State health officials announce Opioid Council report, action plan to fight addiction

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A council tasked with fighting opioid addiction in Alabama released its first formal report of its findings along with an action plan on Wednesday.

The Alabama Opioid Overdose and Addiction Council, created by Gov. Kay Ivey in August, and its subcommittees have met several times over the past six months to develop the strategic plan “that establishes recommendations for policy, regulatory and legislative actions to address the overdose crisis in Alabama.”

“I am thankful for the hard work of the Opioid Overdose and Addiction Council. We must find a solution to the opioid crisis in our state, as this epidemic is literally tearing families apart,” said Ivey. “I look forward to working with the Council and the Legislature to consider these recommendations and to make meaningful reforms which will help us address this problem once and for all.”

The council is overseen by Mental Health Commissioner Lynn Beshear, as well as her co-chairs, Attorney General Steve Marshall and Acting State Health Officer Dr. Scott Harris.

Beshear said the next step in the plan is to convene the implementation team and to continue to meet quarterly.

“Families, healthcare professionals and government officials at every level seek real solutions concerning the impact the opioid crisis has on Alabamians,” said Lynn Beshear, Commissioner, Alabama Department of Mental Health. “The next step in our effort will convene the Implementation Team of the Alabama Opioid Overdose and Addiction Council, as well as quarterly meetings of the full Council to implement researched opportunities. We believe the work of the Council offers preventive strategies, intervention and treatment options, and a community response that addresses this dire need. Working together, it will require organized sustained engagement of citizens and government with healthcare professionals.”

According to data from the Centers for Disease Control and Prevention, of Alabama’s 736 reported drug overdose deaths in 2015, 282 were caused by opioids. The data also shows that Alabama doctors in 2012 wrote 1.43 prescriptions for opioid pain relievers per person — a rate higher than any other state.

Opioid addiction and abuse is a tremendous problem that affects Alabama in many different ways. Our hospitals, schools, churches and prisons are all struggling to deal with the problems caused by addiction and by increasing numbers of opioid deaths,” asserted Harris.

He continued, “The comprehensive action plan the Council has developed includes improvements to the Alabama Prescription Drug Monitoring Program that make it easier for prescribers to identify opioid abuse and to motivate abusers to find help for themselves, their families and communities. We are encouraged that the Council has offered strategies that have the potential to reverse this crisis that affects so many Alabamians, and appreciate the input of so many individuals to find effective solutions.”

“After working with the dedicated people who have given so much of their time and concern to this Council and its subcommittees, I am heartened that we can make progress to fight the terrible blight of opioid abuse in Alabama,” added Attorney General Steve Marshall.

The Council’s report presents a four-pronged action plan to address prevention of opioid misuse, intervention within the law enforcement and justice systems, treatment of those with opioid use disorders, and community response that engages the people of Alabama in finding solutions at a local level.

Some of the major findings are summarized below:     

PREVENTION

  • Improve and modernize the Alabama Prescription Drug Monitoring Program so that it will be more user-friendly, and more prescribers will participate and be better informed; the Governor is requested to support a legislative appropriation of $1.1 million to the Alabama Department of Public Health for this;
  • Strengthen prescription data and research capabilities and create a unique identifier for each individual patient;  
  • Promote efforts to educate current and future prescribers, better implement current guidelines, adopt guidelines specific to opioid prescribing and impose mandatory opioid prescribing education;
  • Create a website and messaging campaign to reduce the stigma of opioid addiction; and implement an outreach program to teach young people the dangers and to avoid opioids;
  • Create a website and social media campaign to motivate opioid abusers to seek help and to effectively connect them and family members with ways to get help;
  • Create a partnership for the Alabama Department of Mental Health to provide training about addiction to law enforcement agencies and the judiciary.

INTERVENTION

  • Advocate legislation in the 2018 session to specifically prohibit trafficking in fentanyl and carfentanil, which is particularly important because vastly smaller amounts of these than other opioids can be deadly; for example, a lethal dose of fentanyl is 1000 times less than that of heroin, and the threshold amounts for the crimes of trafficking in fentanyl and carfentanil would better be measured in micrograms; 
  • As overdoses are 50 times greater for those leaving incarceration or other enforced abstinence, establish a process for the Department of Mental Health to reduce the stigma of medication assisted treatment, and begin a pilot program by the Department of Corrections in partnership with the Board of Pardons and Paroles to use naloxone, counseling and life skills to help released inmates remain drug free.

TREATMENT AND RECOVERY

  • Promote adequate funding for treatment services and recovery support;
  • Establish collaboration between the Department of Mental Health and recovery support providers to increase access;
  • Support creating two addiction medicine fellowships to train Alabama physicians to recognize and treat substance abuse;
  • Expand access and target effective treatment and prevention programs to areas where there is greater need;
  • Improve education of professionals through continuing education for licensing and expand postsecondary and graduate curriculums.

COMMUNITY RESPONSE

  • Increase access to naloxone and maintain a list of participating pharmacies;
  • Prioritize naloxone to law enforcement and for distribution in areas of greatest need;
  • Provide naloxone training for first-responders;
  • Encourage prescribing naloxone for high-risk patients;
  • Have a Community Anti-Drug Coalitions of America program in each judicial circuit and work toward having them at municipal levels;
  • Engage employers, businesses, higher education and private-sector in a network to get resources into communities;
  • Encourage having a Stepping Up Initiative in each county to work with the criminal justice system regarding incarceration of those with mental health problems;
  • Develop ways to provide service to veterans regarding opioid issues.

A copy of the Council’s report is available for download here.

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