Doctor's Note: Addressing Virginia’s Opiate Crisis

The crises of opiate addiction and overdose deaths continues to escalate. Virginians impacted by addiction all over the Commonwealth are doing all they can to reverse the course. I remain committed to ensuring the state is doing everything we can.

There are two sides to addressing this issue. We need to decrease those at risk for becoming addicted and find the best ways to help treat and support everyone already addicted. To reduce the likelihood of addiction, I have carried legislation for the last three years that deters overprescribing, and am doing the same this year. That’s because 70 percent of opiate addictions start with a prescription from a medical provider.

This year, some of the legislation I am carrying includes:

SB 632 will require all providers to check the Prescription Monitoring Program (PMP) before prescribing opiates for acute pain beyond 7 days. For those at risk, addiction is more likely the longer you continuously take the opiate, and much less opiate is actually needed for acute pain than we have traditionally thought. Additionally, excess unused medication in the home can increase access for others to use or abuse. So limiting dosing is important.

SB 735 will give Medicaid the ability to track over-prescribing patterns in Medicaid recipients. Other states have had serious over-prescribing problems of opiates in the Medicaid population so we want to be sure we have the right checks and balances in place.

SB 728 will require a report from the PMP board annually to the Joint Commission on Healthcare (JCHC). The PMP board has started using the PMP to identify providers whose prescribing patterns are outside the parameters set for best practices. This is an attempt to proactively catch over-prescribers and intervene. The General Assembly wants to ensure we are as proactive as possible.

Probably one of the most important pieces of legislation I am carrying this year is SB 719. This bill would direct the state to develop a data system to connect localities to one another and to state agencies as well as interconnect the state agencies. Virginia is way behind in using data to track information and improve how we work. Unlike the private sector, data is collected in the silos of agencies and localities and is never shared or overlapped to identify patterns. People, of course, cross these boundaries. An example of why this is a problem would be someone who has overdosed, been given Narcan by the police, taken to the ER and treated for an overdose. No one taking care of her would know if this had happened before or if she was in a treatment program in a neighboring locality. We need to be able to share this data and look to see how we can work together, while also protecting privacy while we look for patterns. This bill has now been incorporated into SB 580 - which sets up a new Chief Data Officer for Virginia to lead the initiative for the Northam Administration and put together the experts to develop the system.

Additionally, I carried SB 726 to make it possible for people with many illnesses to have access to cannabidiol oil. You can read my blog post about this legislation here. The Virginia legislature passed legislation to compound CBD and THC-A oil two years ago, but it was only allowed for severe epileptic seizure. The oils help in many ways including as an anti inflammatory but they do not give the user a “high”. One added benefit of these oils stem from data which shows that in states where some form of cannabis is available medically, there is a 25 % decrease in opiate overdose. It appears it is helpful in reducing opiate use for chronic pain. While not the main intention of the legislation, I certainly hope it helps with our opiate crisis as well.

Yours,

Siobhan