The fight against opioids
Posted on 14 November 2017
Montana law now allows overdose reversal drug prescriptions
Governor Steve Bullock today announced that broad access to a life-saving opiate overdose reversal drug called naloxone is now more accessible in Montana since a new law passed in the 2017 Legislative session has been fully implemented.
The new law, through HB 333, made it possible for the State of Montana to issue a standing order to prescribe on a statewide basis an opioid antagonist to eligible recipients.
Bullock said lives will be saved by this action.
“Nationwide and in Montana, too many of our fellow friends, neighbors, and family members have been personally affected by this invisible epidemic and too many lives have sadly ended abruptly,” said Governor Bullock. “While we may not have all the solutions, we do know that by working together we can make significant progress. This is one piece to the puzzle that will give folks a second chance at life.”
Since 2000, there have been more than 700 deaths from opioid overdose in Montana. Opioids include prescription painkillers such as hydrocodone, oxycodone, morphine, and codeine, as well as illegal drugs such as heroin. Anyone who uses opioids—prescription and/or illegal—is at risk of developing an addiction or experiencing an overdose.
Multiple state agencies, including the Department of Public Health and Human Services (DPHHS), Montana Department of Justice, Montana Medical Association, Board of Pharmacy, Board of Medical Examiners, have been involved in the statewide rollout of naloxone through the standing order issued by DPHHS.
Dr. Nicole Clark of the Montana Medical Association said the organization she represents helped bring this key legislation forward because the evidence is unequivocal that is saves lives.
“Montana, like many states, has suffered too many opioid deaths,” Clark said. “Physicians are prescribing few opioids in Montana. This added measure is something we know will prevent future tragedies.”
Increased access to naloxone also expands this tool to law enforcement and first responders.
“This will help us tremendously when responding to emergency situations that call for the need to stabilize an individual in a crisis situation,” Bryan Lockerby, administrator for the Division of Criminal Investigation at the Montana Department of Justice, said.
The standing order will allow trained first responders, public health professionals, and others to carry and administer naloxone. DPHHS will also offer a training program later this year to teach first responders, law enforcement and others how to administer the drug in a time of crisis. And, thanks to a federal grant, DPHHS has funds available to purchase a limited supply of the drug for first responders and law enforcement across the state to help launch this effort.
The standing order also authorizes pharmacists who maintain a current active license practicing pharmacy located in Montana to provide a prescription and dispense a naloxone opioid antagonist formulation to eligible recipients.
Those eligible under the standing order include:
An individual who there is reason to believe is experiencing or at risk of experiencing an opioid-related overdose;
A family member, friend, or other person in a position to assist an individual, where there is reason to believe is at risk of experiencing an opioid-related overdose;
Or a person who through the duties of their job description may be required to assist an individual believed to be experiencing an opioid-related overdose.
DPHHS State Medical Officer Dr. Greg Holzman said the Centers for Disease Control and Prevention recommends a number of strategies to address the current opioid epidemic, including broad access to naloxone. Several states have already implemented similar measures.
Naloxone is a prescription drug that can reverse the effects of prescription opioid and heroin overdose, and can be life-saving if administered in time. Montanans are also advised to always call 911 whenever naloxone is administered.
Eligible recipients receiving naloxone from a licensed pharmacy or medical practitioner will be provided with basic instruction and information, which is made publicly available at: https://dphhs.mt.gov/publichealth/emsts/prevention/opioids
The 2017 Legislature also passed a second bill, HB 323, that makes it legal to authorize emergency use of naloxone in a school setting. From 2000-2015, there have been 15 deaths among youth and children less than 18 years of age associated with opioid use.
“It is very important to point out that school-aged children have not been immune from these tragedies,” Holzman said. “We need to do all we can to prevent these tragic events.”
On average, every year there are 89 hospital admissions and 66 emergency department visits associated to opioid use in Montana – four of those hospital admissions and 12 of those emergency department visits per year were among those less than 18 years of age.
Holzman stresses that naloxone is safe, and has no potential for abuse. It can be safely administered by both health care and trained non-health care professionals. The naloxone strategy is similar to providing schools with the authority to store and administer epinephrine/epi pens for children experiencing anaphylactic shock.