Opioid Crisis

Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically they are primarily used for pain relief, including anesthesia. However, they are extremely dangerous when used incorrectly. Many Georgians have lost their lives caused by opioid overdose. In Georgia, within the last year, hospital emergency rooms have been inundated patients who have overdosed.

This crisis is constantly a reoccurring subject in the news. GHA is working with hospitals and state and federal agencies to develop strategies on saving lives. 

GHA President Editorial

The abuse of opioids has tormented families and friends nationwide, claiming thousands of lives. Amid all the heartache, one thing is constant: Everyone recognizes that immediate attention is needed.

The Georgia Hospital Association (GHA) has supported solutions at both the federal and state level to address this epidemic. Our hospitals and partners have developed resources and tools and conducted seminars and meetings to educate the public. 

Now, in addition to the tremendous work that Georgia Attorney General Chris Carr is currently doing, some much-needed help at the federal level may be on the way. Our elected officials on both sides of the aisle have come together to support legislation that, hopefully, will provide answers and resources for so many families in need. On Oct. 3, the House and Senate overwhelmingly approved House Resolution 1099, the “SUPPORT for Patients and Communities Act.”

Our main mission is to give patients the best care possible. When it comes to opioid treatment, this piece of legislation is a step in the right direction. The extensive bill, if approved by President Trump, would allow states like Georgia to receive federal Medicaid matching funds for up to 30 days per year for services provided to adults aged 21-64 for substance abuse disorders (SUD) in institutions for mental diseases. Additionally, the bill will address several other provisions related to opioids and pain management, including the promotion of opioid alternatives in emergency departments; care coordination for drug overdose patients; and improvements to prescription drug monitoring programs.

I applaud the work of legislators to address opioid abuse. The creation of this bill goes hand-in-hand with the efforts of our hospitals, physicians, and other healthcare providers who are working around the clock to eliminate the abuse and misuse of opioids.

By itself, this legislation will not fix the crisis entirely. But it is another important step in our nation’s recovery from this epidemic.

Earl Rogers
GHA President

Senate Sends Opioid Package to President

On October 3, the Senate passed by a vote of 98-1 the SUPPORT for Patients and Communities Act, the final House and Senate agreement on legislation to address the opioid crisis. Approved by the House last week, the legislation includes an AHA-supported provision that would allow states to receive federal Medicaid matching funds for up to 30 days per year for services provided to adults aged 21-64 for substance use disorders in Institutions for Mental Diseases. The bill also includes AHA-supported provisions addressing health insurance for former foster youth; maternal and infant health; access to telehealth and medication-assisted treatment; parity in Children's Health Insurance Program mental health and SUD benefits; a demonstration program to promote alternatives to opioids in emergency departments; revisions to the Hospital Consumer Assessment of Healthcare Providers and Systems questions relating to pain management; care coordination for drug overdose patients; and improvements to coordination of prescription drug monitoring programs. (distributed by the American Hospital Association)

Resources Available for Rural Communities Combating the Opioid Epidemic

The US Department of Agriculture Rural Development agency has resources that can assist rural communities combating the opioid epidemic.  The USDA Rural Development are thankful to be able to team up with Georgia’s statewide opioid task force.  
 
These funds can be used through public bodies or non-profit corporations to build, renovate, equip or rehabilitate essential community facilities such as hospitals, mental health clinics, withdrawal centers, educational facilities and more. Eligible uses also includes upgrading E-9-1-1 systems and equipment and purchasing police, fire and ambulance vehicles.
 
In general, a city, town or unincorporated area with a population of less than 20,000 and unable to secure funding elsewhere can be eligible. Direct loans, loan guarantees and grants are available. Grants are capped at $25,000 per eligible project.
 
Contact USDA Rural Development to get started. Rural Development Georgia Opioid Response Coordinator:
Deborah Callahan706-552-2595, Deborah.Callahan@ga.usda.gov

Cartersville 678-719-3508
Monroe 770-267-1413, Ext. 4
Fort Valley 478-827-0016, Ext. 4
Sandersville 478-552-6073, Ext. 4
Tifton 229-382-0273, Ext. 4
Douglas 912-384-4811, Ext. 4

FDA Broadens Treatment Options

The Food and Drug Administration approved a new dosage option for buprenorphine and naloxone sublingual film, applied under the tongue as a maintenance treatment for opioid dependence. The medication-assisted treatment was approved through an abbreviated pathway under the Federal Food, Drug, and Cosmetic Act, which may rely on the FDA's finding that a previously approved drug is safe and effective. "There's an urgent need to ensure access to, and wider use and understanding of, medication-assisted treatment for opioid use disorder," said FDA Commissioner Scott Gottlieb, M.D. "The introduction of new treatment options has the potential to broaden access for patients."

