On October 1, Governor Tom Wolf launched his administration’s first Opioid Command Center Opioid Summit: Think Globally, Act Locally. The two-day summit, held in in Boalsburg, Pa. in Centre County, gathered 200 Pennsylvanians who are helping their communities fight the opioid crisis in community organizations, non-profits, schools, health care organizations, addiction and recovery centers and in affected families. The summit focused on the importance of communication, cooperation and collaboration in providing and implementing state initiatives at the local level.
Following the governor’s opening remarks, the state’s health secretaries involved in the Opioid Command Center held a panel discussion.
“It is essential that the work being done on the state and federal level filters down to those working in local communities,” said Secretary for Health Preparedness and Community Protection Ray Barishansky, who also serves as the Incident Commander for the Opioid Command Center.
“In many ways, these individuals are the boots on the ground enacting change in their communities and helping to address the opioid epidemic.”
A study by the Commonwealth Fund, a private health care research foundation, measured the effectiveness of state health systems in the U.S. and found that Pennsylvania had the third-highest rate of drug overdose deaths in the nation (5,559 or 44.3 per 100,000) in 2017, the latest year for which comprehensive data were available. Only West Virginia and Ohio had more overdose deaths that year.
Where the commonwealth is succeeding
The state’s 2015 Medicaid expansion has allowed hundreds of thousands to obtain care, including about 20,000 people with substance use disorders.
The American Medical Association released a study in December 2018 that scored Pennsylvania’s efforts to combat the opioid crisis high in four areas:
Comprehensive support for medication assisted treatment (MAT) for substance use disorders. This includes eliminating prior authorization requirements and establishing 45 Centers of Excellence across the state to expand access to MAT, including mental and behavioral health care services.
Enforcement of parity laws. The Pennsylvania Insurance Department (PID) is actively reviewing benefit packages, prior authorization policies, and cost-sharing obligations to enforce mental health and parity laws. The PID found significant parity violations and is now completing exams on all leading insurers.
Comprehensive naloxone access. The state has been successful in distributing more than 13,000 free naloxone kits across the commonwealth during three distribution days and 50,000 kits to first responders who have administered nearly 30,000 doses of the life-saving medication.
Medically based oversight for Medicaid patients. The commonwealth has combined medical oversight of patients on opioid therapy with expanded access to non-opioid pain management strategies in Medicaid, including coverage of non-opioid prescription medications and alternative therapies, such as physical therapy, occupational therapy and behavioral health.
“Our prescription drug monitoring program is robust and has virtually eliminated ‘doctor shopping,’ and it assists both providers and pharmacists as they work in this crisis,” said Barishansky.
“We have seen opioid prescriptions decrease by nearly 28 percent through the work of the program.”
Overcoming the stigma of addiction
One of the obstacles that has hindered treatment and recovery has been a stigma associated with opioid addiction, which is one reason why the term “substance use disorders” is now widely used by government agencies instead of substance abuse or drug addiction.
“We know that stigma is still a serious concern across Pennsylvania when it comes to the opioid crisis, and we absolutely reject the notion that someone who has overdosed does not deserve to have their life saved,” said Barishansky.
“This is akin to telling someone who has had a heart attack that if they do not change their eating habits, begin to exercise, etc., that they would not be worth saving.
“Addiction is a disease, a rewiring of the chemistry of the brain. We have to get past the notion of ‘junkies’ and realize that this crisis can affect anyone, from every community and from all walks of life. The opioid crisis does not discriminate.”
State legislators weigh in on the crisis
In April, State Representative Scott Conklin, who serves part of Centre County including State College and Philipsburg, introduced a bill that would add kratom to the list of the state’s controlled substances.
“Deaths due to kratom are on the rise nationally, because those addicted to opioids are using it to either increase the effects of those drugs, or people are using it as a treatment for withdrawal,” said Conklin.
“There is no reliable evidence to support kratom’s use to treat opioid addiction or for any other health conditions, so it’s time to put this substance on the Schedule 1 list within the state’s Controlled Substance, Drug, Device and Cosmetic Act.”
In June, the State Senate Republicans advocated a package of seven new bills to combat opioid crisis 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.
Last year, the Clean Slate bill passed with a near unanimous vote in state legislature. It allowed offenders especially juveniles with certain convictions, including misdemeanor drug arrests, to have those convictions expunged from their records, so they would be able to find a job. Poverty in rural communities has been identified as a major contributing factor to addiction.
“Employers have been struggling to fill job openings due the number of applicants who fail the drug screening tests, and that’s why this crisis is not an individual or family problem as some would like to think,” said State Senator Jake Corman, who represents Centre, Huntingdon, Mifflin and Juniata counties.
“Everyone should care – even if you don’t know someone, you certainly have been affected by the opioid crisis due to its impacts on our economy.”
Is Pennsylvania turning the corner on the opioid crisis?
“We are seeing positive results and reports as the number of overdose deaths are decreasing,” said Corman.
“We are hoping it’s a lasting impact as we continue to take steps to mitigate the effects of this crisis.” .