Prescription drug abuse and heroin use have taken a toll on families and communities across the country. According to a recent Wall Street Journal article, a poll in New Hampshire ranked drug abuse as the most important issue in the 2016 Presidential campaign, more important than jobs and the economy.
The past few months have seen a number of important developments the area of drug abuse and overdose prevention law and policy. Here are a few of the more important stories at the federal, state, and local levels:
In late October, President Obama traveled to West Virginia where he announced a number of initiatives aimed at addressing the prescription drug and heroin overdose epidemic. These include requirements that health care professionals who work for the federal government receive evidence-based training on opioid prescribing practices and that federal agencies review barriers to medication-assisted treatment and develop plans to reduce those barriers. He also announced a number of commitments from professional associations, nonprofit organizations, and provider groups, such as a doubling of the number of physicians certified to prescribe the medication buprenorphine, for the treatment of opioid use disorder, over the next three years. While most of these commitments are not binding, they represent the importance of the issue to the White House and a broad group of interested parties.
In early November, Senator Tim Kaine (D, V.A.) introduced the Co-Prescribing Saves Lives Act, which would establish education and guidelines for the co-prescription of the overdose reversal medication naloxone in all federal health settings, and would authorize funds for state health departments to increase access to naloxone. This proposed legislation joins a large group of other proposed measures aimed at addressing the overdose crisis.
At the state level, Pennsylvania became the first to issue a statewide standing order for naloxone. This order permits pharmacies to dispense naloxone to any individual who is at risk of overdose or may be in a position to assist someone at risk of overdose without that person first receiving a prescription. The state had previously issued a similar standing order for first responders to administer the medication. Meanwhile, Illinois recently passed a comprehensive overdose prevention law that, among other things, permits pharmacists to dispense naloxone under a statewide protocol, authorizes third party prescriptions for naloxone, and requires most first responders to carry naloxone and be trained in its use. In the first such measure in the country, the law also requires most insurance plans in the state to provide coverage for at least one opioid antagonist like naloxone as well as substance use disorder treatment, and implements an education program regarding the state’s overdose Good Samaritan law.
Finally, localities are engaging in numerous efforts to address the epidemic. Both Allegheny County (PA) and Baltimore City have created jurisdiction-wide standing orders for pharmacy naloxone distribution. Other states and cities across the nation continue to hold trainings and increase access to naloxone, and it is now being stocked by school nurses in Delaware, Massachusetts, New York, Pennsylvania and Rhode Island. In Gloucester, MA, the Police Department announced that any person who comes to the police station to hand in their drugs will not be arrested, but rather be offered treatment. To date, more than 100 people have taken advantage of the program.
All of these efforts are welcome and needed. As an article in the Proceedings of the National Academies of Science recently noted, the mortality rate of middle-aged white men in the United States increased between 1999 and 2013, largely due to an increase in drug overdoses. Such an increase is nearly unheard of in developed countries, and reducing it will take a sustained, comprehensive effort from every level of government as well as the private and non-profit sectors. It is encouraging to see action from across all levels of government.
This post was developed by Corey Davis, Deputy Director, the Network for Public Health Law – Southeastern Region at National Health Law Program.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this post does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF.