Pennsylvania’s opioid disaster plan turns 1. Time to celebrate?
On Jan. 10, 2018, Gov. Tom Wolf dusted off the state’s disaster declaration manual, usually reserved for marshaling government resources for a natural calamity, to tackle a man-made crisis: opioid addiction, overdoses and deaths.
On Monday, members of the Democratic governor’s administration gathered at the Harrisburg headquarters of the Pennsylvania Emergency Management Agency to explain how the declaration has allowed their agencies to jointly combat addiction and deaths.
“Addiction is a disease, it is not a moral failing,” Health Secretary Rachel Levine said.
Wolf’s declaration, re-upped five times, has allowed the state to focus its drug fighting efforts with county and local officials on “prevention, rescue and treatment,” she added. The declaration allowed the departments of Health, Drug and Alcohol, state police, corrections and other agencies to share data and staff to look for patterns of drug abuse, hospitalizations and deaths. Those collaborative efforts are housed at PEMA.
Wolf’s declaration has been helped by bills passed by the Republican-controlled Legislature, Levine added.
Two laws limit medical professionals’ ability to write prescriptions for opioid pills to seven days for children and emergency room patients.
A 2016 law requires physicians and pharmacists to check the state’s prescription drug monitoring database to determine if doctors are running pill mills by purposely writing numerous prescriptions, or if patients are doctor-shopping for more pills. Use of the prescription drug database used to be limited to the attorney general’s office, which conducts investigations into pill mills. The 2016 allowed the Health Department to have access to the records, too.
Wolf’s declaration provided access to even more agencies, even to other states and Washington, D.C., said Ray Barishansky, a deputy Health secretary. West Virginia, he said, is asking for advice on creating a similar collaborative effort.
In addition to the new laws and Wolf’s declaration, the health department has written additional prescribing guidelines to help doctors more wisely choose when and how to prescribe opioids, Levine said. Those efforts, she said, have resulted in fewer opioid prescriptions.
The number of prescriptions spiked by 45 percent to 1.86 million midway through 2014, when there were fewer government eyes on doctors and patients, according to a Health Department website created under Wolf’s declaration. Prescriptions kept rising until mid-2016, when a mandatory prescription review law took effect.
The number of prescriptions dropped 23 percent between the third quarter of 2016, to 1.5 million as of the second quarter of 2018, records show.
The website also shows the opioid epidemic may be waning, or experiencing cyclical ups and downs, — but it is far from over.
The number of emergency room visits for all types of opioid overdoses, including heroin, rose in the second and third quarters of 2018 after declining during 2017 and the first quarter of 2018.
Wolf’s declaration is working, said Jennifer Smith, secretary of Department of Drug and Alcohol Programs. Some counties are seeing fewer repeat overdose victims in their emergency rooms if they employ someone to help addicts find treatment. That so-called “warm handoff” approach has greatly reduced overdose re-admissions in Armstrong, Indiana and Cambrian counties, she said, but not every hospital in the state uses such an approach.
Not as many people are dying, and that is attributed partly to anti-overdose medicine narloxone the state has given to first responders and others.
Since 2015, the state’s naloxone kits have saved 6,400 lives, the website shows. Last month, Levine, using Wolf’s disaster declaration, handed out 6,100 more kits at a cost of $380,000.
Pennsylvania’s opioid-related overdose rate dropped 11 percent to 5,067 between May 2018 and May 2017 based on available but incomplete data culled by the U.S. Centers for Disease Control and Prevention. That surpassed the national decline of 1 percent.
Nationally, the opioid epidemic may have peaked, U.S. Health and Human Services Secretary Alex M. Azar II has said.
“Plateauing at such a high level is hardly an opportunity to declare victory,” Azar said in October. “But the concerted efforts of communities across America are beginning to turn the tide.”