Between 2009 and 2014, there were more than 2,000 accidental and unintentional opioid involved deaths that occurred in 150 of Connecticut’s 169 cities and towns. Nationwide, 18- to 24-year-olds are more likely to die from drug overdoses, primarily from prescription pain relievers, than from motor vehicle accidents.
Connecticut residents can be proud of the fact that we have a statute that allows for access to Naloxone for overdose reversal and we have a Good Samaritan law that protects someone from arrest if they call 911 to save a life while in possession of drug paraphernalia. Narcan has no street value, few if any side effects, can be administered either nasally or intramuscularly, and is much safer to administer than an Epi-pen. Narcan provides a 30- to 90-minute window of opportunity to call 911 and get someone to the emergency room.
Gov. Dannel Malloy’s bill further strengthens existing efforts to combat opiate misuse and overdose in four ways.
First, requiring prescribers to have education about prescribing controlled substances and pain management. Currently, there are only a few certified pain management prescribers in the state, yet patients receive prescriptions for opiates without a screening for potential misuse, or history of substance use; education about potential dangers of opioids; or a corresponding prescription for Naloxone in case of an accidental overdose. Enhancing prescribers’ education by including CME would help ensure more informed prescriptions being written.
He also is calling for strengthening the state’s Prescription Drug Monitoring Program (PDMP). HB 5782 requires real-time reporting and mandates that a practitioner, or the practitioner’s delegate who is a licensed health care professional, check the PDMP before prescribing more than a 72-hour supply of a controlled substance. In a preliminary analysis of current state data, we’ve seen an increase in heroin deaths rising. The simple explanation is that oxycodone was reformulated in 2011 to make it more difficult to crush it in order to snort or inject it, so people who had become addicted to prescription opiates turned to heroin, which is cheaper, plentiful and easier to purchase. While the majority of prescription opioid users do not become heroin users, research found that approximately 3 out of 4 new heroin users report having abused prescription opioids prior to using heroin.
Currently, while prescribers are required to register for the PDMP, only 20 percent register, and even fewer utilize it. This makes it much easier for someone seeking opiates to get prescriptions across multiple providers and across state lines.
The proposal requires all pharmacies in Connecticut to report the dispensing of prescriptions for all controlled substances immediately – rather than weekly – through the state’s prescription monitoring program (PMP), helping ensure that prescribers have accurate, real-time data for treatment decisions.
Third, this legislation will allow pharmacists to prescribe and dispense Naloxone. Naloxone is the life-saving antidote to an opioid overdose. It is a short-acting medication that revives a person within minutes and allows a window of opportunity to access medical help. Naloxone has no street value, little to no side effects, and has a lower incidence of adverse reactions than an Epi-pen, antibiotics or Aspirin.
Unlike many other medications, Naloxone cannot be abused, or misused. Used in hospitals and ambulances for decades, the medication has no abuse potential.
Connecticut law allows for anyone to be prescribed Naloxone. However, the governor’s proposal would increase access to Naloxone by expanding pharmacists’ scope of practice by allowing them, after being certified and trained by the Department of Consumer Protection, to prescribe Naloxone. It also clarifies that prescriptions written by pharmacists can be covered by health insurance, eliminating this financial barrier.
And finally, the governor is reconvening the Alcohol and Drug Policy Council to focus on addiction in Connecticut and inform the governor and General Assembly on future policy changes and public awareness strategies necessary to combat addiction. The National Institute on Drug Abuse reports that the relapse rate for drug addiction is 40 to 60 percent. Clearly, something different needs to be done.
We applaud the governor’s efforts and look forward to working with him, and others in the state, to address this epidemic.
Shawn Lang is the deputy director of programs and policy at AIDS Connecticut.
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