Heroin/Opioids and PA’s Prescription Drug Monitoring Program

 

The Center for Rural Pennsylvania

Wednesday, September 25, 2019 at 9:00 a.m.

Keystone Building, PUC Hearing Room #5


9:00 AM
Welcome and Opening Comments
Senator Gene Yaw, Chairman, The Center for Rural Pennsylvania                       

9:10 AM
Dr. Thomas Farley, Director, Philadelphia County Health Department
Ms. Melissa Lyon, Director, Erie County Health Department
Ms. Barbara Kovacs, Director, York City Health Department

9:40 AM
Ms. Meghna Patel, Deputy Secretary of Health Innovation and
Mr. Jared Shinabery, Director, Prescription Drug Monitoring Program, Pennsylvania Department of Health
Ms. Laken Ethun, Project Director, Program Evaluation and Research Unit, University of Pittsburgh School of Pharmacy
Mr. Michael Krafick, Certified Recovery Specialist, Armstrong-Indiana-Clarion Drug and Alcohol Commission

10:10 AM
Closing Remarks and Adjournment

Brooks’ Bill to Curb Suboxone Abuse Passes Senate

HARRISBURG (June 28, 2019) Legislation introduced by Sen. Michele Brooks to attack the heroin and opioid crisis and crack down on the abuse of Suboxone (buprenorphine) — a treatment drug that contains an opioid — has passed the Senate.

“In the past few years, we have read many unsettling news stories pertaining to fraud and the illegal handling of the treatment drug Suboxone, which contains the opioid buprenorphine and naloxone,” Brooks said.  “Suboxone has been sold and re-sold on the black market and has even become the drug of choice for some who are struggling with addiction. By having improved oversight on prescribing, and providing safeguards that patients using the drug are in treatment, we can ensure this drug is actually being used to treat an addiction, not feed one.”

“When used properly and as part of a treatment program, Suboxone can be a tool for treating addiction in some patients, but ignoring fraud and abuse does not help those struggling with addiction or their families, and it can put others in danger,” Brooks said.

She cited several recent instances of abuse.  A State Trooper in Huntingdon lost his life when a criminal traded his Suboxone for a firearm.  A child in Scranton was seriously injured when he ingested a strip of Suboxone hidden in a Dora the Explorer book. In Pittsburgh, the founder and staff of an opioid treatment facility pleaded guilty to health care fraud after submitting claims to Medicaid and Medicare to cover the costs of unlawfully prescribed drugs. And in Philadelphia, a doctor admitted to submitting illegal prescriptions for more than 18,000 doses of buprenorphine, netting him $5 million through these illegal sales.

Doctors who are allowed under federal law to prescribe Suboxone can prescribe for 30 patients, but over time, can increase that limit to up to 275 patients.

“Senate Bill 675 will better monitor office-based buprenorphine settings by requiring that they be certified by the Department of Drug and Alcohol Programs (DDAP) and that clinics ensure that patients participate in a treatment program, in conjunction with their buprenorphine,” Brooks said.

Brooks added that the maker of Suboxone, Indivior, was recently charged with fraud and conspiracy by the U.S. Department of Justice. The company falsely maintained that Suboxone was less likely to be abused than generic alternatives.  There are also growing concerns that Suboxone is more addictive than previously thought. 

Calls for better safeguards surrounding Suboxone emerged in 2017, when Auditor General Gene DePasquale  recommended that Pennsylvania undertake better monitoring of physicians and their prescribing practices because of the high potential for diversion among patients.  Calling for additional licensing, DePasquale said patients should be given buprenorphine in a safe, well-controlled environment to ensure these dispensing facilities are legitimate treatment sites, and not “pill mills.”

Brooks’ bill requires the state’s Department of Drugs and Alcohol (DDAP) to create a program to certify prescribers of buprenorphine, and to ensure that prescribers have their patients actively participate in a treatment program. 

Other states, including Massachusetts and West Virginia, have put additional regulations in place on buprenorphine.

Citing a report by the Substance Abuse and Mental Health Services Administration, or SAMHSA, Brooks said, “In only five years, between 2005 and 2010, the number of emergency room visits linked to buprenorphine has increased almost 10 times. In some cases, a substance hailed as a ‘solution’ has fueled the disease.” 

Senate Bill 675 has now been sent to the House for that chamber’s consideration.

Contact:            Diane McNaughton                            (717) 787-1322

                           dmmcnaughton@pasen.gov

Senate Approves Package of Bills to Combat Opioid Addiction Crisis

HARRISBURG – The Senate completed work on a package of bills today to combat the state’s heroin and opioid epidemic by improving prescription drug monitoring, limiting opioid prescriptions, targeting drug dealers and taking other steps to limit the damage inflicted by the addiction crisis in Pennsylvania communities.

