In 2018, a bi-partisan group of lawmakers plan to submit several bills to combat Colorado’s growing opioid addiction crisis. Hundreds of people in the state have died, and the bills aim to reverse that trend, coving a range of solutions from prevention to intervention to treatment.
The state legislative session starts up in January. Ahead of that, we look at the main aims of six bills.
1. Limit most opioid prescriptions to a seven-day supply and mandate that medical professionals check the Prescription Drug Monitoring Program database before issuing refills. Currently, Colorado doctors must register with the program but don’t have to check it before writing a refill.
More: The federal Centers for Disease Control and Prevention recommends that doctors prescribe no more than three days’ worth of opioids for acute pain. Prescriptions, the CDC advises, should exceed seven days in rare occasions.
In August, Colorado’s Medicaid program released new prescribing guidelines for patients who haven’t had an opioid prescription in the past year. A seven-day supply can be given initially and then a patient can receive two additional refills. A fourth request will require prior authorization from the Department of Health Care Policy and Financing and possibly a consultation with a pain management physician.
2. Create a supervised injection facility in Denver as a pilot, making the city a pioneer in the United States. Like needle-exchange programs, data shows that supervised injection facilities (SIFs) do not increase the use of illicit drugs but can lower the spread of diseases like HIV and hepatitis C. They also increase referrals to medical and/or substance abuse treatment professionals and facilities. Denver City Council President Albus Brooks said the opioid epidemic is a serious issue and he supports supervised injection facilities: “I believe this is one strategy of many that could help.”
More: There are about 100 SIFs in nine countries in around the world. This includes Vancouver, Canada, where the first supervised injection site in North America opened in 2003. Currently, there are no safe injection facilities in the United States but several other cities – including Seattle, San Francisco and Philadelphia – are proposing sites.
3. Increase access to residential treatment for people with substance use disorders. Fifteen counties in Colorado do not have a residential treatment option for opioid abuse.
Rep. Jonathan Singer, a member of the group, supports additional state funding to help people who can’t access treatment right now:
“The hardest thing out there is someone actually having the courage to ask for help. The least we can do is meet them where they’re at and say, ‘If you’re asking for help, we’re here to help.’”
4. Improve “prior authorization” standards so that insurance companies and Medicaid patients don’t turn to opioids while waiting for approval to begin their treatment. The bill would ensure pharmacists can administer certain kinds of medication-assisted treatments while reducing copays for physical therapy, acupuncture and chiropractic alternatives to narcotics.
More: In 2015, 259 people in Colorado died from prescription opioid overdoses – from drugs like oxycodone and hydrocodone. Almost 30 percent of those who died were Medicaid members. Sen. Irene Aguilar said this bill would allow people who come to the hospital after an overdose to immediately start treatment.
If prior authorization standards aren’t improved, drug users could go into withdrawal and start using again.
“You could potentially miss that window when they’re ready to make a change,” she said.
5. Create training programs for health professionals, law enforcement, and at-risk communities for safe opioid prescribing, medication assisted treatment, and overdose prevention. Medication assisted treatment combines opioid medications – like methadone, buprenorphine or naltrexone – with counseling and behavioral therapies to help reduce drug ravings, ease withdrawal symptoms and maintain recovery. Many experts believe the treatment is best for opioid addiction while critics say patients are just replacing one drug for another.
More: In May, only 33 out of 64 counties in Colorado had health services that provided medication assisted treatment. But a federal grant received by 17 health centers could expand access to treatment across the state because most MAT providers are in the central and northern parts of the state.
6. Expand the Colorado Health Service Corps program, which includes loan repayment and scholarship programs for medical professionals who commit to working in underserved areas where substance abuse is more likely to go untreated.
More: Increasing the number of medical professionals will allow greater access to substance use disorder services, which include – emergency/medical detox providers, residential treatment providers, outpatient services, and methadone clinic providers. There are currently six counties in Colorado that do not provide any of the four services.
Do you have a question about how the opioid crisis is affecting Colorado? We want to know.