Gov. Wolf to Pa. lawmakers: Act fast on opioid addiction bills

- Democratic Gov. Tom Wolf told lawmakers Wednesday that now is the time to take a stand against opioid addiction, and he outlined his legislative priorities in the waning days of the fall legislative session.

In an address to a joint session of the state House and Senate, Wolf urged quick action on a package of legislation designed to combat opioid and heroin addiction. Some 3,500 Pennsylvanians lost their lives to addiction in 2015, Wolf said, noting that such a loss is like losing the population of Parkesburg, Freeland or Mifflinburg every year.
 
"The opioid epidemic did not start overnight, and we will not fix it overnight or even in this session," he told lawmakers. "But by acting on these bills, and by putting other ideas on the table, we can continue to stem the tide of opioid abuse. We can make progress for the families we have met, the parents who have cried on our shoulders."
 
Lawmakers gave a standing ovation after the 15-minute speech.
 
Wolf's top priorities include passage of bills to require prescribers to check a prescription drug monitoring database every time they prescribe opioids and to limit opioid prescriptions to emergency room patients to seven days. Wolf has said, however, he does not know whether either provision can pass the Legislature.
 
The limitation on emergency prescriptions is a narrower version of what passed in Massachusetts, where lawmakers limited all doctors to a seven-day limit.
 
The governor's office listed six concepts he supports, most or all of which are already included in bills pending in the Legislature.
 
  -- Require prescribers to check the state's Prescription Drug Monitoring Database every time they prescribe opioids
 
  -- Limit the opioid quantities prescribed to emergency room patients to seven days
 
  -- Require medical professionals to receive updated education about opioids and pain management
 
  -- Require public school students to be taught about opioid misuse
 
  -- Require insurers to provide coverage of abuse deterrent opioid formulations
 
  -- Require the Department of Health to develop and publish a uniform voluntary non-opioid directive form, which could be used by a patient to deny or refuse the administration or prescribing of an opioid drug by a practitioner.
 
These were Gov. Wolf’s remarks as prepared to address the Joint Session of the legislature:

"Thank you for allowing me to address a joint session of the legislature.

Working together, we have had great success in moving Pennsylvania forward, but we still have a lot more work to do.

I am grateful to President Scarnati and Speaker Turzai, Leaders Corman, Costa, Reed and Dermody for your willingness to make the fight against opioid addiction a priority and for your work in the past to address this crisis.

The Center for Rural Pennsylvania, chaired by Senator Gene Yaw, has worked on solutions to the opioid epidemic since 2014. The work the center has undertaken has positioned many pieces of legislation for passage that we can now finalize. Senator Wozniak and Representatives Kavulich and Everett have also been strong voices in this effort.

I am also thankful to the Chairs of the HOPE Caucus - Representatives Ed Gainey and Aaron Kaufer as well as Senators Gene Yaw and Jay Costa - for their laser focus on fighting the opioid epidemic in communities throughout Pennsylvania.

I would also like to acknowledge Representative Gene DiGirolamo for his passion and his work to fight addiction.

Many members here today have provided thoughtful legislation and innovative ideas to fight opioid addiction.

We are all aware of the opioid epidemic facing Pennsylvania - a public health crisis, the likes of which we have not before seen.

Every day we lose ten Pennsylvanians to the disease of addiction.

This disease does not have compassion, or show regard for status, gender, race, or borders.

It affects each and every Pennsylvanian, and threatens entire communities throughout our commonwealth.

The disease of addiction has taken thousands of our friends and family members. In the past year alone we lost over 3,500 Pennsylvanians - a thousand more lives taken than the year before.

We are not alone. According to the Centers for Disease Control, prescription opioid overdose deaths in the United States have quadrupled since 1999.

Families have identified loved ones. People have buried their childhood friends.

It is a crisis that has been building for years, right here in Pennsylvania and all across the country.

Addiction too often is an invisible problem.

People with substance use disorders and their families fear the stigma of addiction, which keeps them isolated and unwilling to ask for help.

The consequences fall to law enforcement, jails and prisons, and understaffed treatment centers.

But in Pennsylvania the problem is visible -- in the lives lost. The families broken. The communities shaken.