Bills in the package that were approved this week include:

  • Senate Bill 93, sponsored by Senator Camera Bartolotta (R-46), which cracks down on drug dealers by creating a new statute establishing a second degree felony for the delivery or distribution of an illicit drug that results in “serious bodily injury” to the user.
  • Senate Bill 112, sponsored by Senator Gene Yaw (R-23), which seeks to prevent addiction stemming from opioid prescriptions by limiting the prescription for a controlled substance containing an opioid to seven-days unless there is a medical emergency that puts the patients’ health or safety at risk.
  • Senate Bill 118, sponsored by Senator Wayne Langerholc, Jr. (R-35), which will help break the cycle of addiction by creating a Recovery-to-Work pilot program to connect individuals in recovery with occupations through local workforce development boards
  • Senate Bill 223, sponsored by Senator Kristin Phillips-Hill (R-28), which will ensure more overdose victims get timely, life-saving treatment in the future by allowing providers to leave a dose package of naloxone with an on-scene caregiver of a patient who overdosed on opioids.
  • Senate Bill 432, sponsored by Phillips-Hill, which will improve prescription drug monitoring by allowing Medicaid Managed Care Organizations to have access to the information in the Prescription Drug Monitoring Program.
  • Senate Bill 572, sponsored by Senator Ryan P. Aument (R-36), which will help identify individuals in need of treatment and prevent prescription drug diversion by requiring new patients who need a prescribed opioid regimen to enter into treatment agreements with a prescriber.
  • Senate Bill 675, sponsored by Senator Michele Brooks (R-50), which will help prevent the abuse of the addiction treatment drug buprenorphine by requiring certification of office-based prescribers and limiting its use.

The package of bills is a continuation of bipartisan efforts led by Senate Republicans over the past six years to combat the opioid epidemic.

Beginning in 2014, lawmakers joined the Center for Rural Pennsylvania for a series of hearings to study the problem and identify solutions. As a result of these hearings, new laws were created to limit prescriptions, improve and expand addiction treatment, and improve public education about the dangers of drug abuse.

According to the Pennsylvania Department of Health, opioid drug deaths statewide rose steadily in the early part of the decade before peaking at 5,559 in 2017. The number of opioid drug deaths finally declined in 2018 to 4,267. At the same time, opioid prescriptions in Pennsylvania declined by 14 percent between 2016 and 2017.

The bills were sent to the House of Representatives for consideration.

Senate Republicans highlighted the bills at a news conference this week. Audio and video of the news conference is available below.

Listen

 

CONTACT:  Colleen Greer 717-787-1463 (Senator Bartolotta)
                        Rita Zielonis 717-787-3280 (Senator Yaw)
                        Gwenn Dando 717-787-5400 (Senator Langerholc)
                        Jon Hopcraft 717-787-7085 (Senator Phillips-Hill)
                        Ryan Boop 717-787-4420 (Senator Aument)
                        Diane McNaughton 717-787-1322 (Senator Brooks)

Senate Approves Langerholc Bill to Aid Individuals in Recovery; Part of New Package to Combat PA’s Opioid Addiction Crisis

Listen

The State Senate today approved legislation sponsored by Senator Wayne Langerholc, Jr. (R-35) that is aimed at breaking the cycle of addiction by establishing a pilot program to help individuals in recovery obtain meaningful employment opportunities.

Senate Bill 118  would create the “Recovery to Work Pilot Program” to connect individuals in recovery with high-priority occupations through local workforce development boards.  

“An important, yet often overlooked, side effect of this epidemic is the vicious cycle that many individuals with a history of substance abuse fall into when trying to find and maintain steady employment,” Langerholc said.  “Meaningful employment is essential to an individual’s long-term recovery.  It provides a renewed sense of purpose and helps those in recovery support themselves and their families.”

Langerholc said the pilot program will be spearheaded by the Department of Labor and Industry with the assistance of the departments of Health, Community and Economic Development, and Drug and Alcohol Programs, as well as the Pennsylvania Commission on Crime and Delinquency. 

These departments will develop a plan for the local workforce development boards to work with the treatment and recovery community as well as local employers and training providers to offer job training and employment opportunities to individuals in recovery.
 
“Since the local workforce development boards will be leading the implementation of the pilot program, the strategies will be locally focused to meet the needs of area employers and the local treatment and recovery community,” Langerholc said.

