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Lawmakers funnel millions into opioid fight

John Silk, a client at the Spokane Regional Health District clinic, blows a breath sample to make sure he hasn’t had alcohol recently while staff verifies his identity before his daily dose of Suboxone. The Washington legislature is looking at ways to better treat opioid addiction, including leveraging funds to provide treatment options like Suboxone. (Jesse Tinsley / The Spokesman-Review)
John Silk, a client at the Spokane Regional Health District clinic, blows a breath sample to make sure he hasn’t had alcohol recently while staff verifies his identity before his daily dose of Suboxone. The Washington legislature is looking at ways to better treat opioid addiction, including leveraging funds to provide treatment options like Suboxone. (Jesse Tinsley / The Spokesman-Review)

OLYMPIA –The Legislature could funnel millions of dollars into fighting opioid addiction, with more money for medication that helps addicts recover and a program to monitor prescriptions.

Those are among several ideas lawmakers have offered to fight the growing drug problem.

“We have to hit it from a lot of different directions,” said Rep. Eileen Cody, D-Seattle. “It didn’t happen overnight. It’s not going to get solved overnight.”

Gov. Jay Inslee proposed spending nearly $16 million on treatment options, such as increasing Medicaid coverage for medication-assisted therapies, or MAT, and another $4 million in preventive measures like a prescription monitoring program and opioid prevention services.

The most recent supplemental budget passed this week by the House would spend $5.4 million in state money for opioid treatment. When combined with federal money and other grants, that grows to more than $12 million. The legislation passed the House 98-0.

The bill, which provides comprehensive treatment and prevention measures, puts a strong emphasis on increasing funding for MAT.

It requires the state’s Health Care Authority to work with the Department of Health, Department of Corrections and other agencies to leverage Medicaid funding from federal money and private grants for treatment options like methadone, Suboxone and naltrexone.

Vicky Sneed, clinical supervisor at Sun Ray Court inpatient treatment center in Spokane, said MAT programs can help improve recovery rates. But relapses still happen, and patients who take unprescribed medications while on these treatment programs are kicked out.

“I think that relapse happens less for say, a heroin addict, if they happen to be on Suboxone or another opioid replacement therapy,” she said. “But it does still happen.”

Recovering addicts also face barriers such as a lack of outpatient care after their initial recovery, she said.

“Sometimes when they get out of (inpatient) treatment, life becomes really hard right away,” Sneed said. “Lots of times they go back to using because it’s easier and it’s what they know.”

Provisions of the comprehensive opioid bill could help by increasing money for “Hub and Spoke” networks that would provide support with anti-addiction drugs and community outreach after patients finish intensive inpatient treatments.

The Hub and Spoke program was introduced to Washington through an executive order two years ago. The bill’s supporters hope continued outreach from networks could help addicts stay on track.

Many other early bills to address the state’s opioid problems were wrapped into the comprehensive bill, Cody said. One provision would require physicians to tell patients about the addiction risks of the drug with their first prescription.

Medical practitioners who prescribe opiates would be required to sign up for a monitoring program and go through a one-hour continuing education session.

The original prescription notification bill was named after Jeremy Wolfe, who grew up in Goldendale, Washington, and was prescribed opiate painkillers at age 14. He became addicted and overdosed two years ago. He was in a coma for 11 days.

At a Jan. 19 hearing, Wolfe said many patients don’t understand the risks of the drugs they’re prescribed.

“I want this bill to pass so that nobody has to go through the stuff that I went through,” he said. “By the time I did know (the risks), it was too late.”

The bill also would create rapid response teams for areas with a high number of overdoses and require the state to work with independent organizations to provide more support for those in crisis.

It also would increase the availability of Naloxone that could be administered without a prescription. The drug is an emergency overdose medication.

Sneed said she would want to know more about the training process for the teams, but would support any measure that could help prevent deaths and bring people closer to getting help.

“Last year we lost seven or eight people,” she said of Sun Ray’s former patients.

She doesn’t know how many people died of overdoses in Spokane or the state last year. The state doesn’t require overdose deaths to be reported outside of emergency rooms.

Part of the legislation would require nonemergency room overdoses and overdose deaths from licensed ambulances and aid services to be reported, and create an online data system for the information.

Cody said the knowledge gleaned from the reports could help future legislators understand how to fix the state’s opioid problem.

“(The Legislature) has really come to understand the opioid problem and the treatment a lot better,” she said. “Now, I think we’re all headed in the same direction.”