Quick Facts: Drinking Vs. Drugs

Written By: Calvin Pegus

With the current opioid epidemic raging across America at unprecedented levels, many may believe that addiction to prescription painkillers and heroin are powerful drugs that have placed alcohol abuse in the shadows. But it is important to remember that the number of Americans abusing alcohol have consistently remained the same. According to the National Survey on Drug Use and Health (NSDUH) and the Treatment Episode Data Set (TEDS), alcohol addiction is the number one admittance to treatment centers across the nation. Alcohol can have short-term risks that can involve intimate partner violence, alcohol poisoning, risky sexual behavior, homicide, suicide to name a few. Long-term effects of course can increase problems with one’s physical, mental, social health. Finding help for yourself or a loved one may be the best chance a full recovery. SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders. SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889. SAMHSA’s also provides Behavioral Health Treatment Services Locator.

House Bills and the Opioid Crisis

Written By: Calvin Pegus


H.R. 6, SUBSTANCE USE-DISORDER PREVENTION THAT PROMOTES OPIOID RECOVERY AND TREATMENT FOR PATIENTS AND COMMUNITIES ACT. The House of Representatives passed a bipartisan, comprehensive bill on 6/22/2017, which aims at curbing the country’s growing opioid epidemic.  A vote of 396-14, the House passed H.R. 6, the SUPPORT for Patients Communities Act.  H.R. 6 targets Medicaid, Medicare, and public health reforms by advancing treatment and recovery initiatives.  Improving prevention, protecting communities, and bolstering efforts to combat illicit synthetic drugs like fentanyl.




  • Require state Medicaid programs to not terminate a juvenile’s medical assistance eligibility because the juvenile is incarcerated. A state may suspend coverage while the juvenile is an inmate, but must restore coverage upon release without requiring a new application unless the individual no longer meets the eligibility requirements for medical assistance (H.R. 1925)
  • Enable former foster youth who are in care by their 18th birthday and previously enrolled in Medicaid to receive health care until the age of 26 if they move out of state (H.R. 4998)
    Require the Centers for Medicare and Medicaid Services (CMS) to carry out a demonstration project to provide Can enhanced federal matching rate for state Medicaid expenditures related to the expansion of substance-use treatment and recovery services targeting provider capacity (H.R. 5477)
  • Require all state Medicaid programs to have a beneficiary assignment program that identifies Medicaid beneficiaries at-risk for substance use disorder (SUD) and assigns them to a pharmaceutical home program, which must set reasonable limits on the number of prescribers and dispensers that beneficiaries may utilize (H.R. 5808)
    • Require state Medicaid programs to have safety edits in place for opioid refills, monitor concurrent prescribing of opioids and certain other drugs, and monitor antipsychotic prescribing for children (H.R. 5799)
  • Require CMS to issue guidance on Neonatal Abstinence Syndrome (NAS) treatment options under Medicaid and require a study by the nonpartisan Government Accountability Office (GAO) on coverage gaps for pregnant women with SUD (H.R. 5789)
  • Provide additional incentives for Medicaid health homes for patients with substance use disorder (H.R. 5810


  • Instruct CMS to evaluate the utilization of telehealth services in treating SUD (H.R. 5603)
  • Creates a pass-through payment extension under Medicare to encourage the development of clinically superior non-opioid drugs (H.R. 5809)
  • Add a review of current opioid prescriptions and, as appropriate, a screening for opioid use disorder (OUD) as part of the Welcome to Medicare initial examination (H.R. 5798)
  • Incentivize post-surgical injections as a pain treatment alternative to opioids by reversing a reimbursement cut for these treatments in the Ambulatory Service Center setting, as well as collect data on a subset of codes related to these treatments (H.R. 5804)
  • Require e-prescribing, with exceptions, for coverage of prescription drugs that are controlled substances under the Medicare Part D program (H.R. 3528)
  • Require prescription drug plan sponsors under the Medicare program establish drug management programs for at-risk beneficiaries (H.R. 5675)
  • Provide access to Medication-Assisted Treatment (MAT) in Medicare through bundled payments made to Opioid Treatment Programs for holistic service (Section 2 of H.R. 5776)

