SJR 73: Joint Subcommittee Studying Strategies and Models for Substance Abuse Prevention and Treatment

November 16, 2010

The fourth and final meeting of the Joint Subcommittee Studying Strategies and Models for the Prevention and Treatment of Substance Abuse was held at Youth for Tomorrow in Bristow, Virginia.

Suboxone Program

Keith Shuster, LPC, Prince William County Services Board
Ms. Shuster described the Prince William County Community Services Board’s Suboxone program for people with opioid dependence. The program provides 90 days of Suboxone-assisted residential treatment for people with opioid dependence, including residential treatment for individuals in need of stabilization. The program has served 89 clients since 2008. Early results based on the first 16 months of program operations show that retention rates for program participants were significantly higher than retention rates for clients with opiate dependence who did not receive Suboxone as part of their treatment program (73 percent as compared to 34 percent). Recent data shows that program participants are involved with treatment for an average of 343 days, which is close to the recommended 365 days. Studies show that longer treatment involvement correlates with higher rates of success and lower rates of criminal activity.

Prescription Monitoring Program

Ralph Orr, Program Director, Virginia Prescription Monitoring Program
Mr. Orr reported on the Virginia Department of Health Professions’ study of Prescription Monitoring Program Utilization, as required by Senate Joint Resolution 73 (2010). Mr. Orr stated that the Prescription Monitoring Program was established in 2003, and in October of 2009 underwent several programmatic changes, making the service available 24 hours a day through an automated service. This change has made the program more user-friendly. At the same time, the Department of Health Professions has increased public awareness and education activities around the Prescription Monitoring Program, providing educational conferences and materials to health care professionals. The Department and Prescription Monitoring Program staff also continues to work together with Virginia Commonwealth University’s School of Medicine to offer an online chronic pain management course that licensed health professionals may take at no cost to satisfy continuing education requirements. As a result, the number of registered users has doubled since October 1, 2009. As of the end of September 2010, the Prescription Monitoring Program had 7,906 registered users. Between January 1 and September 30 of 2010, the Program had processed over 300,000 requests for information; while approximately one million prescriptions are reported to the Program each month.

Even though changes made to the Program have resulted in increased use of the Prescription Monitoring Program, the Department of Health Professions did recommend several enhancements to the Program that can be viewed in their entirety on the joint subcommittee’s website at http://dls.virginia.gov/GROUPS/subabuse/meetings/111610/materials.htm.

Substance Abuse Insurance Parity

Althelia Battle, Bureau of Insurance, Virginia State Corporation Commission
Ms. Battle presented the Bureau of Insurance’s (Bureau) report on Data Collection and Information on Substance Abuse Treatment Services. Ms. Battle reported that the Bureau mailed requests for information to 798 health insurers, health service plans, and health maintenance organizations licensed to sell accident and sickness insurance in Virginia as of August 16, 2010, and received responses from 468 companies. Of these companies, 34 companies reported issuing policies that included coverage for substance abuse services. These 34 companies reported a total of 30 complaints, with a total of $23,991,007 paid to settle those claims. During 2009, the Bureau received three complaints related to substance abuse services. The Bureau did not report any recommendations for change.

Alcoholic Energy Drinks

Dr. Randy Koch, Ph.D., Exec. Director, Institute for Drug and Alcohol Studies, Virginia Commonwealth University
Dr. Koch presented information on alcoholic energy drinks. Dr. Koch reported that alcoholic energy drinks include alcohol (usually malt liquor) mixed with caffeine and other stimulants. Premixed alcoholic energy drinks are frequently sold in large cans containing up to 23.5 ounces of beverage, and may contain up to 12 percent alcohol by volume. A study of consumption of alcoholic energy drinks in North Carolina found that 68 percent of college students reported drinking alcohol in the previous month, and that 24 percent of college students reported drinking alcoholic energy drinks on at least one day in the past month. Studies of consumption of alcoholic energy drinks indicate that those who drink alcoholic energy drinks are likely to consume more alcohol per episode of drinking, possibly because stimulants in alcoholic energy drinks counteract the depressant effects of alcohol and interfere with drinkers’ perceptions of intoxication. Studies also show that individuals who drink alcoholic energy drinks are:

• More likely to engage in risky behavior.
• Twice as likely to binge drink.
• Nearly twice as likely to be sexually assaulted (females).
• More than twice as likely to sexually assault someone (males).
• Twice as likely to get hurt or injured.
• More than twice as likely to require medical treatment.
• Four times as likely to drive than individuals who consume alcohol that has not been mixed with stimulants.

In response to these risks, Dr. Koch reported that several states have banned the sale of alcoholic energy drinks. Others have reclassified alcoholic energy drinks as distilled spirits. Dr. Koch and the SJR 73 work group recommended that the General Assembly ban the sale of alcoholic energy drinks in the Commonwealth. Alternately, the General Assembly should:

• Provide funding to the Governor’s Office of Substance Abuse Prevention to conduct a public awareness campaign about alcoholic energy drinks, their effects, and the associated dangers.
• Provide additional funding to the Department of Alcoholic Beverage Control to conduct compliance checks on sales of alcoholic energy drinks.
• Consider re-classifying alcoholic energy drinks in a manner that would provide for sale of these beverages through package stores only.
• Increase the tax on alcoholic energy drinks to reduce consumption; funds received as a result of this tax should be allocated to substance abuse prevention and treatment services.
• Require warning labels on premixed alcoholic energy drinks sold in the Commonwealth.
• Prohibit the mixing of alcohol and energy drinks in restaurants and other establishments that serve alcohol.

Discussion of Recommendations

Following presentations, the joint subcommittee discussed recommendations developed by the SJR 73 work group and voted to adopt those recommendations. A complete list of the recommendations adopted can be accessed through the study website.

Chairman:
The Hon. Emmett W. Hanger, Jr.

For information, contact:
Sarah Stanton, DLS Staff