The Bankruptcy Abuse Prevention and Consumer Protection Act of 2005 provided new requirements for bankruptcy filers and gave the U.S. Trustee Program (USTP) new areas of responsibility. One new requirement is that any individual filer must have received credit counseling during the 180 days before filing. USTP must develop measures of credit-counseling agency effectiveness, then apply those criteria to decide whether to reapprove those agencies. Complicating the effectiveness issue is the increased use of Internet-based credit counseling and whether the mode of delivery influences the counseling's adequacy and effectiveness. USTP asked RAND for help in examining what constitutes effective prebankruptcy credit counseling and how to measure it. The authors concluded that USTP should first explicitly identify the goals of prebankruptcy credit counseling; that there are no common standards or accepted sets of metrics for USTP to adopt in whole; and that there are no accepted views on the various modes of delivery. They recommend that USTP use certain upcoming reports to inform the process of developing measures of effectiveness and approving or reapproving credit-counseling agencies; that it consider whether an agency up for reapproval is providing the services stated in its initial approval application, as well as any pre- and post-testing that the agency conducts; that it survey prebankruptcy credit counselors; that it choose a few measures of effectiveness; and that it take some debtor characteristics into account when measuring agency effectiveness.

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Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.