It is visible because parents have come to us - every single one of us -  asking for help.

It is visible because the members of this building listened and made the fight against opioid addiction a priority right here in Harrisburg.

And because you have brought the voices of your constituents here, it is now possible for us to fight with every tool we have.

And that is what we are going to do.

We are going to take a stand against the vicious disease of opioid addiction.

This past year has moved from conflict to civility.

We have achieved some very good things working together.

And while achieving these things, we have made fighting the opioid epidemic a top priority.

I have traveled the commonwealth with Republicans and Democrats. We have listened to our fellow Pennsylvanians. We’ve held parents’ hands as they cried and we’ve hugged those in recovery who’ve risen above this disease - and we’ve heard their stories.

Parents and those suffering from the disease of addiction have broken down telling us about the difficulty of finding treatment options.

We heard them, so together in this year’s budget we increased funding for treatment centers by more than $20 million. That will create 45 centers for treatment, allowing nearly 11,000 Pennsylvanians to receive care.

These centers integrate behavioral health, primary care and, when appropriate, evidence-based medication assisted treatment.

And by expanding Medicaid to provide nearly 700,000 Pennsylvanians with health care, we also provided treatment to 63,000 Pennsylvanians battling the disease of addiction who previously did not have access to care.

We are doing more to treat this like the public health crisis it is.

Doctors and other medical professionals have voiced frustration at the inability to find centralized prescribing information.

We heard them, so together we redesigned the Prescription Drug Monitoring Program - a database created by the legislature through a bill authored by Senator Pat Vance.

The online database allows prescribers and pharmacists to monitor who is obtaining opioids, and where and how often they were prescribed.

This critical tool will support medical professionals in identifying patients struggling with the disease of addiction and get them the help they need.

Police and first responders asked us for more tools to save people.

We heard them too, so together we have made an opioid overdose reversal antidote - naloxone - available to Pennsylvanians, including local police departments.

Last year, Physician General Dr. Rachel Levine signed an order enabling all Pennsylvanians to access naloxone without a prescription at their local pharmacy.

And since November 2014, more than 1,500 opioid overdoses have been reversed by local and state police officers.

As York District Attorney Tom Kearney said of law enforcement officials - this disease was not their public health issue, but many of them made it their fight and for that, we owe them a great debt of gratitude.

Ordinary Pennsylvanians wanted to know how they could help.

We heard them, so together we are helping communities properly dispose of unused and unwanted prescriptions through a drug take-back program.

There are nearly 520 take-back boxes located at police stations across Pennsylvania, and we have collected and destroyed over 145 thousand pounds of prescription drugs including opioids.

Together, we have taken important steps to stop this crisis in Pennsylvania.

But we have more to do.

Over the past six months, I’ve sat with many of you in roundtables with families, law enforcement and medical professionals to discuss the opioid epidemic in Pennsylvania.

But in addition to the stories we have heard, every one of us likely has a personal story they can recount by heart. And so many of these stories are the same - no matter how different the storytellers are.

Just a few weeks ago, I was chatting with a friend who asked me if he could give me a letter. I asked if he just wanted to talk, but he had trouble composing his words.

When he gave me the letter, I was surprised to learn that his own child had recently passed away from the disease of addiction.

He was heartbroken, but thanked all of us for the work we’ve done to help people suffering from the disease of addiction while imploring us to do more.

This is one example of the far-reaching effects of the opioid crisis.

This crisis reaches into every population, every age group, and every kind of family.

It is our job to make sure no families have to write these letters or bear this pain ever again.

We must address this epidemic, but how can we make the biggest difference in the short  time we have left this year?

We should not place limitations on what we can achieve in this session, we all have priorities, and we all want action.

But I want to talk about several bills that have already been introduced and discussed - and in some cases even passed by a chamber. We need to get them to my desk so I can sign them and we can make progress in this fight.

If we work together, we can continue to fight back against this epidemic. We must act now - many Pennsylvania families are counting on us.

First, physicians should check the commonwealth’s Prescription Drug Monitoring Program each time they prescribe opioids and other controlled substances.

