Oklahoma opioid commission lays out legislative priorities
Oklahoma City — The Oklahoma attorney general's commission fighting the opioid crisis proposed at a meeting Tuesday a mix of changes to law enforcement, new rules for prescribers and increased data collection.
The commission, which has met multiple times this year under the direction of Attorney General Mike Hunter, laid out five initial recommendations for lawmakers when they return for regular session in February.
They proposed lawmakers create penalties for trafficking fentanyl, a synthetic opioid that is more powerful than heroin; requiring doctors to use electronic prescriptions, which are more difficult to duplicate or forge; creating a "Good Samaritan" law that would prevent prosecution for people who call for help during an overdose; setting up a database to track overdoses; and urging changes to Drug Enforcement Agency rules that limit the number of patients a doctor can treat with medications to prevent withdrawal from opioids.
Terri White, commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services, said about 9,000 people in Oklahoma used medication-assisted treatment last year, and as many as 14,000 could do so in the current fiscal year. People who receive that type of treatment are less likely to experience an overdose or commit crimes and more likely to keep a job, she said.
Rural access is limited
Access to treatment in rural areas is a problem, she said, as is a federal law limiting how many patients a doctor can treat with methadone or buprenorphine. Both drugs prevent patients from experiencing the unpleasant symptoms of withdrawal, but don't cause euphoria.
“That's so incredibly frustrating, because we have so many patients in need of treatment,” she said.
The commission also recommended building on efforts to equip first responders with naloxone, a drug that can reverse an overdose if used quickly. It isn't clear how much such a plan would cost, and lawmakers face an approximately $600 million budget gap for the fiscal year that will begin in July.
Any recommendations that require legislative action also face a tight timeline, since preliminary versions of bills are due in mid-January.
David Kendrick, founder of MyHealth Access Network, urged the commission to consider what the network could do to prevent addiction. Member doctors and hospitals can share a patient's records through it, allowing them to see if a patient goes to the emergency room frequently to request opioids or if they followed through with a referral to drug treatment, he said.
Charlotte Horning, a pain patient, urged the commission to expand the scope of its work to look at insurance companies' behavior.
Horning, who uses a small dose of methadone to manage pain from cancer treatment and back problems, said she's had to fight her insurance harder to get coverage for non-opioid therapies she uses than for pills. Pain specialists generally recommend an interdisciplinary approach to treating chronic pain, but many patients don't have access to therapies other than pills.
“If insurance companies are only willing to pay for drugs, that's a problem,” she said. “Doctors don't have time to mess with the truckloads of paperwork the insurance companies require.”
Horning also urged them to balance the needs of pain patients with efforts to prevent addiction.
“There are patients and survivors like me who need a way to cope with real pain,” she said. “We need empathy, respect and compassion.”