Public Health

  • Direct the Food and Drug Administration (FDA) to issue or update guidance on ways existing pathways can be used to bring novel non-addictive treatments for pain and addiction to patients. Several approaches have proven successful in speeding the availability of treatments for severe conditions through the FDA (H.R. 5806)
  • Authorize grants to state and local agencies for the establishment or operation of public health laboratories to detect fentanyl, its analogs, and other synthetic opioids (H.R. 5580)
  • Enable clinical nurse specialists, certified nurse midwives, and certified registered nurse anesthetists to prescribe buprenorphine; and make the buprenorphine prescribing authority for physician assistants and nurse practitioners permanent. Also, H.R. 6 will permit a waivered-practitioner to immediately start treating 100 patients at a time with buprenorphine (skipping the initial 30 patient cap) if the practitioner has board certification in addiction medicine or addiction psychiatry; or if practitioner provides MAT in a qualified practice setting. Medications, such as buprenorphine, in combination with counseling and behavioral therapies, provide a whole-patient approach to the treatment of opioid use disorder (H.R. 3692)

View Bills Here

H.R. 5590, Opioid Addiction Action Plan Act
H.R. 5603, Access to Telehealth Services for Opioid Use Disorder
H.R. 5605, Advancing High-Quality Treatment for Opioid Use Disorders in Medicare Act
H.R. 5798, Opioid Screening and Chronic Pain Management Alternatives for Seniors Act
H.R. 5804, Post-Surgical Injections as an Opioid Alternative Act
H.R. 3692, Addiction Treatment Access Improvement Act of 2017
H.R. 4684, Ensuring Access to Quality Sober Living Act of 2018
H.R. 5329, Poison Center Network Enhancement Act of 2018
H.R. 5580, STOP Fentanyl Deaths Act of 2018
H.R. 5587, Peer Support Communities of Recovery Act
H.R. 5797 IMD CARE Act
H.R. 5799, Medicaid DRUG Improvement Act
H.R. 5800, Medicaid IMD ADDITIONAL INFO Act
H.R. 5801, Medicaid PARTNERSHIP Act
H.R. 5715, Strengthening Partnerships to Prevent Opioid Abuse Act
H.R. 5716, Commit to Opioid Medical Prescriber Accountability and Safety for Seniors (COMPASS) Act
H.R. 5796, Responsible Education Achieves Care and Healthy Outcomes for Users’ Treatment (REACH OUT) Act of 2018
H.R. 5228, Stop Counterfeit Drugs by Regulating and Enhancing Enforcement Now Act
H.R. 5752, the Stop Illicit Drug Importation Act of 2018
H.R. 5806, 21st Century Tools for Pain and Addiction Treatments Act
H.R. 4998, Health Insurance for Former Foster Youth Act
H.R. 5477, Rural Development of Opioid Capacity Services Act
H.R. 1925, At-Risk Youth Medicaid Protection Act of 2017
H.R. 3192, CHIP Mental Health Parity Act
H.R. 4005, Medicaid Reentry Act
H.R. 5583, Requiring Medicaid Programs to Report on All Core Behavioral Health Measures
H.R. 5808, Medicaid Pharmaceutical Home Act
H.R. 5795, Overdose Prevention and Patient Safety Act
H.R. 5807, Substance Use Disorder Coordination, Access, Recovery Enhancement (SUD CARE) Act of 2018
H.R. 5811, to amend the Federal Food, Drug, and Cosmetic Act concerning post approval study requirements for certain controlled substances, and for other purposes
H.R. 5812, Creating Opportunities that Necessitate New and Enhanced Connections that Improve Opioid Navigating Strategies Act (CONNECTIONS) Act
H.R. 5809, Postoperative Opioid Prevention Act of 2018
H.R. 5810, Medicaid Health HOME Act
H.R. 5789, To amend title XIX of the Social Security Act to provide for Medicaid IMD coverage for pregnant and postpartum women

*It is important to note that some of these bills were passed by voice vote, which is a vote taken by indicating the relative strength and volume of calls of aye and no.

