Opioid Crisis Bill Would Send $2 Million to Four Counties to Address Epidemic

The 2018 legislation is modest compared to the problem at hand, but a work group will meet after the session to recommend stronger proposals.

Oregon's House Health Committee unanimously passed Gov. Kate Brown’s latest set of proposals to address the opioid epidemic -- requiring all prescribers to register with the state monitoring program and putting $2 million toward overdose prevention, including the use of peer recovery monitors.

Brown’s bill, House Bill 4143, will also task the Department of Consumer & Business Services, the Oregon Health Authority and the Department of Corrections to analyze obstacles to getting opioid addicts into treatment and to treating pain with less reliance on narcotics. The legislation must still be approved by the Committee on Ways & Means before it heads to the House floor.

While the 2018 proposals for tackling the opioid crisis are modest, these government agencies will be expected to offer more concrete solutions in the 2019 long session, said Rep. Brock Smith, R-Port Orford, who sits on the governor’s bipartisan task force. “This epidemic is statewide,” he said.

“We are aimed at taking a look at barriers to appropriate treatment access in Oregon,” said Brown’s point man on the opioid epidemic, Jeff Rhodes. “We want to create a bridge from an overdose episode to appropriate, evidence-based treatment.”

Currently, dispensers -- pharmacists -- already have to register with the Oregon Prescription Drug Monitoring Program, but it’s voluntary for doctors, nurse practitioners and other prescribers, a significant gap. Expanding the program to mandate registration by all prescribers of opioid medications would bring Oregon up to standards of Washington, Idaho and 23 other states.

Multnomah County Commissioner and emergency room physician Sharon Meieran said that she uses the drug monitoring program in her work, and supports having all physicians on board so that they can see who else might be prescribing opioids. “It gives doctors a better picture,” Meieran said. “As a physician, I was one the of the first to sign up. The PDMP can be a powerful tool, but we need providers to participate.”

Physicians have faced heat for over-prescribing highly addictive opioid medications while insurers have also been dogged for making cheap narcotic pills readily available but hedging on approval of more costly hands-on treatments for pain like physical therapy and acupuncture as well as medication-assisted addiction treatment.

The $2 million attached to the bill will target resources at the local level, where Meieran said they could be used most effectively.

Overdose prevention will include peer recovery monitors, who work with people who have survived a drug overdose and guide them toward and through treatment after acute episodes. The program will start in four counties -- Multnomah, Marion, Jackson and Coos -- but could be expanded in the future if successful and if more funding is available. The new program will launch in January 2019 and run to the end of 2020 unless renewed.

House Bill 4143 drew wide support from local politicians across Oregon, as well as the Oregon Association of Hospitals and Health Systems, leading insurer Cambia Health Solutions and the Oregon Chapter of the American College of Emergency Physicians.

Dr. Raki Pai of Cambia testified that his company has reduced its number of opioid prescriptions by 22 percent since 2015. “Cambia also favors eliminating barriers to appropriate treatment,” Pai said. “Our health plans require no prior authorization for medication assisted substance abuse treatment, and we applaud the taskforce for evaluating obstacles that might limit a patient’s ability to receive help.”

Dr. Michelle Shaw, the president of the emergency physicians’ organization, said that though her fellow doctors are on the front lines of the epidemic, they prescribe less than 5 percent of prescription opioids. She recommended streamlining registration for the prescription drug monitoring program to make it easier for doctors to participate.

Reach Chris Gray at [email protected].

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