Legislative remedies sought for WV addiction crisis

CHARLESTON, W.Va. — The West Virginia State Medical Association is suggesting several possibilities for legislation meant to curb addiction problems, including limiting the duration of prescriptions and broader reporting of overdose treatment.

Brad Henry, president of the West Virginia State Medical Association, spoke Tuesday to members of the state Legislature.

“We sat down this year as a group of physicians, realized that this is an issue, we want to be a part of the solution,” Henry said before the Joint Committee on Health during legislative interim meetings.

“We would certainly like to see legislation to work to get us out of this problem.”

Barbara Fleischauer

Delegate Barbara Fleischauer, D-Monongalia, expressed appreciation for the ideas.

“We are desperate for ideas for solutions. Thank you for giving us suggestions,” she said.

Henry provided a checklist of possible policy for legislators to consider:

— Chronic prescriptions of controlled substances should be limited to 30 days, he said. He said his own practice has already limited the amount of time prescriptions are valid. “We don’t write 90-day prescriptions for controlled substances any more,” he said.

— 12 states have limited acute pain prescriptions to 7 days or less. He said the risk of continued opioid use increases at four to five days, based on information from the Centers for Disease Control and Prevention.

He said patients have been accepting of this kind of limitation because of addiction concerns. “It seems like sometimes the patients are realizing there’s a problem,” he said.

— He suggested the drug gabapentin, which is used to treat conditions such as epilepsy, neuropathic pain and hot flashes, should be classified as a Schedule 4 drug. “Moving it to a Schedule 4 is a chance to get a better handle on it,” he said.

— Overdose treatment should be reported, he said. “If we have a better reporting process I think that will help us to see the problem broadly,” he said.

— He said providers should be able to share substance abuse problems with prescribers.

— Access to the Prescription Drug Monitoring Program should be mandatory, he said. “I think it needs to be expanded to utilize it more,” he said. “I think physicians need to be able to access it more.”

Much of the public’s attention is focused on heroin addiction now. The amount of opioids prescribed in the United States peaked in 2010 and then decreased each year through 2015.

Despite the reductions, Henry said, the amount of opioids prescribed remains about 300 percent higher than in 1999 and four times higher than in Europe.

Most people who gain access to an opioid prescription without having a medical condition of their own do so because it’s given by a friend or relative for free, Henry said.

“When you have 53 percent of the pills leftover from the surgery, this is where people get their pills,” he said. “Most of the time they come from family and friends.”

He also warned about the broadening risks of benzodiazepines — tranquilizers. He said deaths have been on the rise nationally over more than a decade.

“There are other drugs being abused,” he said. “Benzodiazepines are at the head of the list.

Tom Takubo

Committee chairman Tom Takubo, who is a doctor, agreed on that point.

“There’s more soccer moms that are heavily addicted to benzos,” said Takubo, R-Kanawha.

“If you don’t do something to control that, that’s the gateway. There’s a lot of working moms or stay-at-home moms.”

State Health Officer Rahul Gupta also discussed the addiction crisis before the committee. He said the Office of Drug Policy is trying to take a broad approach to coming up with solutions.

Rahul Gupta

“It’s a comprehensive approach that we’re taking,” Gupta said. “This particular epidemic has touched a lot of parts of society. So we’ve got to address all of those.”

He said overdose deaths involving heroin or fentanyl have surpassed deaths involving other drugs.

“We’re seeing this epidemic evolve in front of our eyes. It might have started as a prescription drug epidemic. But what’s happening with this problem is, it’s evolving into one of heroin, fentanyl and possibly crystal meth.”

Gupta said authorities are working to review 830 deaths of West Virginians that occurred in 2016 to try to find common threads that can be used to prevent future deaths.

“We have people dying and people suffering, but we don’t know which people are likely to overdose,” he said.

He said the goal is to be able to provide caution for those most likely to overdose: “Here are the kind of people you want to pay attention to.”

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