Why These Bill are Important

According to the Centers for Disease Control and Prevention (CDC):

1,000 people are treated for opioid misuse in emergency departments per day.

115 Americans die per day, and opioid-related overdoses have increased steadily since 1999.

Life expectancy dropped in 2015 and 2106 due to an increase in unintentional injuries (drug overdoses). The opioid crisis has affected the labor force by almost 1 million workers ($702 billion) in the years between 1999 and 2015.

In 2015, the total economic burden of the opioid epidemic was estimated to be $504 billion.
More than 2 million Americans will suffer from addiction to opioids in 2018.

What’s Next

It is now up to the Senate to craft its legislation. We know that the opioid legislation should be a priority, but there is not a specific timeline for the Senate to draft the bills.  We may have to wait up until November to see what proposals or policy ideas if any are coming out of the Senate.  For more detailed information about the House Opioid bills, here is a look at some of the most impactful bills. http://ow.ly/N1se30kI7pm

Effectiveness of Diversion Programs

Writtne By: Calvin Pegus

Diversion programs can be implemented in various forms. The ultimate purpose of these programs is to assist individuals who were charged with a crime the ability to complete community-based substance abuse treatment programs instead of being incarcerated. Diversion programs are a useful tool that can target and solve the underlying issues that have led up to addiction, improve community collaborations, and reduce recidivism. The notion of “sticking” someone into a prison or jail cell and not dealing with the underlying problems, then turning them back onto the streets does not provide a sound solution that will change the individual’s behavior.

According to the National Council on Alcoholism and Drug Dependence, Inc., there are three types of crimes related to drug use:

1. Use-Related crime: These are crimes that result from or involve individuals who ingest drugs, and who commit crimes as a result of the effect the drug has on their thought processes and behavior.
2. Economic-Related crime: These are crimes where an individual commits a crime to fund a drug habit. These include theft and prostitution.
3. System-Related crime: These are crimes that result from the structure of the drug system. They include production, manufacture, transportation, and sale of drugs, as well as violence related to the production or sale of drugs, such as a turf war.

Though drug addiction and criminality have a symbiotic relationship, it is essential that when you analyze the patterns of addiction, diversion programs can provide children and adults the ability to deal with substance abuse issues, and have the capacity to successfully learn lifelong coping skills rather than being immersed into the criminal justice system. Seeking help for addiction is only the start and recovery can be a problematic lifelong process in staying clean and sober which can be difficult if poverty and crime surround the individual’s environment. These programs can provide support that is critical to the success of the individual and the drug diversion program.

Incarceration based policies have been shown to drain public resources, place an added burden on communities who are affected, and never deal with the real issues at hand. Diversion programs provide the opportunity for behavioral change. Diversion programs typically address the substance abuse illness by giving a restorative framework. The most substantial diversion efforts are built on the concepts of underscoring Treatment Accountability for Safer Communities (TASC) models which serve as a bridge between the person and the service delivery system. Under the TASC models, individuals are screened (for substance use disorders, mental health, etc.), assessed, and placed in appropriate programs and services.

It is important to remember that the purpose of diversion programs are not to take away the power of the judicial system, but to utilize the system to facilitate treatment options. The collaboration with community partnerships will provide a stronger treatment service, which can also provide services that target physical and mental health. These diversion programs should ensure that individuals as are receiving a continuum of services. It is imperative to build positive community values that reflect support for individuals that is a holistic, collaborative approach to bring together a coordinated plan for successful recovery.

We Should be Concerned with the Increasingly High Rates of Opioid Use by Children

Written By: Calvin Pegus

Child health disparities have always been a concern for healthcare practitioners, social scientist, and policymakers.  Health disparities are the differences in health outcomes for specific health indexes between groups within the population.  As the opioid epidemic ravages the fabric of American communities across the nation, opioid addiction continues to have a high rate of abuse by children and teenagers.

