Letter to MassHealth (Dec. 16) o Letter to Centers for Medicare and Medicaid Services and Palmetto GBA (Aug. 27) o Letter to Noridian Healthcare Solutions, LLC (Feb. 7) Safer Prescribing Policy Proposals – CLAAD developed safer prescribing standards in July through collaboration with its coalition partners as well as policy analyses from states at the forefront of addressing prescription drug abuse, such as Florida and Kentucky. CLAAD has since proposed these safer prescribing guidelines for certain controlled substances in multiple states: o Letter to Alabama Board of Medical Examiners (Sept. 3, July 16) o Letter to Vermont Governor Peter Shumlin (Apr. 23) o Letter to Delaware State Board of Pharmacy and Division of Public Health (July 21) State Legislation – CLAAD drafted the Overdose Death Prevention Act (ODPA) in partnership with the Narcotics Overdose Prevention & Education (NOPE) Task Force. The ODPA would require emergency department staff to notify a patient’s primary care physician, the emergency contact or the next of kin, and, if the patient is currently undergoing addiction treatment, the treatment provider, that the patient has suffered a life-threatening, non-fatal overdose. Language is currently being proposed to lawmakers ahead of Florida’s 2015 Policy Leadership continued • Policy Outreach and Sign-On Letters o Letter to U.S. Senate Judiciary Committee Chairman Patrick Leahy (D-VT) and Ranking Member Charles Grassley (R-IA) in support of White House Office of National Drug Control Policy Acting Director Michael Botticelli’s nomination (Nov. 11) o Letter to U.S. Senators Orrin Hatch (R-UT) and Sheldon Whitehouse (D-RI) in support of their bill, the Regulatory, Transparency, Patient Access, and Effective Drug Enforcement Act of 2014 (Oct. 14) o Letter to U.S. Department of Health and Human Services Secretary Sylvia Mathews Burwell in support of U.S. Food and Drug Administration Commissioner Margaret Hamburg amid calls for her resignation (Oct. 8, 2014); received reply on Oct. 21 from Center for Drug Evaluation and Research Deputy Director Douglas Throckmorton o Letter to nine governors appointed to the National Governors Association Health and Human Services Committee seeking continued focus on reducing prescription drug abuse (Sept. 19) o Letter to the Centers for Medicare and Medicaid Services seeking reform of the Physician Payments Sunshine Act (Sept. 15) o Letter to Alabama Board of Medical Examiners regarding favorable proposed rule to indiscriminately apply safer prescribing standards for powerful controlled substances (Sept. 8) o Submitted Citizen Petition and corresponding letter to the Center for Substance Abuse Treatment in support of amending the Drug Addiction Treatment Act of 2000 (Sept. 3) o Letter to Health Canada regarding proposed regulations related to tamper resistance under the Controlled Drugs and Substances Act (Aug. 26) o Letter to Department of Health and Human Services Secretary Sylvia Mathews Burwell urging the Obama Administration to address limited benefits, high cost-sharing, and lack of transparency in the Health Insurance Marketplace (“exchanges”) (July 28) o Letter to U.S. Representative Tom Marino (R-PA) in support of the Ensuring Patient Access and Effective Drug Enforcement Act of 2014 (July 25) o Letter to U.S. Senator Jeanne Shaheen (D-NH) in support of the National All Schedules Prescription Electronic Reporting (NASPER) Reauthorization Act to strengthen prescription monitoring programs (July 18) o Letter to Food and Drug Administration supporting Citizen Petition No. FDA-2014-P-0205 to impose safety labeling changes on immediate-release opioid analgesics (Mar. 13) Policy Leadership continued • Meetings and Events o Hosted the seventh annual National Prescription Drug Abuse Prevention Policy Meeting in Washington, D.C. with 36 participants representing 30 not-for-profit public health and safety organizations, private companies, and government officials to collaborate and share the limited resources available to reduce prescription drug abuse (Dec. 2) o Attended the Appropriate and Safe Use of Prescription Pain Medication Advisory Board meeting in Chicago, Illinois (Dec. 3-4) o Attended the National Association of Drug Diversion Investigators 25th Annual Conference in Cincinnati, Ohio (Nov. 17-19) o Attended the U.S. Food and Drug Administration Public Meeting on the Development and Regulation of AbuseDeterrent Opioid Medications in Silver Spring, Maryland (Oct. 30-31) o Hosted