Elected officials, DEA consider solutions to heroin epidemic
PITTSBURGH — As overdose deaths increase across the country, elected officials and law enforcement agencies are recognizing a need for action and legislation that addresses the epidemic of opioid abuse.
In order to introduce a new act aimed to stop rampant use of prescription medication in Pennsylvania, Sen. Pat Toomey, R-Zionsville, with the help of Sen. Bob Casey, D-Scranton, held a investigatory hearing Thursday afternoon at Allegheny General Hospital. Several area addiction experts and health care professionals testified to their experience in dealing with heroin and opioid abuse before an auditorium crowded with doctors, parents and community members.
At the start of the hearing, Toomey cited a widely accepted statistic that claims eight in 10 heroin users started abusing prescription medication before turning to street drugs. That statistic has lead to increasing overdose deaths have across the entire country. Pennsylvania ranked seventh in most overdose deaths last year in the United States, Toomy said. Ohio ranked eighth, and West Virginia had the highest number of overdose deaths, he said.
In order to address the epidemic impacting the tri-state region, Toomey has proposed a three-pronged approach to fighting the heroin epidemic — stopping the diversion of prescription medications, stopping the over-prescription of controlled substances and providing effective treatment to those addicted to opioid-based drugs.
Toomey, along with Sens. Sherrod Brown, D-Ohio, Rob Portman, R-Ohio, and Time Kaine, D-Va., introduced the Stopping Medication Abuse and Protecting Seniors Act, aimed to combat doctor and pharmacy shopping for prescription medication.
At-risk beneficiaries are identified and locked into using one prescriber and one pharmacy to prevent individuals from obtaining multiple prescriptions for controlled substances. Toomey believes this will also improve patient care by identifying those battling addiction, ultimately helping their physician to lead them to effective substance abuse treatment.
The proposed prevention initiative already exists in Medicaid and commercial health care plans, but is not a part of Medicare Part D, which assists in coverage for prescription medication, and Medicare Advantage.
Supporters of the proposal estimate it could save taxpayers between $79 and $115 million over 10 years by eliminating fraudulent prescription payments from Medicare. It will also allow data sharing between Medicare and Medicaid ensures and contractors to avoid “waste, fraud and abuse.”
The second part of the act, which aims to protect older Americans, ensures seniors who need high amounts of pain medication are not “inappropriately” prevented from access to their prescriptions.
Individuals receiving hospice care, as well as those in long-term care facilities, will also be exempt from the lock-in, Toomey said.
Dr. Shari Ling, deputy chief medical officer for the Centers for Medicare and Medicaid Services (CMS), testified at the hearing about quality health care for patients across CMS, as well as the accessibility and coverage of naloxone, a drug that reverses the side effects of an opioid overdose.
Several local officials also testified at the hearing, including Dr. Neil Capretto, medical director for Gateway Rehabilitation Center, Eugene Vittone, district attorney of Washington County, Ashely Potts of the Crisis Stabilization and Diversion Unit, and Dr. A. Jack Kabazie, systems director for the pain medicine division of the Allegheny Health Network.
Dovetailing with Toomey’s proposal is a new initiative taking place in Drug Enforcement Administration (DEA) branches across the state.
Special Agent in Charge Gary Tuggle of the DEA’s Philadelphia Field Division announced a new initiative Thursday at the Pittsburgh field office in Kennedy Township. In addition to regulation and enforcement, agents across the country will focus on community outreach, education and prevention.
Tuggle said the department also is aggressively investigating pharmacies and physicians which over prescribe prescription medications. As Pennsylvania awaits an already approved prescription-monitoring program, Tuggle said agents rely on traditional investigations and often find fraudulent physicians and pharmacies through tips made to the department. He said it is critical that statewide monitoring programs are able to communicate across state lines to insure individuals can’t fill prescriptions simply by traveling outside of their home state.
While he expects U.S. attorneys across the country will continue to strongly prosecute offenders, he said the DEA can’t “arrest” their way out of the epidemic. As part of the department’s goal toward education and prevention, Tuggle said local DEA agents are working to de-stigmatize addiction and help people through prevention and treatment.
The DEA anticipated creating non-traditional partnerships with health care providers and schools throughout Pennsylvania.
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