Of the six opioid bills introduced to the state legislature this session, five passed and are on Gov. John Hickenlooper's desk. A bi-partisan group of state lawmakers drafted the bills last November to address Colorado's growing opioid epidemic. The bills look at the issue from many sides, including increasing access to behavioral health care providers and medication-assisted treatment, limiting pain pill prescriptions limits and changing how insurance and Medicaid handle opioid dependence medications.
"We have a very strong package of bills that will literally be saving lives and at the end of the day,
that's what this is about," said Democratic Rep. Jonathan Singer of Longmont, one of 10 lawmakers on the Opioid and Other Substance Use Disorders Interim Study Committee.
Here's a look at the five bills that awaiting the governor's signature.
Limiting prescription pill access
Last year, a record number 357 Coloradans died from prescription pain medication. According to federal data, the state ranked second worst for prescription drug misuse in 2013 and a 2017 study showed that 70 percent of heroin users has used pain pills first.
Senate Bill 22 aims to stop addiction before it starts by limiting the number of pain pills that can be prescribed. Under this bill, health care providers may prescribe an initial 7-day supply, then use their judgement if another week-long prescription is needed.
The bill exempts patients who have cancer or chronic pain that lasts longer than 90 days, are undergoing palliative or hospice care or experiencing post-surgical pain that's expected to last more than 14 days.
"I think that's going to be a rather immediate change. It'll change the process by which doctors and
pharmacies actually prescribe these drugs," said Sen. Kent D. Lambert, R-El Paso. "They're going to have to think long and hard about what's the value of these or are there other alternatives to strictly addictive opioid drugs that they can be using. And there are."
Increasing access to health care providers
While opioid overdose deaths are highest in the state's larger, more urban areas, rural counties have the highest death rates. One reason for the high rate could be a lack of treatment options in rural areas.
Senate Bill 24 will expand access to behavioral health care providers by providing incentives like loan repayment and scholarships in exchange for a multi-year commitment to working in underserved communities.
"Getting workers into the rural areas and into the underserved, where we're having shortages, that's just key," said Sen. Cheri Jahn, an unaffiliated senator from Jefferson County.
Addressing the issues of Medicaid and insurance
One key barrier to receiving treatment for opioid addiction is that Medicaid, by law, cannot provide treatment in facilities with more than 16 beds. The federal government is encouraging states to apply for a waiver to bypass this law. With House Bill 1136 , Colorado plans to join more than a dozen other states that have either approved or are seeking waivers.
"Rather than continuing the revolving door where people are trying to get treatment, not getting the care that they need and ending up straight back in our emergency rooms where taxpayers are footing the bill," said Singer, "this will allow for a waiver from our Medicaid system to allow other treatments to happen, so we can end this revolving door of going to the emergency room."
House Bill 1007 will ensure that insurance companies and Medicaid provide coverage - without prior authorization - for a five-day supply of at least one of the Federal Food and Drug Administration-approved drugs for the treatment of opioid dependence. The bill will give patients immediate access to treatment, keeping them from using opioids while waiting for insurance approval.
"If somebody has to wait five day, three days, four days, whatever, to get authorized for treatment, they're gone. They're gone, you've lost them," said Jahn.
Jahn, Singer, Lambert and other members of the committee will continue to tackle opioid Colorado's opioid crisis for another year after the passage of House Bill 1003.
The only opioid bill not to pass would have allowed one Colorado community to create a facility where drug users could safely inject under the supervision of medical staff.