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Will Delaware's New Attack on Heroin Be an Example to Other States?
(Novus reports to professionals in the treatment industry to help support the help needed to handle the epidemic of addiction in the US.)
Delaware has announced a four-pronged attack on heroin and opiate addiction in the state, and educating doctors on the dangers of prescribing opioid painkillers is at the top of the list.
Delaware’s Attorney General Matt Denn wants to see new, standardized regulations to govern how freely doctors and other providers prescribe opiate drugs.
To that end, the state’s Division of Professional Regulation has proposed new legislation, called the Uniform Controlled Substances Act Regulations. The proposed Regulations create a new 9-member Controlled Substances Advisory Committee to oversee the more than 10 pages of detailed regulations covering prescriptions, labeling, physician and pharmacy record and inventory controls, practitioner dispensing of controlled substances and much more.
Rounding out Denn’s proposals are better analysis of the circumstances of overdose deaths, increasing the availability and proper use of drugs used for the treatment of addiction and expanded use by emergency responders of the opioid-overdose-reversal drug naloxone.
Prescribing habits seen as major source of the heroin problem
The massive increase in opioid painkiller prescribing over the past 20 years is seen by many as one of the main causes, if not the root cause, of America’s current heroin epidemic.
This isn’t a brand new idea, but it’s been gaining a lot of credibility lately as opioid painkiller abuse and overdose statistics have been followed by heroin. In fact illicit opioid deaths have soared during the same basic period of time – and have more than tripled in just the past 10 or so years.
Delaware’s decision to standardize the prescribing regulations of controlled substances is a reaction to the state recently being ranked in the top 10 in the nation for drug overdose rates.
“The human cost of substance use disorder on those who use the drugs, their families and their communities is so significant that additional action is demanded,” Denn said at a news conference announcing the proposed new Regulations. The AG added that Delaware has taken some significant steps in recent years, but “alarmingly high rates” of opiate and heroin abuse continue to plague the state and more work needs to be done.
The four-pronged attack on opiates and heroin
The Delaware plan should “positively impact the prevalence of prescription opioid and heroin abuse.” As quoted in the press release, the new plan aims to bolster four main areas:
- Strengthen the regulations that govern the amount of care that health care providers must exercise in prescribing opiate drugs. The state Controlled Substance Advisory Committee has drafted regulations to govern prescription by doctors and the plan includes ideas – already submitted in comment form – to make those regulations even stronger before they are finalized.
- Conduct routine state reviews of deaths caused by prescription opiate and/or heroin overdoses to determine what could have been done differently – similar to reviews currently done in child death cases. Such a process would need to be created by the action of the legislature in 2016.
- Maximize the responsible use of medically assisted treatment of substance abuse disorder. A group of medical professionals and advocates would convene to discuss best practices in the use of medications like Suboxone, methadone and naltrexone, which some doctors have advocated for wider use of to treat addiction.
- Encourage our state’s law enforcement community to expand the number of officers who carry naloxone, a drug that is effective in reversing the effect of heroin overdoses. This drug has been successfully employed in nine cases by New Castle County Police (7), Middletown Police (1) and Ocean View (1) police to avert a potentially fatal overdose. Officials say that the state needs to conduct routine reviews of overdose deaths to effectively meet the heroin epidemic, to ascertain if possible what other approaches need to be taken to help prevent such tragedies.
It should be noted that not all treatment specialists agree that the opiate methadone is the most beneficial treatment response for all patients. Here at Novus Medical Detox Center, it’s been our experience that addicts generally want to get off opiates altogether, rather than continue to be dependent on another opiate such as methadone.
Grass-roots groups and the cops are a big part of the program
AG Denn has included the participation of not just health officials and lawmakers in shaping and carrying out the new programs, but also key members of law enforcement and local citizen groups as well.
Don Keister, a board member of the citizens’ group atTAcK Addiction, said that doctors need to limit the number of opiate painkiller pills they prescribe, and inquire into each patient’s family history and personal situation for signs of potential drug misuse. “When doctors prescribe opiates as pain medication, it is like giving patients a loaded gun that must be handled properly so that death by the disease of addiction does not occur,” Keister said.
In New Castle County, where at least 7 lives already have been saved thanks to naloxone being provided to policemen, Chief Col. Elmer Setting said that “the folks that are addicted to heroin aren’t necessarily criminals [but] they are certainly victims. These people need help and I am so glad that I am not the only person saying it any longer. This is not just a police problem.”
Delaware Fraternal Order of Police president Fred Calhoun added his support for equipping officers with the addiction-countering medication naloxone. “None of my officers want to be standing in the doorway when a family member or child walks up…looking into their eyes, knowing that the next thing you’re going to tell them will impact them for the rest of their lives.”
Prescription Drug Monitoring program will expand its scope
The AG’s office says deaths from prescription opioid abuse and illegal heroin are big problems in Delaware. But the state’s Prescription Drug Monitoring Program, which began operating in 2012, is “a significant advancement that should become more effective over time with improved utilization,” the office said.
The Prescription Drug Advisory Committee found in 2013 “that Delaware had the nation’s ninth highest drug overdose rate, had a significantly higher percentage of its residents engaging in non-medical use of prescription opioids than the national average, and had the nation’s fifth highest overall rate for opioid sales.” The number of deaths in Delaware from heroin overdoses increased from 8 deaths in 2009 to 23 in 2013.
“Far too many Delawareans are dying from prescription drug and heroin overdoses,” Denn said. “The catalysts behind many of the state’s efforts in the last several years to deal with substance use disorder have been the family members of Delawareans who suffered from drug overdoses – some of whom did not survive. We owe it to them, and other families who have lost loved ones, to redouble our efforts.”
Here at Novus we continue to provide state-of-the-art opiate medical detox care that goes much further preparing patients for a more successful rehabilitation.
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