a Policy Discussion on Protecting Consumers from Black Market Prescription Drugs in Washington, D.C. with participants representing 17 organizations, including not-for-profit public health and safety organizations, industry, and government officials (Oct. 21) o Presented “Addressing an Evolving Epidemic Through Substance Use Intervention and Treatment Policies” at the International Nurses Society on Addictions 38th Annual Educational Conference in Washington, D.C. (Oct. 16) o Attended the National Consumers League Trumpeter Awards in Washington, D.C. (Oct. 8) o Attended Capitol Hill briefing hosted by the Alliance for Health Reform and the Pharmaceutical Care Management Association entitled “Prescription Opioid Abuse: Fighting Back on Many Fronts” (Sept. 29) o Exhibited at the Partnership for Safe Medicines Interchange 2014 meeting in Washington, D.C. (Sept. 18) o Presented “Addressing an Evolving Epidemic Through Substance Use Intervention and Treatment Policies” at the American Society of Pain Management Nursing 24th National Conference in Atlanta, Georgia (Sept. 17) o Presented “Proper Utilization of Urine Testing in Identifying and Treating Substance Use Disorders” and “Leveraging the Equity Act and ACA To Improve Access to Treatment for Substance Use” at the 27th Annual Cape Cod Symposium on Addictive Disorders in Hyannis, Massachusetts (Sept. 11) o Attended an Arthritis Foundation Capitol Hill briefing on back pain in Washington, D.C. (Sept. 5) o Attended the Entertainment Industries Council PRISM Awards Showcase in Washington, D.C. (Sept. 3) o Presented “From Campuses to Capitals: Activating the Recovery Community To Address Evolving Trends in Substance Use” at the Generation Rx University Conference in Columbus, Ohio (Aug. 7) o Attended a Congressional Forum on Women and Addiction in Washington, D.C., hosted by U.S. Senators Sheldon Whitehouse (D-RI), Rob Portman (R-OH), Amy Klobuchar (D-MN), and Kelly Ayotte (R-NH) (July 22) o Presented “Prescription Drug Monitoring Programs: An Exploration of Best Practices and Opportunities for Collaboration” at the National Association of Attorneys General Summer Meeting in San Diego, California (June 4) o Moderated “Avoiding the Dangers of Rumor-Based Medicine” and “Integrating PDMP Data Into the Clinical Workflow” at the National Rx Drug Abuse Summit in Atlanta, Georgia (Apr. 22) o Presented “Prescription Drug Abuse: Legal Strategies to Curb the Evolution of the Epidemic” at the National Association of Attorneys General Southern Region Meeting in Point Clear, Alabama (Apr. 2) o Presented “Choices and Consequences: Health Policy and the Affordable Care Act” at the University of Arkansas Law Review Symposium in Little Rock, Arkansas (Feb. 28) o Presented “Legal and Policy Strategies To Address and Evolving Epidemic” at the West Virginia Law Review Symposium in Morgantown, West Virginia (Feb. 13) o Moderator at the Addiction Executives Industry (aXis) Summit in Naples, Florida (Feb. 9) o Presented “Prescription Drug Fraud, Diversion, and Abuse: Policies To Address the Evolving Epidemic” at the National Sheriffs’ Association 2014 Winter Conference in Fort Lauderdale, Florida (Jan. 24) Coalition Building “I am pleased to see that CLAAD has brought together so many dedicated stakeholders in putting forward a comprehensive plan to improve medicine, strengthen drug education, and ensure our children have a bright, drug-free future.” • Missouri Prescription Drug Monitoring Program NOW (PDMP NOW) Coalition – CLAAD joined the Missouri PDMP NOW Coalition with more than 30 other organizations supporting implementation of a PDMP in Missouri, the last state without a program. Coalition members include not-for-profit public health and safety organizations and pharmaceutical manufacturers. • Outreach and Awareness – Throughout 2014, CLAAD conducted outreach to dozens of not-for-profit organizations in order to grow its footprint and raise awareness of prescription drug abuse issues. Organizations include Trust for America’s Health, National Governors Association, U.S. Conference of Mayors, Pew Charitable Trusts, Clinton Foundation, Transforming Youth Recovery, Arthritis Foundation, NCAA, The Jed Foundation, Johns Hopkins Bloomberg School of Public Health, Legal Action Center, National Association of Counties, Network for Public Health Law, and State Association of Addiction Services, among others. • Commercial Coalition Members – CLAAD secured support from multiple for-profit organizations that