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How Maine prisoners kicked addiction

The ideas and innovators shaping health care
Jan 13, 2023 View in browser
 
Future Pulse

By Ben Leonard, Ruth Reader and Erin Schumaker

Programming note: We'll be off Monday for Martin Luther King Jr. Day but will be back in your inboxes on Tuesday.

WEEKEND READ

The August Recovery Reentry Center in Bangor, Maine.

The Augusta Recovery Reentry Center in Bangor, Maine, helps people recently released from correctional facilities with their recovery process. | ARRC

CASE STUDY IN TREATMENT: America's sprawling network of more than 4,400 state prisons and local jails has emerged as a front line in the nation's unrelenting opioid crisis, which killed more than 80,000 people in 2021 and has helped drag U.S. life expectancy to its lowest levels in a quarter century.

POLITICO's Krista Mahr traveled to Maine to examine the state's efforts to wean prisoners off dangerous drugs like opioids and prevent fatal overdoses by prescribing medications like buprenorphine and methadone.

About 40 percent of inmates across the prison system are administered drugs to treat opioid use disorder. Krista writes that the Biden administration is taking notice and touting the program as a model for the rest of the country.

Maine's program offers voluntary medication and counseling to anyone in a state prison diagnosed with an opioid use disorder regardless of their release date and ensures everyone leaving the prison has naloxone, a drug used to reverse overdoses, and fentanyl test strips, which can be used to detect whether the powerful opioid is present in other drugs, like cocaine or meth.

The program, budgeted at $3.3 million for this year, has fundamentally changed the atmosphere at Maine State Prison, residents and prison staff told Krista. They said that the black market for drugs has dried up. There are fewer fights and fewer suicide attempts. The security staff and residents get along better. And fatal overdoses among people leaving prison have dropped 60 percent since the program started in 2019, according to the state Department of Corrections.

A resident at the Hebrew Home receives a COVID-19 booster shot.

Edward Williams, a resident of the Hebrew Home at Riverdale, receives his bivalent Covid booster last year. | Seth Wenig/AP Photo

WEAK BOOSTER UPTAKE: Less than 40 percent of people over 65 have taken the updated booster shot that became available in the fall, according to the CDC, leaving millions with little protection against the latest Covid strain now sweeping the U.S., POLITICO's Megan Messerly and Adam Cancryn report.

The Biden administration — which is growing frustrated with the low vaccination rates in nursing homes — is forwarding lists of facilities for elderly adults with zero people boosted to state regulators for review and possible penalties, which could include fines. The administration is also pushing governors to increase their states' immunization rates.

Despite a concerted White House effort to raise the number of people over age 65 who have gotten their updated booster ahead of the holidays, only 38 percent of them have taken the shot, according to CDC data, compared with 94 percent who have received their first two shots.

"You have a conundrum where, on one hand, it has never been easier to get a shot in the U.S. You can walk into any pharmacy and get it for free — and we know that's not going to be the case forever. On the other hand, the bivalent booster is just not getting the interest and uptake that we think it should," said Joseph Kanter, Louisiana's state health officer.

NEW YORK,  NEW YORK - MAY 01: A view of crates stacked up outside of CVS Pharmacy during the coronavirus pandemic on May 1, 2020 in New York City. COVID-19 has spread to most countries around the world, claiming over 239,000 lives with over 3.4 million infections reported. (Photo by Cindy Ord/Getty Images)

Anti-abortion activists plan to picket CVS because the drugstore chain said it will dispense an abortion pill. | Getty Images

NEW FRONT IN THE ABORTION WARS: It could be your local CVS, POLITICO's Alice Miranda Ollstein and Lauren Gardner report.

Anti-abortion advocates are organizing pickets outside CVS and Walgreens in early February in at least eight cities, including Washington, D.C., in response to the companies' plans to take advantage of the Food and Drug Administration's decision last week allowing retail pharmacies to stock and dispense abortion pills in states where they're legal.

The demonstrations aim to bring the same chants, signs and confrontations to drugstore parking lots that groups have long used to try to deter visits to abortion clinics. The protests will coincide with a call-in campaign and a planned national boycott of the chains.

"We want people to be uncomfortable going into a CVS that has a demonstration going on and to consider going to a different pharmacy," said Caroline Smith, a leader of the group Progressive Anti-Abortion Uprising.

WELCOME TO FUTURE PULSE

Kiawah Island, South Carolina

Kiawah Island, South Carolina | Ben Leonard

This is where we explore the ideas and innovators shaping health care. 

Scientists now think they know why chocolate is so good — the lubrication when it mixes with saliva. Or, it could just taste good too, we think.

Share any other thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com.

Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.

Today on our Pulse Check podcast, Ben talks with Ruth about the impact the end of the Covid-19 public health emergency might have on access to drugs used to treat substance use disorders and mental illnesses.

Play audio

Listen to today's Pulse Check podcast

TECH MAZE

A person on computer.

Hackers pose a threat to health care supply chains. | Sean Gallup/Getty Images

Health care organizations' supply chains pose a cybersecurity risk, reveals a new Ponemon Institute survey conducted for the Healthcare Sector Coordinating Council's Cybersecurity Working Group.

Ponemon is a Michigan research firm; the working group is made up of companies and industry organizations from the health care sector and advises government agencies.

The survey fielded responses from more than 400 health IT and security officials and found significant disparities in preparedness among large and small organizations.

Some of the key findings included: 

— Just half of those surveyed said they analyze cyber risks to patient care created by new products.

— Less than half of respondents said they analyze the "integrity" of vendors' software and technology.

— Fewer than 1 in 5 organizations surveyed have a "complete" accounting of their technology, physical goods and other services.

— Fifty-seven percent of small organizations budget for less than $500,000 in supply-chain risk management.

"This survey hammers home the urgent need for automation and actionable risk insights to help supply chain leaders effectively manage inventory, cyber risk, fraud, safety, and supplier redundancy," said Ed Gaudet, CEO of Censinet, a Boston firm that manages cybersecurity risks for health care organizations, and a member of the working group, in a statement.

DANGER ZONE

The Medicare logo in Sydney, Australia. I

The HHS inspector general wants to help Medicare Advantage plans identify fraudulent claims. | Brendon Thorne/Getty Images

HHS' watchdog is developing a tool to help providers and insurers better uncover telehealth fraud, Melissa Rumley, a spokesperson for the agency's inspector general, told Ben.

Similar to existing inspector general tools for detecting fraud in opioid prescribing, the new offering will include guidance on how to review telehealth claims data electronically.

"Users can also modify the measures to meet their individual needs, such as identifying providers at varying levels of risk," Rumley said. "This will be a valuable analytic tool for public and private sector partners such as Medicare Advantage plans, private health plans, state Medicaid fraud control units and other federal health care agencies that want to assess telehealth claims for potential fraud, waste or abuse."

Why it matters: The potential for telehealth fraud is an ongoing concern as the government has expanded access to virtual visits through Medicare.

Even so: In September, the inspector general reported that telehealth fraud was rare amid the pandemic, finding that 0.2 percent of claims were a high risk to Medicare for waste, fraud or abuse.

 

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