Statewide Opioid and Substance Use Response Plan Released

GHA joined the Department of Public Health for the roll out of the statewide Opioid and Substance Use Response Plan. This Plan, which includes input from various stakeholders around the state, including GHA, compiles goals and objectives for six work groups:  Prevention and Education, Maternal Substance Use, Data and Surveillance, Prescription Drug Monitoring Program, Treatment and Recovery, and Control and Enforcement. The Department of Public Health brought together many other state agencies, including the Department of Community Health, the Department of Behavioral Health and Developmental Disabilities, the Attorney General’s Office, the Department of Education, the Department of Human Services, and various law enforcement agencies to ensure a well-coordinated, statewide response. As we move on to the implementation phase of the Plan, GHA will continue to support our members in this important work.  

AHA President's Perspective

Action Needed to Fight Opioid Epidemic (published August 24)

Rick PollackThe opioid crisis continues to take a devastating toll on our communities. According to the latest estimates from the Centers for Disease Control and Prevention, nearly 50,000 people died last year as a result of an opiate overdose, contributing to a record high number of drug overdose deaths.

Providers across the health care continuum – from frontline emergency responders and ED clinicians to outpatient substance use disorder counselors – are providing treatment for patients and support for their loved ones. But the health care community's efforts alone are not enough to stem the tide of this epidemic. We need more help from the federal government.

Earlier this summer, the House of Representatives passed a package of bills designed to address various aspects of the epidemic. We applaud the inclusion of numerous AHA-supported provisions, including ones to: guarantee mental health and SUD parity in state Children's Health Insurance Programs; provide hospitals with resources to develop protocols for discharging patients who have presented with an overdose; improve federal support for, and coordination between, state-run prescription drug monitoring programs; and establish demonstration programs to test alternatives to opioids in hospital EDs. We were especially pleased by the overwhelming support for legislation to ensure providers have access to their patients' full medical history by aligning the outdated 42 CFR Part 2 regulations with the Health Insurance Portability and Accountability Act. Since 2000, HIPAA regulations have permitted the responsible sharing of patients' health records for treatment, payment, and health care operations. But 42 CFR Part 2 requires SUD treatment records to be treated differently – maintained in a separate record and disclosed only pursuant to a specific, lengthy, and time-limited consent. Failure to provide physicians access to complete patient histories is dangerous for the patient and contributes to the stigmatization of SUDs. Modernizing 42 CFR Part 2 will help ensure clinicians are neither prescribing opioids to a patient in recovery nor recommending other medications that might result in a negative drug interaction.

Now, it's the Senate's turn to act. Multiple committees have reported bills, some of which align with the House package. However, the Senate has not included legislation to align 42 CFR Part 2 with HIPAA, thus keeping in place the dangerous wall between patients' SUD and other medical records.

Please urge your senators to ensure the final opioid bill includes this vital provision. Improving patients' access to care, and providers' access to information, will help ensure that care is the safest and best course of treatment for the patient. Moreover, it will save countless lives, and is critical to making progress against this epidemic.

Rick Pollack
President and CEO

Surgeon General Releases Spotlight on Opioids

Facing Addiction in America: The Surgeon General’s Spotlight on Opioids calls for a cultural shift in the way Americans talk about the opioid crisis and recommends actions that can prevent and treat opioid misuse and promote recovery.

The Spotlight – the Surgeon General’s newest update on opioid addiction – also provides the latest data on prevalence of substance misuse, opioid misuse, opioid use disorder and overdoses.

The Surgeon General today also released a digital postcard, highlighting tangible actions that all Americans can take to raise awareness, prevent opioid misuse and reduce overdose deaths.

“Addiction is a brain disease that touches families across America – even my own,” said U.S. Surgeon General Jerome M. Adams. “We need to work together to put an end to stigma.”

