By Carmen Paun, Erin Schumaker and Daniel Payne

Photographs of young people who died of fentanyl overdoses hang on a wall at the Drug Enforcement Administration in Arlington, Va. | Agnes Bun/AFP/Getty Images

Since Congress passed landmark opioid-fighting legislation in 2018, the number of fatal overdoses has shot up by 64 percent, from about 67,000 to nearly 110,000 last year.

Among them were at least 1,800 teens who died between July 2019 and December 2021, a 182 percent increase compared with the previous period, according to the most recent data from the Centers for Disease Control and Prevention.

Lawmakers are responding to a harsh new reality: Most of those overdoses are from the synthetic opioid fentanyl, which is taking a toll on a growing number of children, Carmen reports.

In the states: Desperate to keep fentanyl out of the hands of kids, Texas lawmakers enacted Tucker’s Law this summer to launch an education campaign about its dangers in middle and high schools.

A world away politically, California lawmakers are considering Melanie's Law, which would require schools to tackle opioid overdoses in their safety plans.

States enacted more than 100 laws dealing with fentanyl during their 2023 legislative sessions, seeking to raise awareness, increase penalties for dealers and prevent overdoses. Some focus on the danger it poses to young people.

In Congress: Two Coloradoans in the House, Republican Doug Lamborn and Democrat Joe Neguse, introduced their Protecting Kids from Fentanyl Act in July.

It would permit states to use money from a $146 million federal grant to train students and school employees on how to use the opioid overdose reversal drug naloxone.

Seeking answers: Parents and public health experts say increasing rates of mental illness in children, combined with the ease with which kids can buy pills online, is proving deadly.

They say more needs to be done, including increasing the number of facilities and health care professionals who can treat teenagers with opioid use disorder since the few that exist are overwhelmed by demand.

Lake Louise, Alberta, Canada | Sam Oates

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

More than 85 percent of women in high-income countries aren't getting effective treatment for their menopause symptoms, a new study finds. Fear that regulator-approved hormone therapy is dangerous has prompted women to seek out unproven alternatives, The Guardian reports.

Share any thoughts, news, tips and feedback with Carmen Paun at [email protected], Daniel Payne at [email protected], Evan Peng at [email protected] or Erin Schumaker at [email protected].

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

Today on our Pulse Check podcast, your host Daniel talks with POLITICO health care reporter Alice Miranda Ollstein about why abortion disputes threaten the reauthorization of the law governing the President's Emergency Plan for AIDS Relief, the 20-year-old program credited with saving 25 million lives in the developing world.

A political job at the Department of Health and Human Services offers a doorway to Industry for many. | AFP via Getty Images

Nearly a third of political appointees at the Department of Health and Human Services left for industry jobs between 2004 and 2020, a new study has found.

While that revolving door isn't inherently a cause for concern — the private sector tends to pay better than the government does — the scale of those departures demands scrutiny, the researchers said.

Why it matters: “What I am really concerned about is whether the personnel flow might lead to biases in government decision making,” Genevieve Kanter, lead study author and senior fellow at the USC Schaeffer Center for Health Policy & Economics, said in a statement.

The particulars: The authors analyzed the career histories of 766 HHS employees between 2004 and 2020 using the United States Government Policy and Supporting Positions directory, also known as the Plum Book, which lists those with appointed political jobs. They then researched where those individuals worked in the two years before and immediately after their HHS tenures.

Since career civil servants aren’t listed in the Plum Book, the researchers excluded them from the study sample so the findings likely underestimate the size of HHS' revolving door. The study was published Tuesday in Health Affairs.

It found: 

— 32 percent of those appointed to HHS between 2004 and 2020 took industry jobs within two years of leaving the department.

— By comparison, 15 percent of appointees had worked in industry in the two years before their HHS appointment.

— A greater percentage of HHS appointees went to industry than to other sectors, such as government, nonprofits or academia.

