Wolf urges action on opioid epidemic
‘Let’s get this done’
HARRISBURG — In a sometimes-personal address, Gov. Tom Wolf on Wednesday urged final passage of some half-dozen measures that he hoped would slow the opioid epidemic that last year took nearly 3,500 lives in the state.
“We’ve all held parents’ hands as they’ve cried,” Mr. Wolf told a packed House chamber in a rare joint session of the General Assembly. “We’ve hugged those in recovery who’ve risen above this disease — and we’ve heard their stories. Parents and those suffering from the disease of addiction have broken down telling us about the difficulty of finding treatment options.”
After the speech, Sen. Gene Yaw, R-Williamsport, who with the Center for Rural Pennsylvania has led nearly a dozen
hearings on the opioid crisis, said he gave the governor credit for understanding the statewide nature of the epidemic. But he cautioned that any attempt to improve the situation would take time.
“I will feel very fortunate if we can make a difference in this problem in 10 years,” Mr. Yaw said. “It is not going to be an overnight solution by any stretch of the imagination.”
Senate Majority Leader Jake Corman, R-Centre, noted that members of the opposing party usually highlight their differences after the governor delivers an address.
“Obviously, today is a completely different issue that I think we all are united in,” he said.
Senate Minority Leader Jay Costa, D-Forest Hills, described the proposals the governor spoke about as “low-hanging fruit” that did not seem to be controversial. He said he believes the Legislature should hold a special session in January to continue to address opioids.
“I do see that this issue is going to continue to be a major part of our conversations in January, February, March, April and May,” he said
Mr. Wolf said a close friend of his, who lost a child to addiction, was so heartbroken that he communicated it not by speaking, but by hand-delivering a letter to the governor.
“Families have identified loved ones. People have buried their childhood friends,” Mr. Wolf said. He called the addiction crisis “an invisible problem” with concrete ramifications.
“People with substance use disorders and their families fear the stigma of addiction, which keeps them isolated and unwilling to ask for help. The consequences therefore fall to law enforcement, jails and prisons, and understaffed treatment centers.”
Mr. Wolf urged lawmakers not to limit their expectations despite the waning of the legislative session, noting that numerous measures have passed one chamber or the other.
The governor said he wants to limit — with some exceptions — prescriptions of opioids to one week’s worth of pills for minors and patients seen in emergency rooms.
“We’ve all have heard too many stories — too many horror stories — about high school athletes whose futures are robbed by addiction that begins with prescription painkillers,” he said. “Of course, those suffering from crippling pain need relief, and we must be careful to protect the ability of sufferers of long-term pain or victims of trauma to receive appropriate medication.”
A bill by Mr. Yaw, which passed the Senate on Wednesday, would generally bar medical providers from prescribing more than a sevenday supply of any opioid to a minor, or face potential discipline against their licenses. If more than a week’s worth of opioids was needed, the prescriber would first assess whether the young person had a mental health or substance abuse disorder, and discuss the risks with a parent or guardian.
The Pennsylvania Medical Society, which represents doctors, has helped to write prescribing guidelines but has generally opposed legislation setting prescribing rules. A spokesman said Wednesday in an email that the society is reviewing the proposals, and looks “forward to working with elected leaders in finding solutions that work.”
Mr. Wolf would also like to compel doctors to check the new patient drug history database every time they prescribe a controlled substance.
“Our current law is not strong enough,” he said. “It only requires doctors to check the system the first time they prescribe to a patient, or if they believe a patient is suffering from the disease of addiction.”
He also proposed that legislators tell insurers to cover abuse-resistant formulations of painkillers, mandate opioid education in schools, and create a system under which patients can formally declare that they don’t want to be prescribed opioids. He would like medical schools, as a condition of receiving state funding, to teach good painkiller prescribing practices, and doctors, as a condition of renewing their licenses, to take regular refresher courses.
“The opioid epidemic did not start overnight and we will not fix it overnight, or even in this session,” he said. “But by acting on these bills — and by putting other ideas on the table — we can continue to stem the tide of opioid abuse In Pennsylvania. We can make progress for the families we have met — the parents who have cried on our shoulders.”
Earlier Wednesday, before the House Children and Youth Committee, Kim Rogers, administrator of Washington County Children and Youth Services, related a 911 call placed by two children, ages 5 and 6, reporting a parent’s overdose.
“Our young children are the ones calling 911 and it’s really difficult to understand what they’re saying, because they are crying and screaming while they watch their parent die,” said Ms. Rogers. She said that referrals to her agency driven by parental substance abuse doubled from 2014 to 2015, and continue to rise.
A Pittsburgh Post-Gazette investigation published in May showed that the state lagged behind many of its neighbors in efforts to monitor patient drug histories, teach doctors the dangers of opioids, promulgate guidelines for the use of painkillers and discipline physicians who prescribed them wantonly. The investigation found that over five years, 608 doctors were disciplined for narcotics prescribing practices in the states that include most of Appalachia — but just 53 of those were in Pennsylvania.
“State officials also need the tools to identify inappropriate prescribing and dispensing practices among health care providers to better crack down on abuse,” Mr. Wolf said Wednesday.
Wider distribution of the medicine naloxone, encouraged by Mr. Wolf’s administration, has resulted in 1,502 “saves” in potentially fatal overdoses since November 2014. The Board of Medicine approved opioid prescribing guidelines for several medical specialties. Last month, the state became the 49th in the nation to operate a prescription drug monitoring program, through which doctors must check a patient’s medication history before adding a new controlled substance. The budget includes $20 million in new funding for treatment, including 45 Centers of Excellence meant to treat 10,000 people annually.
Mr. Wolf said the crisis “calls on us to cast aside partisanship once again. It calls on us to reject cynicism once again. It calls on us to take action once again . ... Let’s get this done.”