An armed guard surveys the grounds from the railing of a prison watchtower.

Surveying US Correctional Facilities’ Pandemic Policies on Medication for Opioid Use Disorder

By Laura Hannon and Alex Willhouse 

An estimated 65 percent of the United States prison population has an active substance use disorder (SUD). Providing comprehensive substance use treatment to incarcerated individuals has been shown to reduce both drug use and crime upon release. Treatment is a critical intervention to prevent opioid overdose deaths, which the CDC estimates increased by 15.4 percent, from 70,029 in 2020 to approximately 80,816 in 2021. Medications like methadone, buprenorphine, and naltrexone are an important part of a comprehensive approach to addressing opioid use disorder (OUD).  

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Suboxone.

Prior Authorization Insurance Requirements: A Barrier to Accessing Lifesaving Treatment for Opioid Use Disorder?

By Juan M. Hincapie-Castillo and Amie J. Goodin

Policies to mitigate the drug overdose crisis continue to fall short, as evidenced by increasing rates of opioid-involved overdoses and deaths in the United States. The COVID-19 pandemic has exacerbated this overdose crisis, and efforts are urgently needed to mitigate harm.

Individuals who have problematic opioid use are most frequently involved in opioid-involved overdoses, meaning that the use of a prescription opioid, or much more commonly a non-prescription opioid (such as non-medically sourced fentanyl or heroin), is used in a way that adversely affects the person’s life. Problematic opioid use may lead to a diagnosis of opioid use disorder (OUD). The medication buprenorphine has been proven to reduce opioid-involved overdose and harms and is one of few OUD treatments available as a prescription that can be dispensed by community pharmacies rather than from specialized facilities or specialty providers.

The federal government and several states have implemented strategies to improve and promote OUD treatment access, especially for the relatively inexpensive and effective medication buprenorphine. However, there are significant barriers that remain that preclude adequate and timely access to buprenorphine.

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Bill of Health - American currency (50, 100, 20) on a wooden table next to pills and spilling bottle of pharmaceuticals

Many Hospitals Receiving Discounted Drugs May Not Offer Patients Pharmaceutical Assistance

By Amy Cook, JD, Jonathan Larsen, JD, MPP, and Sabrina Ruchelli, JD

Section 340B of the Public Health Service Act requires that pharmaceutical manufacturers give discounts on specified outpatient drugs to certain covered entities who typically serve low-income or otherwise underserved patients, including hospitals and clinics.

However, according to the Government Accountability Office (GAO), there are no measures built into the program to assure that 340B program discounts are being used to support care for low-income populations, let alone to improve access to medicines discounted through the program.

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San Diego CA 6-24-2020 Tourists eating at Mexican restaurant with waitress wearing mask in historic Old Town State Park.

Improving Job Quality and Scheduling Predictability Can Advance Public Health and Reduce Racial Inequities

By DeAnna Baumle

The ongoing COVID-19 pandemic has thrown into sharp relief deeply rooted structural inequities in the United States. As U.S. government officials and media celebrate recent economic gains, women — especially women of color — are not recouping their economic losses. Further, the pandemic continues to kill nearly a thousand Americans daily and disproportionally affect Black, Indigenous, and Latinx communities. It is no accident that these communities have been left behind in the nation’s so-called recovery: racial capitalism has long excluded marginalized communities from economic and social gains.

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Police car.

New Data Highlights Complexity of Good Samaritan Overdose Law Landscape

By David Momjian

Since 1999, over 800,000 people have died from a drug overdose in the United States, with more than half of those deaths (500,000) resulting from opioid overdose.

Additionally, all 50 states have experienced a spike in overdose deaths in the wake of the COVID-19 pandemic. In the 12-month period ending in May 2020, 81,000 drug overdose deaths occurred in the United States; the highest number of overdose deaths ever recorded in a 12-month period.

To combat the rising death toll from drug overdoses, 47 state legislatures and the District of Columbia have passed Good Samaritan laws (GSLs) to protect bystanders from criminal prosecution if they call for medical assistance during a drug overdose. Bystanders to a drug overdose are often worried that by calling for help, they could be arrested for drug possession or evicted by the police, who often arrive first at the scene of a 911 call, even if it is a medical emergency.