There is an alarming increase of Neonatal Abstinence Syndrome (NAS) which happens when a baby is exposed to drugs in the womb before birth.  This syndrome can affect babies who have to deal with drug withdrawal after birth.  According to the National Institute for Children’s Health Quality every 25 minutes a baby is born with some form of opioid withdrawal.  The rate of people becoming addicted have also left an increasing number of grandparents to raise grandchildren.

The opioid epidemic in America is at a pivotal crisis and requires an urgent response. According to the article Current State of the Opioid Epidemic as it Pertains to PediatricOrthopaedics From the Advocacy Committee of the PediatricOrthopaedic Society of North America.  80% of high school seniors reported nonmedical use of prescriptions opioids.  The research showed that these students had legitimate prescriptions but still misused the leftover doses.  The enormity of prescription opioid abuse by adolescents needs to be addressed in order to reduce opioid overprescribing and misuse.  According to the National Poison Data System, it reported that 60 percent of pediatric exposures to prescription opioids, reported as poisonings, were in children up to five years old, and 30 percent in teenagers. Most teenage opioid deaths were from intentional opioid use, whereas children under six were exposed unintentionally to medications around the home.   Overall, nearly one-fourth of US high school seniors had some exposure to prescription opioids.  A study of seventh- and eighth-graders found a five percent prevalence of nonmedical prescription opioid use.

Addiction to opioid medications can occur quickly, due to its highly addictive nature and intense cravings. Opiates create a false sense of euphoria, which tricks the body into feeling pain-free. The brain needs to reach the initial level of high and changes the individual from wanting to needing opiates or a similar cheaper drug like heroin to fulfill the cravings.  Common risk factors that may contribute to drug experimentation among adolescents and children include: exposure to social peer pressure; pop cultural norms; inability to achieve high scholastic goals; mental health challenges; genetics; and/or living in a home in which their parents are dealing with addiction.

Though the effects of the opioid epidemic among children and adolescents as a health predicament receives less attention, it does require a more diligent and innovative approach.  With the lack of trustworthy information available on the various social media outlets, many kids are using drugs, without understanding the actual effects and severity of addiction and drug dependency.  What children and adolescents may not understand, is that, once you start using opiates it can take control of the child before they even realize it is happening.

Addiction is a disease and should be treated as a disease.  Prevention is the key to reducing the likelihood of addiction. The earlier we educate our children about drugs, the easier it will be to shift their perceptions of their responsibility in medicinal and social use. Many children and adolescents start using substances early, and teaching children about the risk of drug use need to begin at an early age.  Other strategies could include addressing younger children expectations about pain management, as well as, legislative initiatives to shift the way opiates are prescribed.  It is essential to develop interventions and innovations that will address this new emerging health disparity affecting children in the 21st century.

Substance Abuse, Public Health, and the Harm Reduction Model

Written By: Calvin Pegus

Harm Reduction Model and the relationship to public health is a set of strategies and/or ideas that are used to reduce the damaging consequences associated with substance abuse.   Harm Reduction Model utilizes interdisciplinary approaches like needle exchange programs, educating people on practicing safer usage, and abstinence.  It is a social movement that is built on the premise of social justice and equity which includes a level of respect for the rights of people who are substance abusers.

It is essential to understand that foremost, to combat substance abuse you have to meet the needs of the most vulnerable populations.  The Harm Reduction Model requires addressing not only the conditions of use but all of the determinants that play a part in contributing to use.  Intervention and policy related approaches can benefit from this model by implementing strategies that are designed to address the individual, as well as, the public needs.

A simple google search can retrieve different strategies in addressing substance abuse while utilizing the Harm Reduction Model approach.  The following 8 strategies suggested by the Harm Reduction Coalition, can assist in improving the well-being of individuals affected by substance abuse or substance abuse related policies:

  • Accepts, for better and/or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather than simply ignore or condemn them;
  • Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to total abstinence, and acknowledges that some ways of using drugs are clearly safer than others;
  • Establishes quality of individual and community life and well-being–not necessarily cessation of all drug use–as the criteria for successful interventions and policies;
  • Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they live to assist them in reducing attendant harm;
  • Ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to serve them;
  • Affirms drug users themselves as the primary agents of reducing the harms of their drug use, and seeks to empower users to share information and support each other in strategies which meet their actual conditions of use;
  • Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm; and
  • Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.