Langerholc’s bill is one of seven bills being considered by the State Senate this week.  The package is intended to combat the state’s heroin and opioid epidemic by improving prescription drug monitoring, limiting opioid prescriptions, targeting drug dealers and taking other steps to limit the damage inflicted by the addiction crisis in Pennsylvania communities.

It is a continuation of bipartisan efforts led by Senate Republicans over the past six years to combat the opioid epidemic.

Beginning in 2014, lawmakers joined the Center for Rural Pennsylvania for a series of hearings to study the problem and identify solutions. As a result of these hearings, new laws were created to limit prescriptions, improve and expand addiction treatment, and improve public education about the dangers of drug abuse.

The Senate expects to consider all of the bills this week.

CONTACT:      Gwenn Dando 717-787-5400

Senate Republicans Advocate New Bills to Combat Opioid Addiction Crisis

 

HARRISBURG – Senate Republicans highlighted a package of bills today to combat the state’s heroin and opioid epidemic by improving prescription drug monitoring, limiting opioid prescriptions, targeting drug dealers and taking other steps to limit the damage inflicted by the addiction crisis in Pennsylvania communities.

The package includes:

  • Senate Bill 93, sponsored by Senator Camera Bartolotta (R-46), which cracks down on drug dealers by creating a new statute establishing a second degree felony for the delivery or distribution of an illicit drug that results in “serious bodily injury” to the user.
  • Senate Bill 112, sponsored by Senator Gene Yaw (R-23), which seeks to prevent addiction stemming from opioid prescriptions by limiting the prescription for a controlled substance containing an opioid to seven-days unless there is a medical emergency that puts the patients’ health or safety at risk.
  • Senate Bill 118, sponsored by Senator Wayne Langerholc, Jr. (R-35), which will help break the cycle of addiction by creating a Recovery-to-Work pilot program to connect individuals in recovery with occupations through local workforce development boards
  • Senate Bill 223, sponsored by Senator Kristin Phillips-Hill (R-28), which will ensure more overdose victims get timely, life-saving treatment in the future by allowing providers to leave a dose package of naloxone with an on-scene caregiver of a patient who overdosed on opioids.
  • Senate Bill 432, sponsored by Phillips-Hill, which will improve prescription drug monitoring by allowing Medicaid Managed Care Organizations to have access to the information in the Prescription Drug Monitoring Program.
  • Senate Bill 572, sponsored by Senator Ryan P. Aument (R-36), which will help identify individuals in need of treatment and prevent prescription drug diversion by requiring new patients who need a prescribed opioid regimen to enter into treatment agreements with a prescriber.
  • Senate Bill 675, sponsored by Senator Michele Brooks (R-50), which will help prevent the abuse of the addiction treatment drug buprenorphine by requiring certification of office-based prescribers and limiting its use.

The package of bills is a continuation of bipartisan efforts led by Senate Republicans over the past six years to combat the opioid epidemic.

Beginning in 2014, lawmakers joined the Center for Rural Pennsylvania for a series of hearings to study the problem and identify solutions. As a result of these hearings, new laws were created to limit prescriptions, improve and expand addiction treatment, and improve public education about the dangers of drug abuse.

According to the Pennsylvania Department of Health, opioid drug deaths statewide rose steadily in the early part of the decade before peaking at 5,559 in 2017. The number of opioid drug deaths finally declined in 2018 to 4,267. At the same time, opioid prescriptions in Pennsylvania declined by 14 percent between 2016 and 2017.

The Senate expects to consider all of the bills this week.

 

CONTACT:          Colleen Greer 717-787-1463 (Senator Bartolotta)
                                Rita Zielonis 717-787-3280 (Senator Yaw)
                                Gwenn Dando 717-787-5400 (Senator Langerholc)
                                Jon Hopcraft 717-787-7085 (Senator Phillips-Hill)
                                Ryan Boop 717-787-4420 (Senator Aument)
                                Diane McNaughton 717-787-1322 (Senator Brooks)

Senate Approves Bartolotta Bill to Crack Down on Drug Dealers

 

Listen

HARRISBURG – The Senate approved a bill today that would create tougher punishments for drug dealers whose products cause serious bodily injuries and impairments, according to the bill’s sponsor, Senator Camera Bartolotta (R-46).

Senate Bill 93 would crack down on drug dealers by creating a new statute establishing a second degree felony for the delivery or distribution of an illicit drug that results in “serious bodily injury” to the user.

Pennsylvania currently lacks a statute pertaining to serious bodily injury resulting from an overdose. The absence of that statute often forces district attorneys to refer these cases to federal prosecutors who can seek tougher penalties under federal law.

