SALT LAKE CITY — Several Utah legislators are championing bills this year that they say would curtail inappropriate access to opioids, educate medical providers on exercising caution when prescribing painkillers to their patients, and help the state better evaluate the effectiveness of efforts to rehabilitate those who are addicted.
Among the proposed legislation:
• Rep. Raymond Ward, R-Bountiful, is planning a bill that would would make it faster and easier for law enforcement to access the state Controlled Substance Database for assistance in a specific case.
Only an officer whose specific assignment is relevant to using the database, as well as their department head or police chief, would be allowed to access the database, Ward said.
He believes the bill represents a middle ground between the more expansive access public safety workers used to have, which led to complaints of "a couple egregious examples" in which some abused it by looking up people they knew indiscriminately, and the current status quo in which police "can only access it with a warrant."
Ward said his bill would allow a police officer specifically on a drug case and "is specifically working on diversion" to "access (the database) quickly and simply."
"To get a tip (and) to find that out quickly is one of the things law enforcement tells me would be helpful to them," he said, referring to police tips about a person's possible prescription drug abuse.
Ward said his bill would also require any officer seeking to use the database, as well as their department head or police chief, to first take a course and pass a test pertaining to its proper usage.
• Another bill that Ward is pursuing would instruct the Division of Occupational and Professional Licensing to communicate with a physician and provide educational support — through a letter, a call, and then an office visit — if that doctor is found to be consistently straying from specified opioid prescribing guidelines.
Ward, himself a doctor, said the measure doesn't amount to "enforcement, so to speak," because the guidelines on opioid prescriptions are not legally binding. But he believes that when "someone gets in their face" about their prescribing habits, the state can provide helpful education to a physician as well as a wake-up call motivating them to possible correct course.
"As a physician, if you get enough feedback … you go, 'OK, well I'm going to go look that up," Ward said. "It still doesn't make it easy to cut that person's dose … but at least you start trying to move in the other direction."
Ward said it's easy for a physician to inadvertently increase their prescriptions over time because large opioid regimens are generally popular with patients.
"This isn't a black and white thing, there's every shade of gray. As a prescriber, it's very easy to drift," he said.
Neither of Ward's bills had been publicly listed. He said he is aiming to have their language finalized by early next week.
• Rep. Justin Fawson, R-North Ogden, is sponsoring legislation that he said heightens existing requirements on physicians to check the state Controlled Substances Database before prescribing an opioid federal designated as a Schedule I or Schedule II substance.
HB127 would remove language from existing law that would exempt a prescriber from checking the database if the prescription would last three days or less when taken as instructed, or 30 days or less for prescriptions following a surgery.
"It basically removes (those) exemptions and puts the onus on the doctors to check the database before they prescribe," Fawson told the Deseret News.
The bill does allow for very limited exceptions to checking the database before prescribing, such as instances in which the patient is receiving emergency care and when the database is down for technical reasons, he said.
Besides those reasons, Fawson said, "I don't see any justification for a physician to not check the controlled substance database before they prescribed opioids." Checking the database is a critical way that physicians can help prevent abuse of opioids by their patients, he said.
• Rep. Kelly Miles, R-Ogden, is sponsoring a bill that he hopes will allow the state to more precisely determine whether the money being appropriated toward substance abuse and mental health treatment programs is being used in ways proven to get results.
"As legislators, we're always looking to increase outcomes and get a little more bang for our buck," Miles said.
His bill, HB199, sets the parameters for how treatment programs that use state funds can qualify to be characterized as "evidence-based" and sets a goal that, by 2020, 33 percent of such programs serving groups of clients will fall into that category.
For programs providing clients with "individual therapeutic behavior services," the goal in the bill asks that 20 percent of them be officially considered "evidence-based."
HB199 defines an evidence-based treatment program as one based on written documentation going into detail about what the service is and who it targets, and which "is supported by scientific research that (is) demonstrated through two or more client samples … that (it) improves client outcomes."
The bill also requires evidence that the program's effectiveness has been validated "through randomized control trials or quasi-experimental studies."
"As a society and as a state, we've been trying to reach as many people as we can and maybe not on helping (those we do treat) actually get better," Miles told the Deseret News. "I think what this does is it requires the implementation of treatment in a way that is proven. … There's some good treatment being provided out there and we've been seeing some good results. We just think we can increase that."
Miles' bill would also establish an Outcome Improvement Advisory Board, comprised of eight members, which would certify that treatment programs, as described by local health authorities to the state, are in fact evidence-based.
• A bill sponsored by Sen. Karen Mayne, D-West Valley City, and Rep. Stewart Barlow, R-Fruit Heights, would require nursing facilities to make formal written plans, to be shared with employees, that comply with state and federal standards for what qualifies as the proper disposal of controlled substances.
As part of such plans, SB85 would require that such facilities make every effort "to render the medications unusable" before discarding them as a precautionary measure, Barlow said.
"(It would help) avoid circumstances … where people find out where a facility commonly disposes of unused medications from just taking them out of the garbage can," he said. "Obviously some of these are narcotics — opioids and so forth."
• Ward said Rep. Steve Eliason, R-Sandy, is also preparing to introduce legislation that would require a health care facility to submit a report that other organizations can access in the event that an employee there was discovered to be stealing opioids.
The reasoning behind such a bill is that it would prevent such a worker from taking similar advantage of their next employer, Ward said.
House Speaker Greg Hughes, R-Draper, said earlier this week that he has been in lengthy talks with Utah Attorney General Sean Reyes about emphasizing the state's involvement in litigation against pharmaceutical companies for their role in the spread of opioid addiction.
Reyes told reporters that Utah is among 41 states currently in an effort to negotiate with some of those pharmaceutical companies — and is preparing for a lawsuit if such a settlement is determined to be adequate.
“Should we feel that at any time during the process leading up to settlement that the manufacturers and distributors aren’t cooperating with the states, then we wanted to have the gun loaded, figuratively, ready to pull the trigger on a lawsuit,” Reyes said.
Salt Lake, Weber and Utah counties all passed measures in 2017 announcing their plans to sue pharmaceutical companies in connection with the prevalence of fatal opioid overdoses and overall addiction to painkillers in recent years.
That was just one way in which the issue of opioid addiction gained widespread attention from Utah decision-makers last year. The Utah Department of Health launched an extensive opioid addiction messaging campaign, with the mantra "Stop the Opidemic," one year ago this week.22 comments on this story
Diverting drug addicts from jail and placing them in intensive substance abuse treatment instead was also a top stated priority during Operation Rio Grande, an extensive multi-agency effort launched in August and designed to reduce drug dealing and other crime in the neighborhood around the downtown Salt Lake Road Home shelter.
Also in August, Intermountain Healthcare announced its extensive hospital and clinic network would aim to reduce the number of opioids prescribed for acute pain by 40 percent by the end of 2018.
And a limited form of Medicaid expansion, aiming to add coverage for 4,000 to 6,000 of Utah's poorest who were either homeless, mentally ill or needed substance abuse or mental health treatment, officially took effect in November.