Though the approach addresses drug use explicitly, embracing these steps can help reduce stigma for substance use disorders. Reducing stigma can create an encouraging environment (or welcoming space) for the user to seek treatment. The need for reducing stigma can provide people who are substance abusers with the options that can assist in minimizing the risks of continued substance abuse.  Harm Reduction Model targets the risk and harms of substance abuse while including interventions that can help keep people healthy and safe.  The ability to tailor these interventions and address specific risks and harms can account for the social determinants that contribute to substances abuse.

Understanding that substance abuse will always exist and impact communities’ health, social and economic well-being, the Harm Reduction Model approach has the prospect to be anticipatory in reducing the adverse consequences associated with substance abuse.  The model does not replace primary or secondary prevention strategies but should encourage an open dialogue about the benefits of utilizing this model as a critical component for health practitioners, families and communities members in taking significant responsibility for each other.

The Harm Reduction Model is easy to enact and can have a positive chain reaction effect on individual and community health.  This model proves accessible, achievable, and cost-effective. The model recognizes that interventions like need needle exchange programs; drug-related therapies; access to naloxone; available nicotine replacements strategies; and plans that can provide tactics that will deter minors from binge drinking are needed components.  The ability to reduce these harms can improve the health of communities.  In utilizing this approach, it is important to remember that as prevention advocates and public health practitioners we are accountable for the success of these interventions. The Harm Reduction Model strategies should encourage the inclusion of a wide-range of stakeholders, policy developers, community liaisons, substance abusers and the affected communities.  It ensures that we do not forget the humanity of individuals who abuse substances. Let us remember that they are someone’s parent, spouse, sibling or child.

Legislative Update: Sine Die

The Legislative Session adjourned on March 29th. The Governor then has 40 days to determine whether to sign the bill — creating a law — or veto the bill. If he or she vetoes the bill, it will then go back to the chamber it originated during the next year’s session to see if they wish to override the veto. A vetoed bill requires two-thirds vote of the House/Senate in order to override, according to the “veto power” outlined in the Georgia State Constitution, Article V, Section II, Paragraph IV. In Georgia, the Governor actually has a third option. So, he or she can sign a bill making it a law, veto a bill sending it back to the General Assembly or do nothing at all. In that case, after the 40 days are up, the bill will automatically become a law.

See below for sine die status of bills related to substance use, misuse and prevention.


General Substance Use and Misuse

HB 716 (Rakestraw-19th) Allows individuals to contact law enforcement agencies for referrals to treatment for drug and alcohol abuse or dependence and mental health issues. This bill also provides immunity from arrest or prosecution for certain drug violations for persons who initiate self-referral. STATUS: Died in the Judiciary Non-Civil Committee

SB 352 (Unterman-45th) This bill consist of 3 sections. The first section is geared towards reducing patient brokering and fraudulent Medicaid claims. The third section suggest establishing a Commission for Substance Abuse and Recovery. It also allows the Governor to appoint an Executive Director of Substance Abuse, Addiction or related disorders. STATUS: Passed the Senate on February 7th; DIED in the House Health and Human Services Committee.

HB 895 (Cooper-43rd) Prohibits the sale to and by minors of drug products containing dextromethorphan STATUS: DIED in the House Health and Human Services Committee

HB 161 (Price-48th) Authorizes an employee or agent of a registered syringe serves program to distribute hypodermic syringes or needles. STATUS: House Health and Human Services committee passed bill on February 21st; Senate Health and Human Services committee passed a substitute (amended version) on March 27th, which required approval from the house prior to sine die (March 29th). Thus, substitute bill DIED in the House.

SR 832 (Mullis-53rd) Creates a Senate study committee to review the use and risks of Kratom to determine if action by the state is necessary to address the issue. STATUS: PASSED the Senate on March 27, 2018.