Bartolotta’s bill would eliminate the need for these cases to be referred to overburdened federal courts and allow local prosecutors to hold offenders accountable for their crimes. 

“The heroin and opioid epidemic has destroyed too many promising lives and left countless others with the scars of addiction,” Bartolotta said. “As we continue to explore solutions to this public health crisis, we need to ensure the people who are inflicting this pain on our communities suffer the consequences of the pain they cause.”

Senate Bill 93 is part of a package of bills expected to be considered in the Senate this week to combat the state’s heroin and opioid epidemic. The package is a continuation of bipartisan efforts led by Senate Republicans over the past six years to fight back against the addiction crisis.

Beginning in 2014, lawmakers joined the Center for Rural Pennsylvania for a series of hearings to study the problem and identify solutions. As a result of these hearings, new laws were created to limit prescriptions, improve and expand addiction treatment, and improve public education about the dangers of drug abuse.

According to the Pennsylvania Department of Health, opioid drug deaths statewide rose steadily in the early part of the decade before peaking at 5,559 in 2017. The number of opioid drug deaths finally declined in 2018 to 4,267. At the same time, opioid prescriptions in Pennsylvania declined by 14 percent between 2016 and 2017.

CONTACT: Colleen Greer (717) 787-1463

Senate Panel Approves Bartolotta’s Bill Targeting Drug Dealers

HARRISBURG – District attorneys would be able to hold drug dealers more accountable for the damages they cause under legislation approved by the Senate Judiciary Committee this week, according to the bill’s sponsor, Senator Camera Bartolotta (R-46).

Senate Bill 93 would strengthen penalties for the delivery or distribution of an illicit drug that results in serious bodily injury to the user, such as a permanent disfigurement or the loss or impairment of a body part or organ.

Pennsylvania currently lacks a statute pertaining to serious bodily injury resulting from an overdose. The absence of that statute often forces district attorneys to refer these cases to federal prosecutors who can seek tougher penalties under federal law.

The added caseload on the United States Attorney’s Office places a severe strain on federal courts and takes away the ability of local prosecutors to pursue convictions in their home jurisdictions.

“The heroin and opioid epidemic has destroyed too many promising lives and left countless others with the scars of addiction,” Bartolotta said. “As we continue to explore solutions to this public health crisis, we need to ensure the people who are inflicting this pain on our communities suffer the consequences of their crimes.”

In addition to creating the new statute, Bartolotta’s bill would require the Pennsylvania Commission on Sentencing to create sentencing enhancement guidelines so judges have the ability to increase punishments when appropriate.

The bill was developed based on input gathered from a panel of local district attorneys who testified during a public hearing hosted by the Center for Rural Pennsylvania in Beaver County last year.

The legislation was sent to the full Senate for consideration.

 

CONTACT: Katrina Hanna (717) 787-1463

Aument Legislation to Address Opioid Epidemic, Reduce Addiction Risks, Advances

 

HARRISBURG – A bill sponsored by Senator Ryan Aument (R-36) to reduce the risk of addiction was unanimously reported out of the Senate Health & Human Services Committee today.

Senate Bill 572, which is part of a package of bills currently moving through the Senate that are aimed at further addressing the opioid epidemic in the state, would require patients to enter into treatment agreements with prescribers to ensure they understand the risks of addiction and the importance of adhering to safe, responsible guidelines for opioid use.

The treatment agreements would require new patients to undergo baseline and periodic drug testing to monitor adherence to the prescribed treatment plans.  These requirements would not apply in medical emergencies, to patients with existing relationships with a medical provider, cancer patients nor those who are terminally ill.

Aument said that the drug testing requirement would help prescribers identify prior drug use and verify that patients are sticking to the prescribed treatment plan and not abusing prescription medications.

“Many of today’s addiction problems result from legal prescription use that eventually spirals out of control,” Aument said. “Setting clear guidelines for patients and prescribers can help protect against the misuse of opioids so we can stop addiction before it starts.”

Aument’s legislation is based on recommendations contained in the guidelines for prescribing opioids for chronic pain in the United States which were issued by the Centers for Disease Control and Prevention, as well as Pennsylvania’s guidelines on the use of opioids to treat chronic non-cancer pain.

Each of those authorities, in addition to a report from the General Assembly’s Joint State Government Commission issued in February, cited the value of detection and diagnosis as a key strategy to helping address the growing opioid epidemic.

Additionally, the practice Aument is promoting has been endorsed by the United States Departments of Defense and Veterans Affairs, and is already a policy used by several health care insurers, including Capital Blue Cross, Highmark Blue Shield and WellSpan Health.

