Opioid task force issues recommendations

The task force considering how to address the growing opioid addiction crisis in Alaska is seeking public comment on its first draft of recommendations.

The Alaska Opioid Task Force, convened in May by the Alaska Department of Health and Social Services, the Alaska Mental Health Trust Authority and the state’s Advisory Board on Alcoholism and Drug Abuse, aimed to advise the state government on how to act to combat the growing problem. The approximately 20-member group, comprised of medical professionals, public employees, law enforcement, people in recovery and family members of people in recovery, met every two weeks throughout the summer and came to its draft recommendations at its Oct. 28 meeting.

They are intentionally broad, said Kate Burkhart, the executive director of the state’s Advisory Board on Alcoholism and Drug Abuse, who served as staff on the task force.

“Once we receive public comment we can narrow it down,” she said. “The final recommendations will probably be a bit more specific. I anticipate over the public comment period, the task force members will continue to refine those recommendations … and probably have the final list done early in December.”

The recommendations are structured after the public health framework developed by the Association of State and Territorial Health Officials and suggest sweeping changes to the way the state government, medical professionals and other agencies address addiction, such as developing a comprehensive withdrawal management plan for providing detoxification and treatment in health care settings and requiring public and private health plans to reimburse the cost of medication assisted treatment for substance abuse.

The task force decided early on to take a public health approach to addressing the opioid crisis rather just a law enforcement or health care approach, Burkhart said.

“(The three leading agencies) started developing this idea of, ‘How can we gather Alaskans together to come up with solutions that work for us?’” she said. “I think they came upon this idea of, ‘How can we use a task force to come up with recommendations that really work?’”

The task force had members from all across the state who participated by video conference or phone in most of the meetings, and heard presentations from a variety of people who were not members of the task force, she said. The public also stayed involved, with some people attending every meeting and others coming to speak about a particular issue, she said. The task force members corresponded with local coalitions that have been trying to address the opioid addiction issues in their communities, which provided helpful feedback as well, she said.

Rep. Paul Seaton, R-Homer, who served as an ex-officio member of the task force representing the House of Representatives, participated in all the meetings throughout the summer. He said it was an interesting process and received input from a diverse group of Alaskans throughout.

Homer has developed its own resources to combat the opioid addiction crisis. South Peninsula Hospital operates a needle exchange program to provide those in active addiction with clean needles, preventing communicable diseases like Hepatitis C from spreading among those sharing needles, and staffs an addiction medicine physician who splits her time between South Peninsula Hospital and the Ninilchik Community Clinic. Seaton said he was glad Homer has gotten the needle exchange program and that people are talking about the issue.

One of the issues he pressed in the course of the task force’s work was to put emphasis on prevention rather than just treatment and encouraging the medical industry not to use opioids as readily to treat pain, he said.

“We’ve treated pain as one of those things that no one should endure,” he said. “(The attitude has been that) it should be alleviated to the maximum extent possible, and that has left us with the problem here. But now we know more and now we really need to work fast so we’re slowing down the use of opioids.”

Seaton introduced House Bill 344 in the last session, which aimed to require all medical practitioners who administer, prescribe or dispense controlled substances to register with the prescription drug database and would require a limit of 7 days on initial opioid prescriptions. Though heroin and other synthetic opioids, like fentanyl, have caused overdose deaths, most overdose deaths come from prescription drugs and often begin with prescriptions for pain, Seaton said. A 2013 study from the U.S. Substance Abuse and Mental Health Administration showed that pain medication was a frequent path into addiction that led to heroin use because heroin is cheaper and more readily available than prescription pain relievers.

Seaton said some provisions of HB 344 ended up being included in Senate Bill 74, which reformed the state’s Medicaid program, which is still being implemented. One the task force’s recommendations are finalized, he said he might look at bringing forward another bill similar to HB 344. He said he hoped the Legislature might move on the recommendations because getting control of the opioid epidemic will benefit the state financially as well as socially.

“The only time you don’t get much return (on financial outlay) is if you have recidivism,” he said. “Get people off of these things and you get our society working a whole lot better.”

Burkhart said there had been some estimates on what implementing the recommendations would cost the state, but some have been left until the recommendations are submitted to the governor and the Legislature for the agencies they most affect to do themselves. Some of the recommendations address cost containment directly because of concerns for the rising costs of drugs with a public health use, such as naloxone, an anti-overdose rescue drug being increasingly provided to emergency responders and those in contact with opioid users, she said.

“(For) the recommendation related to access to naloxone, there was specific interest in helping to contain cost there because we’ve seen this with other medications — when it is identified as a public health tool, the price goes up,” she said.

The full recommendations are available for public review on the Department of Health and Social Services’ website. Public comment is open until Nov. 28, 2016 at 4:30 p.m. Comments can be submitted by email to opioid@alaska.gov or by mail to the Advisory Board on Alcoholism and Drug Abuse at 431 North Franklin Street, Suite 200, Juneau, Alaska, 99801.

Elizabeth Earl is a reporter for the Peninsula Clarion and can be reached at elizabeth.earl@peninsulaclarion.com.

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