According to preliminary data from the Centers for Disease Control and Prevention, overdose deaths in 2017 increased by almost 10 percent – claiming the lives of more than 70,000 Americans.. Nearly 48,000 of those were opioid overdose deaths, with the sharpest increase occurring among deaths related to illicitly made fentanyl and fentanyl analogs (synthetic opioids).

Despite the fact that effective treatment for opioid use disorder exists, only about one in four people with this disorder receive any type of specialty treatment. Yet for a variety of reasons, including stigma, inability to access or afford care, or refusal to stop misusing opioids, a treatment gap remains.

In addition, the existing healthcare workforce is understaffed, often lacks the necessary training, and has been slow to implement Medicated-Assisted Treatment, as well as prevention, early identification, and other evidenced-based recommendations.

“Now is the time to work together and apply what we know to end the opioid crisis,” said Dr. Elinore McCance-Katz, Assistant Secretary for Mental Health and Substance Use. “Medication-assisted treatment combined with psychosocial therapies and community-based recovery supports is the gold standard for treating opioid addiction.”

The federal government has been working with key stakeholders to address this problem and is seeing real progress. This week, HHS disbursed more than $1 billion in opioid-specific funding for states, which includes State Opioid Response grant programs administered by SAMHSA to support a comprehensive array of prevention, treatment, and recovery services. Additional funding from the Health Resources and Services Administration (HRSA) went to community health centers to increase access to substance abuse disorder and mental health services, to increase the number of professionals and paraprofessionals who are trained to deliver integrated behavioral health and primary care services as part of health care teams in HRSA-supported health centers as well as to rural grantees to increase services and develop plans to implement evidence-based opioid use disorder prevention, treatment and recovery interventions. There are signs that efforts to stem the opioid crisis are having success, with the use of medication-assisted treatment growing significantly and the number of Americans initiating heroin use dropping significantly from 2016 to 2017.

“Addressing the opioid crisis with all the resources possible and the best science we have is a top priority for President Trump and for everyone at HHS,” said HHS Secretary Alex Azar. “Surgeon General Adams has been a leader in raising awareness about the nature of addiction and the effectiveness of medication-assisted treatment, complementing the support HHS provides for access to treatment and recovery services.”

“Today’s announcement is another step forward in our efforts to educate the American public about steps they can take to prevent addiction,” said Assistant Secretary for Health Brett P. Giroir, M.D, who also serves as the HHS Senior Advisor for Opioid Policy. “We are making progress. Just last week we released the 2017 National Survey on Drug Use and Health (NSDUH) data, which showed significantly more people received treatment for their substance use disorder in 2017 than in 2016. This was especially true for those with heroin-related opioid use disorders.”

The science shows us that no area of the United States is exempt from the opioid crisis. Yet, only 53 percent of the public consider opioid addiction a major concern. As a result, the Surgeon General is calling on all individuals to do the following:

  • Talk about opioid misuse. Have a conversation about preventing drug misuse and overdose.

  • Be safe. Only take opioid medications as prescribed, make sure to store medication in a secure place, and dispose of unused medication properly.

  • Understand pain and talk with your healthcare provider. Treatments other than opioids can be effective in managing pain.

  • Understand that addiction is a chronic disease. With the right treatment and supports, people do recover.

  • Be prepared. Get and learn how to use naloxone, an opioid overdose reversing drug.

For the full document and to view the digital postcard, visit http://addiction.surgeongeneral.gov.

If you or someone you know is struggling with a substance use disorder, call 1-800-662-HELP or visit http://www.samhsa.gov/find-help.


GHA Participates in Task Force

GHA’s Rhett Partin, Sr. Vice President of Services and Public Health participated in the State Attorney Generals Opioid Task Force hosted by Augusta University on August 9. The purpose of the meeting was to bring key public and private stakeholders together in an effort to share information that will help all of us curb Georgia’s opioid epidemic. GHA strives to represent its members at all meetings aimed at improving the health of Georgians.

Opioid Overdose Deaths Continue to Climb

An estimated 46,041 Americans died from opioid overdoses between October 2016 and October 2017, a 15% increase from the prior 12-month period, according to provisional data released May 16 by the Centers for Disease Control and Prevention. Total overdose deaths from opioids, cocaine and psychostimulants rose an estimated 12% to 68,400. The data include national and state-level estimates by drug category.