“Sadly, there is no ‘silver bullet’ to solve all of the problems associated with the opioid epidemic. It is a complex problem that must be addressed from every angle,” Aument said. “This legislation is another piece in the puzzle to prevent more patients from falling victim to addiction as a result of legal prescriptions that are misused.”

 

CONTACT:  Stephanie Buchanan (717) 787-4420

New Law Will Allow Hospice Workers To Dispose Of Unused Prescription Drugs

HARRISBURG – A suggestion by Wyoming County Coroner Tom Kukuchka is about to become the latest state law aimed at counteracting the severe opioid crisis afflicting Pennsylvania communities.

Senate Bill 978, sponsored by Sen. Lisa Baker, R-20th, allows hospice workers to dispose of medications left behind when a home hospice patient passes, relieving the burden of grieving families, and helping to keep the drugs out of the wrong hands. The modification was necessary due to a change to federal Drug Enforcement Agency (DEA) rules that prohibited disposal by homecare providers, unless specifically authorized by the state.  The legislation received final approval today in a 49-0 vote and was sent to the governor for his signature.

“A family losing a loved one has emotions to cope with and difficult decisions to make. They should not have to worry about how to properly dispose of unused medications,” Baker said. “That task can be safely and efficiently handled by the trained medical personnel from the hospice or homecare facility.”

“Overdose fatalities are at record highs,” Kukuchka commented. “One of the ways we can help counteract this epidemic is to prevent properly prescribed drugs from falling into the wrong hands.”

The measure was enthusiastically supported by the Pennsylvania Homecare Association, Bayada Home Health Care, the Pennsylvania State Coroners Association and others.

“The opioid crisis has been declared an emergency because of the heavy toll in lives lost or seriously disrupted. We need to continue to overhaul laws, regulations, and rules that contribute to the problem,” added Baker. “We see encouraging signs of the necessary commitment on the part of public officials, health care professionals, law enforcement, and private citizens to finding additional ways to make a constructive difference.”

Contact:

Andrew M. Seder
aseder@pasen.gov
(570) 226-5960

Aument Introduces Legislation to Address Opioid Epidemic, Reduce Addiction Risks

HARRISBURG – Patients who require opioid prescriptions would have less risk of addiction under legislation introduced by Senator Ryan P. Aument (R-36) today.

Aument’s bill would require patients to enter into treatment agreements with prescribers to ensure patients understand the risks of addiction and the importance of adhering to safe, responsible guidelines for opioid use.

The treatment agreements would require new patients to undergo baseline and periodic drug testing to monitor adherence to the prescribed treatment plans. 

These requirements would not apply in medical emergencies, to patients with existing relationships with a medical provider, cancer patients nor those who are terminally ill.

Aument said that the drug testing requirement would help prescribers identify prior drug use and verify that patients are sticking to the prescribed treatment plan and not abusing prescription medications.

“Many of today’s addiction problems result from legal prescription use that eventually spirals out of control,” Aument said. “Setting clear guidelines for patients and prescribers can help protect against the misuse of opioids so we can stop addiction before it starts.”

Aument’s legislation is built from recommendations contained in the guidelines for prescribing opioids for chronic pain in the United States which were issued by the Centers for Disease Control and Prevention as well as Pennsylvania’s guidelines on the use of opioids to treat chronic non-cancer pain. 

Each of those authorities, in addition to a report from the General Assembly’s Joint State Government Commission issued in February, cited the value of detection and diagnosis as a key strategy to helping address the growing opioid epidemic.

Additionally, the practice Aument is promoting has been endorsed by the United States Departments of Defense and Veterans Affairs, and is already a policy used by several health care insurers, including Capital Blue Cross, Highmark Blue Shield and WellSpan Health.

“Sadly, there is no ‘silver bullet’ to solve all of the problems associated with the opioid epidemic. It is a complex problem that must be addressed from every angle,” Aument said. “This legislation is another piece in the puzzle to prevent more patients from falling victim to addiction as a result of legal prescriptions that are misused.”

The federal Drug Enforcement Agency reports that the total number of fatal drug overdoses in Pennsylvania rose 37 percent from 2015 to 2016. On average, 142 Americans die every day from a drug overdose, according to the Centers for Disease Control and Prevention.

“Opioid addition and its related issues are a clear and present danger to our people, families and communities,” said Aument.  “The seriousness of this issue demands that we do all that we can, and it is my hope that this proposal will offer another part of the solution.”

 

CONTACT:  Jake Smeltz (717) 787-4420