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SALT LAKE CITY — A Utah lawmaker has an idea that he believes will help "reverse the opioid epidemic."
"We need to try to find some way to dig ourselves back out of this hole that we dug for ourselves," Rep. Ray Ward, R-Bountiful, said Wednesday as he presented a draft of a new bill to the Health and Human Services Interim Committee.
Despite fairly new prescribing guidelines, habits haven't changed, Ward said, leading to "the worst man-made epidemic of all time."
Deaths related to narcotic overdoses were relatively flat before 2000, he said, but have since continued to grow, causing the nation to "lose ground on its longevity," with mortality rates going down in the United States.
It was hard to know that opiate medications designed to treat pain would lead to addiction so quickly, Ward said. The lawmaker and family physician said 60 percent of patients on them for three months will still be on them five years from now, and 47 percent are hooked after just 30 days.
"(It) doesn't take very long to dig a hole that is very hard to get out of," Ward said.
Utah health officials recognized the problems of opioid addiction and overdose when prescribing guidelines were drawn up in 2009, but not much progress has been made as the prescribed amounts of the addictive medications has remained steady — matching a steady death rate related to the prescription drugs that are also available for purchase on the street.
Ward said it is clear that "a guideline is not enough to bend the curve and change the habit."
Since 2009, officials have a better scientific understanding of addiction and the drugs that can cause it, as well as national consensus that there is a problem.
Earlier this year, the U.S. Centers for Disease Control and Prevention put out updated prescribing guidelines for patients and providers, also encouraging states to partner with health care providers and consider limiting the number of prescriptions high-risk patients can obtain.
Ward's bill aims to do just that, among other efforts to fight opioid addiction.
"We need to make some actual changes in what we're doing," he said, adding that the more than a dozen bills passed by the Legislature earlier this year addressing opioids were directed at treating addiction, not stopping or preventing it.
A pilot program that encourages wider distribution of naloxone kits has given out $90,700 worth of the overdose reversal drug to various health departments, out of the $150,000 allocated by the Legislature, according to the Utah Department of Health.
Rep. Steve Eliason, R-Sandy, who gave lawmakers an update of the program on Wednesday, said he will likely ask for more funding this year. Eliason said he's troubled that some law enforcement agencies remain skeptical or wary of the drug.
“We’re moving in the right direction,” he said. “We need to move faster.”
Anna Fondario, with the Utah Department of Health, said the state has purchased 1,033 naloxone kits for several local health departments since the program began, including the Salt Lake County Health Department, Southwest Behavioral Health Department and Wasatch County Health Department.
Fondario said the department also provided some kits to the Summit County Sheriff’s Office and Park City Police Department due to concerns about the synthetic opioid known as U-47700 or "pink."
Ward said he believes more can and should be done by physicians, though he admits being regulated by government and having to jump through hoops is not favorable.
"A person in medication assisted treatment still requires treatment for many years and wouldn't need it at all if they didn't get addicted in the first place," he said.
Ward's bill, which will be addressed again at a future interim meeting, will require prior authorization from an insurer for any narcotic prescription that increases more than 90 morphine equivalents from a stabilized dose; anytime benzodiazepines are recommended for a patient already taking narcotics; and when starting a new patient on chronic narcotics.
A prescriber, Ward said, would need to show "medical necessity" for any of those three "risky prescribing habits." Though the stipulations would not apply to patients in hospice or inpatient situations.
"It's very rare that any one doctor intends to start a patient on long-term narcotics, but it so often happens that they're dependent before anyone realizes what has happened," he said.
Contributing: Daphne Chen