A new dataset built by the Center for Public Health Law Research at Temple University’s Beasley School of Law and funded by Vital Strategies, covers the evolution of GSLs in the United States from January 1, 2007, to June 1, 2021.

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Houses.

New Data on Eviction Laws Opens Doors for Evaluation

Even before the COVID-19 pandemic, there was an eviction crisis in the United States. Estimates suggest landlords across the country file 3.7 million eviction cases each year — leaving considerable impacts on health and well-being in their wake. 

The eviction process is regulated by a patchwork of state/territory and local laws and court rules that govern the judicial process, but little is known about the ways in which these laws affect the likelihood of evictions.  

new database, launched by the Legal Services Corporation (LSC) in partnership with the Center for Public Health Law Research, captures the entire eviction legal process, from pre-filing to post-judgment, in different communities around the country.  

The data provide early insights, including: 

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Rows of gold post office boxes with one open mail box.

FDA Expands Medication Abortion Access During Pandemic, but State Barriers Remain

By Adrienne R. Ghorashi, Esq.

Last week, the Food and Drug Administration (FDA) suspended an in-person dispensing requirement for mifepristone for the duration of the COVID-19 pandemic, allowing patients to access medication abortion by mail.

Previously, the FDA REMS requirement mandated that mifepristone must be dispensed in person, forcing patients to travel to a clinic in order to pick up the medication. In light of the pandemic, the requirement would lead to unnecessary risks of COVID exposure for patients and providers, in addition to imposing logistical and financial burdens.

This FDA decision is the latest development in a battle that made its way to the U.S. Supreme Court earlier this year. In its first abortion decision since Justice Amy Coney Barrett joined the bench, the Supreme Court reinstated the in-person dispensing requirement after it had previously been blocked by a federal district court in Maryland due to the risks of COVID-19.

Advocates for abortion access are celebrating the FDA decision as a win for science and evidence-based policy rooted in a growing body of research on the benefits of medication abortion and telemedicine for abortion.

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Russia, Saint-Petersburg, village of Telman - August 2015: a plant for the production of meat products. a worker walks down the hall of meat production in Russia, the village of Telman.

Performance Analysis of OSHA During COVID-19

By Zoey Binder

The United States Occupational Safety and Health Administration (OSHA) was highly criticized this year for an alleged lack of enforcement and failure to protect workers from unsafe working conditions related to COVID-19.

Of particular concern has been its failure to exert authority over the meatpacking industry, whose workers have been disproportionately harmed by the pandemic.

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America divided concept, american flag on cracked background.

COVID-19 Unmasks Issues Around Public Health Preemption

By Jessica Amoroso and Sarah Winston

States across the U.S. are using preemption to stifle local authority aimed at mitigating the spread of COVID-19, resulting in confusion and a fragmented response.

Historically, local governments have played an important role in providing direct and indirect services to their communities, as they have a heightened awareness of their needs compared to state governments. This has proven especially true during the COVID-19 pandemic, as city and municipal initiatives often have been the initial access point for virus-related services.

But state preemption is increasingly being used as a legal tool to prevent cities and municipalities from legislating on issues of importance to public health.

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gavel.

How to Reduce Racial Disparities in the Criminal Justice System

By Caroline Hinnenkamp

Racial disparities in the U.S. criminal justice system are well documented –– people of color are disproportionately arrested, convicted, and incarcerated.

Diversion efforts –– so named for their approach, which is to divert individuals away from the court process and instead offer opportunities for rehabilitation –– risk perpetuating these same racially disparate trends. Particularly if diversion programs have eligibility constraints based on prior records, people of color are more likely to be denied entry, because they are arrested and convicted at a higher rate than their white counterparts.

Historically, prosecutors tended to justify these constraints as mechanisms used to gauge an applicant’s capacity for rehabilitation, with recidivism (the tendency of a convicted criminal to reoffend) reduction as the central goal of diversion. Diversion was an alternative offered to the lucky few deemed “eligible” or “deserving,” with the implication being that reoffenders have a criminal disposition that is not amenable to rehabilitation.

But programs that use these screening methods tend to overlook the underlying facts and circumstances that might have brought about the applicant’s priors, such as implicit bias in law enforcement or the over-policing of specific communities. Without additional safeguards, the seemingly neutral constraint of “priors” fails to account for relevant pre-existing conditions, and risks barring entry to applicants who might otherwise benefit from diversion.

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