Our current law is not strong enough. It only requires doctors to check the system the first time they prescribe to a patient, or if they believe a patient is suffering from the disease of addiction.

Pharmacists should enter data into the database within 24 hours of issuing a prescription, rather than the current standard of 72 hours.

Strengthening program requirements is imperative in helping doctors and pharmacists identify whether patients are doctor shopping or other doctors are overprescribing patients.

State officials also need the tools to identify inappropriate prescribing and dispensing practices among health care providers to better crack down on abuse.

Second, let’s prepare doctors and physicians for prescribing opioids and pain management by improving medical school and continuing education curricula on opioids.

This will give doctors the knowledge and best practices needed to tailor their clinical skills to identify signs of addiction and provide patients with information to avoid abuse or engage in meaningful treatment if they become addicted.

Third, let’s limit the amount of opioids a patient can receive at emergency rooms to a seven day supply with no refills.

And we should put the same restriction in place for minors no matter where they get a prescription. We have heard too many horror stories about high school athletes whose futures are robbed by addiction that begins with prescription painkillers.

Of course, those suffering from crippling pain need relief, and we must be careful to protect the ability of sufferers of long-term pain or victims of trauma to receive appropriate medication.

Fourth, let’s require insurance companies to cover abuse deterrent opioids - similar to what they already have in Massachusetts. This will make it more difficult to abuse prescription drugs.

While many people become addicted by simply swallowing pills, others crush pills to snort or smoke.

Drug manufacturers are rapidly developing new technologies to prevent this kind of abuse.

Some of these drugs are uncrushable, even with a hammer, while others are formulated with naloxone so the more an individual takes, the less effective it is in creating a high and limiting the potential for overdose.

Others turn into a gel when they are crushed, making them impossible to put into a syringe to inject.

These deterrent measures, if crafted properly, can be important tools against intentional or unintentional abuse or overdoses.

Lastly, several new bills deserve our consideration.

Two bills require schools to teach students about opioid misuse in existing drug and alcohol abuse curricula.

Another bill would allow patients to establish a voluntary directive if they do not want to be prescribed opioids.

The point is that the time for action is now.

As many have noted and I said earlier, 3,500 Pennsylvanians lost their lives to addiction in 2015 alone.

That means that each year we are losing the population of Parkesburg, Freeland, or Mifflinburg to the disease of addiction.

And each year the numbers grow.

The opioid epidemic did not start overnight and we will not fix it overnight, or even in this session.

But by acting on these bills - and by putting other ideas on the table - we can continue to stem the tide of opioid abuse. We can make progress for the families we have met - the parents who have cried on our shoulders.

Here in this building, we can make a difference. Right now. With bills that are close to passage.

In my inaugural address, I acknowledged that some people feel indifference toward their government.

In the past two years, we haven’t always helped improve that perception.

But in the past several months we’ve solved some big problems. Many of these issues have vexed Pennsylvania’s elected leaders for generations.

It’s a start, and we have more to do.

But with the most Republican legislature in modern history and a Democratic Governor, we’ve  balanced the budget, we’ve increased education funding, we’ve passed a fair funding formula, we’ve brought medical marijuana to suffering kids, and we’ve reformed the liquor system.

The magnitude of the opioid crisis threatens to cast a shadow over all of these important accomplishments and everything else we work to achieve in this building.

But it is also a calling to use our time and our energy to fix a problem touching too many Pennsylvanians.

The crisis calls on us to cast aside partisanship once again.

It calls on us to reject cynicism once again.

It calls on us to take action once again.

Families in Philadelphia, Brockway, Indiana, Allegheny County, State College, Mount Wolf, and all across Pennsylvania are calling on us to act.

It is life or death.

We have shown that we can work together to make Pennsylvania the great place we know it can be. It is now time to do so again and give the people of Pennsylvania a reason to believe in their leaders.

It is up to us to tackle the opioid crisis and give Pennsylvania the prosperous, healthy, and safe future we know it deserves.

I look forward to a productive session and real progress toward stopping the opioid epidemic.

Let us, here in Pennsylvania, lead the nation in fighting this crisis.

Let’s get this done.

Thank you."

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