Battling the opioid epidemic is getting lots of attention during the 2018 legislative session – and that’s good news for Palm Beach County.
On Tuesday, Gov. Rick Scott restated his proposal to put up $53 million to help crush the heroin crisis. The next day, Agriculture Commissioner Adam Putnam told a group of Palm Beach County business and community leaders that if elected governor he would appoint a “drug czar” to lead the state’s initiatives against the problem.
And legislators have filed several bills addressing the issue on all sides, from requiring pharmacies to provide medication lockboxes for sale to three-day limits on opioid prescriptions. Doctors would be requiredto take a course on safely prescribing them and to consult the prescription drug monitoring database for the patient’s history of opioid prescriptions.
The absence of strong opposition could result in major legislative coups for Palm Beach County, which leads the state in overdose deaths.
The lines are drawn clearly on many issues before the Legislature this year, such as increasing school property taxes or bills that seek to restrict local control.
But Palm Beach legislators say they’re feeling optimistic about the success of opioid-related bills.
That’s because opioid abuse, including heroin, and its effects – spikes in homelessness, more children entering foster care, strains on social services – are not partisan issues, said Rep. Lori Berman, D-Lantana.
“This affects every Floridian across the state,” she said.
In a separate interview, Rep. Al Jacquet, D-Delray Beach, concurred.
“Everyone here is talking about it,” he said. “This is a priority for all of us.”
This past week, opioid-related bills got readings in both chambers of the Legislature.
The House Health Quality Subcommittee on Wednesday unanimously approved a measure incorporating prescription drug limits.
Surgeons protested the changes, saying they could pose problems for patients who’ve undergone open-heart surgery or had their hips or knees replaced.
Earlier that day, Dr. Brian Luskin – a Palm Beach County orthopedic hand surgeon – told the Senate Health Policy Committee that while he supports the state’s attempt to rein in prescription drug abuse, the effort “raises some issues that affect the reality of orthopedic care.”
Senate and House proposals (SB 8 and HB 21) would allow a seven-day prescription only when deemed “medically necessary” by their doctors. That would require patients to visit their doctors more often and possibly increase the number of co-pays as refills for those drugs cannot be called into pharmacies.
That could be a problem in a state where between 200,000 and 300,000 hip and knee replacement surgeries are performed annually, according to Luskin.
On the other hand, a study by the Centers for Disease Control and Prevention showed how quickly someone could get hooked on the drugs. After an initial three days of use, about 6 percent of patients were still using opioids a year later.
By Day 5, it was 10 percent. At an initial 11 days of use, 25 percent of patients were still taking opioids after a year.
While cracking down on the number of prescriptions is part of the battle, Palm Beach County leaders say they need cash to win the war – about $20 million.
That’s the price tag for the county’s opioid resource wish list, which includes a match for a receiving center where addicts could get treatment and “wrap around services” such as counseling and a social worker.
Properly financed, the center could serve as model that could replicated throughout the state, said Rep. Matt Willhite, (D-Wellington).
Willhite, who’s authored a bill (HB 3797) requesting $1 million to finance the center, said there’s a good chance the county could get the money to move forward because the project is “shovel-ready.”
“We’re saying, ‘This where we want you to put (opioid money),’” he said.
But money alone can’t resolve the matter, Jacquet said in a separate interview.
“Putting money behind the problem is like putting a Band-aid on the Titanic,” he said. “Eventually, that Band-aid will fall off.”
A “multi-prong approach” that also addresses the availability of opioid drugs, the pharmaceutical companies that manufacture it and doctors who overprescribe is key, he said.
Still, Jacquet said he envisions that Palm Beach County will “take a huge bite out of that problem this year,” thanks in large part to county leaders joining forces to engage legislators on the issue.
“Palm Beach County is leading on this,” he said. “We are on the right track.”