Initiatives Seek to Combat Opiate Epidemic
By Sarah King
The rate of fatal opioid overdoses in the United States has quadrupled since 2000, claiming nearly a half-million lives, according to the federal Centers for Disease Control and Prevention. On average, nearly 80 Americans, including at least two Virginians, die each day from an overdose of heroin or prescription drugs.
No wonder governments at all levels, as well as health care companies and educators, have mobilized to target the problem.
In March, the U.S. Senate passed the Comprehensive Addiction and Recovery Act. State Attorney General Mark Herring praised the Senate’s action and the work of Virginia Sens. Mark Warner and Tim Kaine to advance the legislation.
“Passage of CARA is a big step forward in addressing what has become a national epidemic of prescription drug and heroin abuse and overdose,” Herring said.
“If anything cried out for bipartisan action, it is this ‘all hands on deck’ moment, and my only regret is that these resources come too late for thousands of families in Virginia and throughout the country who have already lost a loved one to addiction.”
Herring said nearly every day he reads about another Virginian, often a young person, who died from a heroin or prescription drug overdose.
“It’s heartbreaking to read these stories and to talk to the parents, family and friends of these people who never thought anyone in their family would be touched by addiction, but now are trying to carry on in the face of such a tremendous loss,” Herring said.
President Barack Obama said fighting the opioid epidemic is also a priority for his administration. In March, he announced new measures to expand access to treatment. For example, Medicaid, the health care program for low-income Americans, now will cover substance abuse disorder in the same way it covers mental health issues.
The administration is also providing $11 million to states to purchase and distribute the opioid overdose reversal drug, naloxone, and to train first responders and others on its use along with other overdose prevention strategies.
Additionally, this fall, more than 60 medical schools, 50 pharmacy schools and nearly 200 nursing schools will start requiring students to take some form of prescriber education to graduate. The requirement will align with the CDC’s newly released Guideline for Prescribing Opioids for Chronic Pain. Schools in Virginia that have signed on to the initiative include:
● Hampton University
● James Madison University
● Old Dominion University
● Radford University
● Virginia Commonwealth University
National chain pharmacies are also taking part in the effort:
● Rite Aid has trained more than 8,400 pharmacists on naloxone. In 10 states, Rite Aid also is dispensing naloxone to patients without needing an individual prescription; the company plans to expand that policy to additional states.
● Kroger currently dispenses naloxone without an individual prescription at its pharmacies in seven states, with plans to expand to at least 12 more by the end of the year.
● AmerisourceBergen/Good Neighbor Pharmacy will provide educational materials to encourage its 4,000 independently owned and operated retail pharmacy locations to provide naloxone without an individual prescription.
● Walgreens announced in February that it will install safe medication disposal kiosks in more than 500 drugstores across the country, primarily at locations open 24 hours. Walgreens also will make naloxone available without needing an individual prescription at its pharmacies in 35 states and Washington, D.C.
● Since March, CVS Pharmacy locations in 23 states have been able to dispense naloxone to patients without needing an individual prescription. This initiative will increase to 35 states by December.
● CVS Health has launched a program called Pharmacists Teach, which sends the company’s pharmacists into schools across the country to educate students about the dangers of drug abuse. To date, more than 30,000 students have participated in the program.
At the state level, Gov. Terry McAuliffe released his task force on Prescription Drug and Heroin Abuse implementation plan in October. In the 2016 legislative session, McAuliffe signed into law three bills regarding opiate abuse:
● House Bill 1059 directs the Virginia Criminal Sentencing Commission to evaluate sentencing patterns in cases involving heroin and recommend adjustments in sentencing guidelines.
● Under House Joint Resolution 45, the state will study whether to mandate health insurance coverage for “abuse deterrent formulations for opioid medications.”
● Senate Bill 556 removes certain restrictions on health care professions who treat people with opiate addiction using opioid replacements approved by the federal government. Such restrictions include the proximity of the provider to a school or daycare center.
The attorney general, however, says legislators haven’t gone far enough. Herring criticized the General Assembly for failing to pass HB 102, which would have made it a felony homicide to manufacture or provide a controlled substance that later causes a fatal overdose.
“Virginians are losing their lives every day to cheap, potent heroin, and tools to hold dealers and traffickers accountable are a critical part of addressing this problem, along with education, prevention and treatment,” Herring said.
“Too often, the parents of young people who have died from an overdose feel like no one really cares that their child was taken from them, and they’re resigned to the fact that the dealer will never really face consequences for what they’ve done.”
Herring said his office has helped prosecute a number of these cases at the federal level, but local commonwealth’s attorneys need a “proper state-level tool” to hold dealers and traffickers accountable.
HB 102 easily passed the House of Delegates but died in the Senate. It is the only opioid overdose bill proposed by Herring that has yet to pass.
In 2015, the General Assembly approved his legislation to expand the use of naloxone by first responders and make the drug available without a prescription; to create a “good Samaritan” provision to encourage the reporting of overdoses in progress; and to expand access to the Prescription Monitoring Program.