On October 26th I attended the Governor’s Opioid Summit in Des Moines. Medical, substance abuse and legal experts were present to discuss possible solutions to the growing opioid epidemic claiming so many lives in America and Iowa. According to the Centers for Disease Control, deaths in the United States from drug overdose rose by over 17% in 2016, a clear sign that decisive action is required.
Drug overdoses have now become the leading cause of death for Americans under 50. According to Dr. Robert Anderson, Chief of the C.D.C. Mortality Statistics Branch, the deaths have been driven by overdoses of synthetic opioids, mostly fentanyl. The dramatic increase in deaths from overdose is largely due to an increase in prescribed opioid painkillers such as hydrocodone and oxycodone. In 2012 alone, health care providers prescribed enough opioid painkillers to put one bottle in the hands of every American adult. A drug once considered a last resort has now become the drug of first resort, leading to an epidemic of addiction and death.
President Donald Trump recently declared the opioid crisis a public health emergency, and great focus is being placed on this challenge by Governor Kim Reynolds and the Iowa Legislature. Although the challenge in Iowa is not as great as many states are facing, the problem is growing. Overdose deaths in Iowa from heroin and opioid drugs doubled from 2005 to 2015, while treatment admissions more than quadrupled, according to state public health department statistics.
In 2016 the Iowa House & Senate passed legislation, signed by the Governor, to expand access to naloxone without a prescription. This drug can save the life of someone overdosing from opioids, and can now be provided to families of those at risk of overdose, first responders and emergency personnel and certain school officials. This is a good step but much more needs to be done.
Some of the ideas advanced at the Governor’s Opioid Summit include increased use of the Prescription Monitoring Program (PMP). Currently, only 43% of medical professionals in Iowa authorized to write prescriptions for opioids and other medications use the program. A topic for discussion in the upcoming session will be ways we can increase participation in this program, including possibly mandating its use by those writing prescriptions. The PMP can identify and stop “doctor shopping” and over-prescribing of medications such as opioids. This nine-year-old state system will need technology upgrades in the months ahead to make it more efficient to use.
Another idea advanced would limit the amount of opioids that can be prescribed per prescription, an idea opposed by the doctors participating in the summit but supported by Iowa Attorney General Tom Miller. One recommendation advanced by the CDC would be to limit opioid prescriptions to seven days. Doctors object to this “one size fits all” approach but the Attorney General reminded those in attendance that a crisis requires action above and beyond what might be done under normal circumstances. He also recounted that his friend was given a prescription for 30 days of opioids for a procedure that should have received nowhere near such an amount of highly addictive medication.
During the summit, Governor Reynolds courageously recounted her own battle with alcohol addiction and pledged to find effective ways to deal with this crisis. In the coming legislative session that begins January 8th, 2018, we will work with the Governor to find ways to fight this growing public health hazard. There was a time when opioids were prescribed as a last resort. I believe we must return to this mindset, while also combating opioid addiction through education, effective treatment strategies, and legislation as needed to stop the overprescribing of these dangerous and highly addictive drugs.
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