The offices with the highest government-to-industry exit rates were:

— Office of the Deputy Secretary (55 percent)

— Centers for Disease Control and Prevention (54 percent)

— Centers for Medicare and Medicaid Services (53 percent)

— Food and Drug Administration (38 percent)

While Republican presidents were more likely to appoint people from industry, net exits to industry were similar under both parties.

Where they went: Health insurers, information and communication technology firms, biopharmaceutical and device-manufacturing companies, real estate firms with medical property portfolios and consulting firms.

The risk of pro-industry bias: The flow of personnel from HHS to industry is stronger than from industry to HHS, which suggests that government experience is attractive to health industry employers.

While private employers may be attracted to the appointees’ policy expertise, prestige or professional networks, the study authors worry it might be leverage with the government that the employers seek.

“There is concern that some added value could come from the potential influence that these appointees can exert on former colleagues,” the study authors wrote.

Casar didn't drink for nearly 9 hours to protest the lack of a federal water break rule. | Francis Chung/POLITICO

The Labor Department has begun listening sessions with industries likely to be affected if the Biden administration decides to set rules governing how employers should handle extreme heat.

“We’re starting out with small businesses so that they understand what the impact [of] any kind of standard could be,” Acting Labor Secretary Julie Su said during a virtual press conference last week.

Wheels of bureaucracy: The agency is still a long way away from setting a standard, POLITICO’s Marissa Martinez reports.

The most recent action came in July when President Joe Biden said he’d tasked the department to step up workplace safety inspections.

Su said her department was conducting 4,000 heat-related investigations.

The department first broached the idea of a heat standard in October 2021.

Among the industries it expects to fall under any new rules are:

— Agriculture, forestry and fishing

— Dry cleaners and commercial laundries

— Landscaping and facilities support

— Recreation and amusement

— Waste management

Potential areas for regulation, the department says, include:

— Heat hazard identification and assessment

— Heat hazard prevention and control measures

— Medical treatment and heat-related emergency response procedures

— Worker training

The toll: Labor’s Occupational Health and Safety Administration says that data from the Bureau of Labor Statistics reporting a yearly average of 3,389 injuries or illnesses and 33 deaths related to heat, are likely “vast underestimates.”

On the Hill: Rep. Greg Casar, a Democrat elected last year to represent a district stretching from San Antonio to Austin, Texas, recently led a nearly nine-hour thirst strike, during which he drank no liquids, to draw attention to the lack of any federal mandate for worker water breaks.

He joined Su at the press conference to praise Biden’s and her commitment to “finally getting this done.”

Cassidy fears the wrong sort of rules could impede innovation in artificial intelligence. | Francis Chung/POLITICO

In a report obtained by our Ben Leonard, the top Republican on the Senate committee responsible for health policy, Louisiana’s Bill Cassidy, says that regulators must not advantage big companies over small ones in setting new rules for artificial intelligence.

“A sweeping, one-size-fits-all approach … will not work and will stifle, not foster, innovation,” Cassidy said in the report. “There is no federal department of software, nor should there be.”

The details: When using AI to diagnose and treat diseases, Cassidy said that Congress might need to weigh “targeted updates” to medical device regulations to ensure safety and effectiveness, while retaining flexibility.

“Foundational questions about AI applications remain regarding the transparency of algorithm development, ongoing effectiveness of such applications, and who carries the liability if something goes wrong,” he wrote.

Cassidy argued that the FDA’s process for investigating new drugs is “generally well-suited” to monitoring the use of AI in drug development, and suggested the agency could also use the technology to speed up its review process.

He also argued that Congress needs to ensure AI doesn’t deny access to care or weaken privacy, and suggested that lawmakers look into bolstering HIPAA, the federal health privacy law.

What’s next? Cassidy is taking feedback at [email protected].

Follow us on Twitter

Follow us

To change your alert settings, please log in at https://www.politico.com/_login?base=https%3A%2F%2Fwww.politico.com/settings

This email was sent to [email protected] by: POLITICO, LLC 1000 Wilson Blvd. Arlington, VA, 22209, USA

Please click here and follow the steps to unsubscribe.