HB 860 (Dunahoo-30th) Allows social host criminal responsibility for adults who allow persons under 21 to consume alcohol on property that they own, lease, or otherwise control. The bill also offers medical amnesty to individuals who seeks medical assistance for a person experiencing an alcohol overdose. STATUS: DIED in the House Non-Civil committee


HB 835 (Lott-122nd) Allows the issuance of special event tobacco permits to licensed dealers authorizing off-premise sales of certain tobacco products (cigars, cigarettes, or loose or smokeless tobacco) at special events or temporary locations. STATUS: Passed House; DIED in the Senate Finance Committee on February 23, 2018.

Prescription Drugs & Opioids

HB 782 (Rhodes-120th) Expands users with access to the prescription drug monitoring program (PDMP) to allow for monitoring of the database and use of data. Bill also prohibits patient brokering; creates an executive director of substance abuse, addiction and related disorders; and establishes a commission on substance abuse and recovery. STATUS: Language specific to the PDMP was added to SB 407 and reached final passage; HB 782 itself, DIED in the House.

HB 701 (Tanner-9th) Expands drug testing for state employment to include all forms opioids. STATUS: PASSED the Senate on March 21, 2018; sent to the Governor for signature on April 2, 2018.


HB 65 (Peake- 141st) Adds post-traumatic stress disorder and intractable pain to the conditions authorized for the use of low THC oil. The bill also creates a joint study commission on cultivation, manufacturing, access and sales. STATUS: PASSED on March 29, 2018; sent to the Governor for signature on April 4, 2018.
Funding Opportunity



Town Hall meetings are an incredible tool for increasing awareness within your community. Organizing and facilitating a meeting creates an opportunity to foster new partnerships, build relationships with elected officials and  invite media outlets to your event. Voices for Prevention wants to help increase awareness of substance abuse prevention efforts and identify new prevention advocates in the state by awarding 6 communities $500 to host a Town Hall meeting. Here’s what you need to know to apply:

Who can apply?

Public and private non-profit entities, including parent groups, community action agencies and other community-based organizations, community coalitions, city/county/state governments, or any prevention focused groups or persons in Georgia that do not directly receive Drug Free Communities, Alcohol and Substance Abuse Prevention Project grant funding are eligible to apply.

How much will each awardee receive?


What can we spend the award on?

Award can be used, but are not limited to, the following activities:

  • Developing marketing materials
  • Procure a venue
  • Honorarium for speakers/presenters
  • Matching funds for town hall meeting hosted with partner

How can I apply?

The application period is now open through July 2nd. All applications are due by 11:59 PM ET on July 2nd. Apply here!

Download a hard copy of the application here. Remember you must apply online and send a hard copy of the application to:

Voices for Prevention, 3162 Johnson Ferry Rd., Suite 260, #823,  Marietta, GA 30062


The online application requires you to upload a couple of documents. You can only upload documents using a google account. If you have any questions regarding the application process please contact the V4P Coordinator at Brittney@ccapsa.org.



Two of V4P’s Policy Education Committee members (photographed above) had the opportunity to present to the Association of County Commissioners’ (ACCG) Public Safety and the Courts Committee. ACCG Committee membership is open to all elected and appointed officials. Members of the Public Safety and the Courts committee consisted of representatives from the Georgia Sheriff’s Association, Prosecuting Attorneys Council, County Commissioners and many more key community stakeholders!

Michael and Brittney presented the following points:

  • Private parties have repeatedly been identified as the primary source by which minors obtain alcohol; frequently lacking adult supervision and often a source of other drug use, risky sexual behaviors, violence and vandalism. (Shared statistics from GA Student Health Survey).
  • A Social Host Ordinance has proven (in Fayette County) to be an added tool for parents in deferring youth access to alcohol.
  • Social Host Ordinances are an asset for law enforcement in addressing college parties; removes the burden of who provided the alcohol and holds the person in control of the property responsible.
  • Social Host currently focuses on reducing youth access to alcohol by holding host(s) accountable for underage consumption but it can potentially expand to cover other substances.
  • V4P is an alliance of coalitions, here to serve as partners in prevention.

More exciting news!!!— As a result of the presentation, the Public Safety and the Courts Committee will provide a letter of support on behalf of ACCG for Social Hosting efforts.