Arizona Gov. Doug Ducey will call for a special session on Monday to push a spate of changes to prescription and treatment laws in an effort to confront the opioid crisis engulfing the state.
The proposal attacks the opioid epidemic on multiple levels, from adding treatment options and access for people addicted to opioids to increasing penalties and oversight for doctors who prescribe the highly addictive medications and those who manufacture the drugs.
The special session plan comes after the state reported two opioid-related deaths per day in 2016. The governor declared a public health emergency last year, which allowed for enhanced reporting and data collection.
The Arizona Department of Health Services reported that more than 800 people have died of suspected opioid overdoses since June 2017, though the agency’s director, Cara Christ, said not all of those deaths will be proven to be related to opioids. Christ said she expects deaths in 2017 to top the year before.
Three-fourths of people who use heroin and are in treatment reported they started with painkillers, a 2014 study by the Journal of the American Medical Association found.
The fact that many opioid users started in a legal realm – the doctor’s office – underscores how the opioid issue is different from other drugs, said Christina Corieri, the governor’s senior policy adviser.
“Nobody is prescribing meth. Nobody is prescribing cocaine,” Corieri said.
The governor’s proposal sets aside $10 million for more addiction treatment for people who are uninsured or underinsured but don’t qualify for Medicaid.
The governor hopes committee hearings will be held on Tuesday, and wants to see the legislation approved by lawmakers and sent to his office by Friday.
The proposal is expected to have an emergency clause, meaning the money and the laws would go into effect immediately instead of at a later date, gubernatorial spokesman Daniel Scarpinato said.
In addition to the $10 million for treatment, the state wants to require behavioral health facilities and recovery homes to allow people who are receiving medication-assisted treatment, like methadone and suboxone, to receive care in those facilities.
The state would also join 40 other states by putting a Good Samaritan law on the books, allowing people to call 911 in the case of an overdose for any drug and not face prosecution. The proposal would still allow law enforcement to seize any contraband and charge people with any crimes not related to drugs. This part of the omnibus bill would expire in five years.
“The aim of this (provision) is to save lives,” Corieri said.
Under the proposal, doctors and medical students would be required to go through advanced training on opioids and how to prescribe them. Doctors would have to complete three hours of continuing education on opioids, and medical students would have to take three hours of courses on the drugs.
The state has to combat “bad education” from the past, when doctors were previously taught that prescription opioids weren’t addictive, Christ, the health agency director, said.
“These are so highly addictive. We need to teach our prescribers how to use them responsibly,” Christ said.
If approved, the omnibus legislation will increase access to naloxone, a drug that reverses the effects of an overdose, by allowing county health departments and ancillary law enforcement officials, like probation and corrections employees, to use it.
The proposal would crack down on bad actors, including doctors who overprescribe and drug manufacturers. While manufacturers can only be held civilly liable currently, Ducey’s plan would impose criminal penalties, including prison time.
The bill would expand a program, called the Angel Initiative, which allows people to turn in their drugs and request treatment. Currently, the program exists only in Maricopa County. The legislation expands it to all counties.
Doctors would be limited in the amount of opioids they can prescribe. The governor earlier instituted, through the state’s Medicaid program, a 5-day limit for first-time opioid users for prescriptions, with some exceptions for people who have cancer, traumatic injuries, surgeries, hospice care, end-of-life care or nursing home care. The proposal would expand the five-day limit to Arizonans who are insured elsewhere.
Opioid prescriptions would all be required to have a red cap on the bottle to let people know easily and quickly that the drug inside is an opioid.
The governor’s office expects the bill will receive significant bipartisan support, Scarpinato said, adding Democrats were involved in drafting the bill.
Regarding: “In addition to the $10 million for treatment, the state wants to require behavioral health facilities and recovery homes to allow people who are receiving medication-assisted treatment, like methadone and suboxone, to receive care in those facilities.”
Medication-Assisted Treatment, MAT, utilizes methadone or buprenorphine. There are many brand name buprenorphine products, Suboxone being the oldest. The newer products have improved pharmacokinetics and delivery systems. Patients and families need to know there is more than one buprenorphine product for MAT.