Advocacy update

1. Encouraging News for NSF, Mixed Bag for NIH, and Trimming for CDC budget: The Federal 2013 budget arrived on Capitol Hill on February 13, 2012, continuing with the caps adopted in the 2011 Budget Control Act. Though the NIH [National Institutes of Health] budget was not cut, the flat level funding proposed will limit its funding ability. NSF’s [National Science Foundation] funding increase demonstrates the President’s commitment to doubling the three major federal (non-NIH) basic science agencies — NSF, the Department of Energy’s Office of Science and the National Institute of Standards and Technology. All of the scientific divisions across NSF would receive larger budgets for their core disciplinary research, including the behavioral and social sciences. The President’s budget for CDC [Centers for Disease Control and Prevention] was approximately $6.56 billion, with a total budget authority of only $4.99 billion, representing a decrease in budget authority by more than $660 million from 2012 and an approximate 1/5th reduction from 2010. The House will release the budget in March, and bring it to the floor before the month end. Relevant documents are located at the Office of Management and Budget website.

2. Affordable Care Act: HHS [U.S. Department of Health and Human Services] Secretary Sebelius issued a Bulletin in December, 2011 outlining how essential health benefit packages under the Affordable Care Act will be designed; more details are available in an HHS news release. Many mental health associations expressed interest in influencing the design of essential health benefits by proactively reaching out to their state representatives who have subject matter jurisdiction over insurance and advocating inclusion of a breadth of mental health services, as well as the application of the Mental Health Parity and Addiction Equity Act of 2008. The American Psychiatric Association has also convened an “Essential Health Benefits Working Group” comprised of psychiatrists from the Council on Advocacy & Government Relations and the Council on Healthcare Systems and Financing, which is responding formally to HHS’s essential health benefits Bulletin.

3. Lower Teen Alcohol and Cigarette Use, Marijuana Up: National Institute on Drug Abuse (NIDA) released the December 2011 “Monitoring the Future” survey results, which reportson the behavior, attitude, and values of 8th, 10th and 12th graders. Dr. Lloyd Johnson from the University of Michigan reported that rates of cigarette and alcohol use among the three age groups at their lowest point since the survey’s inception in 1975. However, rates of marijuana use increased for the fourth year in a row, with high school seniors reporting daily use at the highest rate in 30 years. More details of the survey (PDF, 3MB) are available. Last spring APA’s Science GRO [Government Relations Office] organized a briefing, hosted by the Friends of NIDA coalition in conjunction with the Congressional Addiction, Treatment and Recovery Caucus, titled "Marijuana Use Disorders: Dependence and Treatment Research," with critical research findings presented by Dr. Volkow and by Dr. Alan Budney of the University of Arkansas for Medical Sciences. [Editor’s note; Dr. Alan Budney is a long-time member and previous president of APA Division 28]. The Substance Abuse and Mental Health Services Administration (SAMHSA) has simultaneously released findings from the 2010 National Survey of Substance Abuse Treatment Services (N-SSATS) in December 2011. Treatment facilities have remained relatively constant between 2006 and 2010, and clients under 18 made up 8 percent of all in the treatment at the time of survey. Detailed findings (PDF, 8MB) are available.

Other advocacy headlines

• In a continuing effort to help ensure that psychological science is used to inform the regulatory actions of FDA’s [Food and Drug Administration] Center for Tobacco Products, APA partnered with several other public health organizations in January 2012 to endorse a set of comments titled Applications for Premarket Review of New Tobacco Products. Several APA scientists worked either directly on the formulation of the comments or on the review. The comments cite a significant body of scientific evidence substantiating the need for rigorous standards of tobacco product review because new products may change the absorption of nicotine, enhance the ease and attractiveness of tobacco use, include other design changes that affect tobacco use behavior or have other as of yet unforeseen consequences.

• In December 2011 the FDA reported major shortage of ADHD and many other prescription medications, due to manufacturing and distribution decisions of the industry. Dr. Robb, the psychiatric liaison for the American Academy of Pediatrics (AAP) Committee on Drugs and chairs the Pediatric Psychopharmacology Initiative for the American Academy of Child and Adolescent Psychiatry (AACAP), said "Fear of abuse should not be the reason to make policy decisions that affect many children, teenagers, and adults that actually need these medications." With 51.5 million ADHD prescriptions in 2010 (up by 11 percent from 2009), patient populations could be left looking for appropriate therapeutic substitutes. An updated list of drugs in short supply can be reviewed.