share our dual mission to reduce prescription drug abuse and optimize patient access to high quality health care. • Collaboration – CLAAD urged Physicians for Responsible Opioid Prescribing (PROP) and Phoenix House to focus efforts toward collaboration among groups working to reduce prescription drug abuse. – HAROLD ‘HAL’ ROGERS U.S. CONGRESSMAN (KY-05) Non-Profits & Government at CLAAD’s Policy Meeting Alliance for Safe Online Pharmacies Allies in Recovery Narcotics Overdose Prevention & Education (NOPE) Task Force American Pharmacists Association National Alliance for Model State Drug Laws American Society for Pain Management Nursing National Association of Attorneys General American Society of Addiction Medicine National District Attorneys Association American Society of Anesthesiologists National Family Partnership Community Anti-Drug Coalitions of America National Governors Association Drug Free America Foundation National Sheriffs’ Association Healthcare Distribution Management Association Northeastern University International Nurses Society on Addictions Office of the State Attorney, 15th Judicial Circuit of Florida Johns Hopkins Bloomberg School of Public Health Information and Analysis • Collegiate Recovery Communities – Drafted blog post for Generation Rx Initiative entitled “Collegiate Recovery Communities: Bringing Substance Use Disorders Out of the Shadows and Into the Sunlight” (Nov. 20) • Legislative Analysis – Monitored and analyzed federal and state legislation to provide support and feedback as it relates to safer prescribing standards for controlled substances, addiction treatment, abuse-deterrent medications, and other related topics. • Media Exposure • • o Weighed in on a KTNV 13 ABC News of Nevada consumer investigative report regarding hydrocodone rescheduling and its impact on access to care for patients (Nov. 17) o Participated in a BioCentury TV interview about abusedeterrent medications (Nov. 10) o Submitted to PainDr.com an op-ed on the need for collaboration among groups working to reduce prescription drug abuse (Aug. 14) o Participated in an in-PharmaTechnologist.com report on abuse-deterrent formulations (Aug. 6) Commercial Support o Drafted opinion-editorial entitled “Let’s Convert Fear Into Meaningful Change” about the need for balanced policies that will reduce prescription drug abuse (June 17) o Participated in FDA Week story entitled “Opioid Promotion Lawsuit Heightens FDA Painkiller Oversight Debate” (May 30) o Drafted op-ed about unsafe prescribing practices entitled “Blowing the Whistle on Dirty Docs” (May 29) o Drafted op-ed about ACLU lawsuit exemplifying confusion regarding therapeutic testing for substance use (May 29) CLAAD receives funding and in-kind support from businesses in the health care field that share CLAAD’s mission to reduce prescription drug fraud, diversion, misuse, and abuse while advancing consumer access to high-quality health care. CLAAD’s commercial supporters include pharmaceutical companies (both abuse-deterrent opioid manufacturers and non-opioid manufacturers), treatment centers, and the urine drug testing (UDT) industry. o Participated in Inside Health Policy story entitled “States Should Focus Efforts On Prescribing, Dispensing Limits, Sources Say” (Apr. 17) Marketing and Communications – Overhaul of CLAAD website, National Prescription Drug Abuse Prevention Policy Meeting website, production of marketing materials, and expansion of email distribution list to more than 1,000 supporters, partners, and other stakeholders. CLAAD is managed by DCBA Law & Policy (DCBA). DCBA also provides legal and policy counsel to professionals and businesses whose activities align with CLAAD’s mission. To avoid conflicts of interest, DCBA adheres to the District of Columbia Rules of Professional Conduct §§ 1.7-1.9. Expanded Social Media Presence – Garnered attention from highprofile public figures through social media, including U.S. Senator Amy Klobuchar (D-MN), White House Office of National Drug Control Policy Director Michael Botticelli, Mississippi Attorney General Jim Hood, former U.S. Representative Mary Bono (R-CA), former Rhode Island State Representative Tom Coderre, and Emmy-winning actress Kristen Johnston. Treatment 2% ADF Opioid 39% UDT 28% Nonopioid 31% Contact CLAAD Center for Lawful Access and Abuse Deterrence 1000 Potomac Street, NW, Suite 150-A Washington, D.C. 20007 Telephone: (202) 599-8435 Fax: (202) 459-9611 [email protected] www.claad.org
© Copyright 2024