Florida Lawmakers Hear Grim Picture Of Opiod Epidemic

October 11, 2017

Facing what one expert called “chemical warfare,” a key Senate panel Tuesday began tackling the opioid crisis that has engulfed the nation and state, ripped families apart and created a public health crisis bound to get worse.

The Senate Health Policy Committee heard from a panel of experts — including emergency doctors, treatment providers, law enforcement officials and insurance company executives — who laid out a litany of woes detailing the severity and complexity of the opioid epidemic, which prompted Gov. Rick Scott to declare a public emergency.

Testimony from the experts made a chilling impression on the committee.

Abuse of prescription painkillers along with fake street pills and street drugs such as heroin and the synthetic opioid fentanyl — and the deaths associated with the drugs — has skyrocketed since lawmakers cracked down on “pill mills” six years ago.

There aren’t enough treatment beds. Access to medically assisted treatment — where addicts receive drugs and other services, such as cognitive behavioral therapy — is limited. A stigma associated with addiction keeps many users in the shadows. The system is disjointed, making it difficult for addicts and their families to navigate.

And nearly all the entities involved — physicians, treatment providers and sheriffs and police departments — are struggling to make do with scarce resources as the number of addicts continues to skyrocket.

“Currently, it’s much easier to get high than it is to get help in Florida,” Aaron Wohl, an emergency room physician from Lee County, said.

Scott has said he will ask lawmakers in 2018 to spend $50 million on programs such as substance-abuse treatment, counseling and recovery. He also is proposing a three-day limit on new prescriptions for opioids, though the prescriptions could be up to seven days under some conditions.

But the prescription-drug limits are mainly a “feel-good” measure that won’t address the larger problem of addiction and access to street drugs, such as heroin and fentanyl, experts agreed.

“To focus on the flow of medications and creating new persons with addiction is certainly one issue that’s important and we want to help with that, but to ignore those persons that are actually addicted currently, and the medications that they’re overdosing on, being heroin and illicitly manufactured fentanyl, then we’re missing the point,” Wohl told reporters after Tuesday’s meeting.

An interim report by the state’s medical examiners covering the first six months of 2016 showed a 13.9 percent increase in drug-related deaths, compared to the first half of the previous year.

Fentanyl was the top killer, followed by benzodiazepines, morphine and heroin, according to the report. Deaths caused by fentanyl increased by nearly 140 percent, and accidental deaths from heroin overdoses jumped by 25 percent, compared to the same six-month period in 2015.

The situation is even more dire than the report suggests, as medical examiners struggle to keep pace as demands for autopsies skyrocket because of overdoses.

“Scrap your numbers. They’re meaningless because they are so under-quoted,” said Raymond Pomm, a doctor with more than 30 years of experience in the substance-abuse field who now serves as the medical director of Gateway Community Services in Jacksonville. “I’m sorry to say whatever numbers you have, they’re far, far worse. Never have we ever seen anything like this.”

Medical examiners in the Jacksonville area have asked Pomm’s agency to provide naloxone, also known as Narcan, a prescription medication that can reverse opioid overdoses. The coroners want access to the treatment because of their exposure to fentanyl. Even miniscule amounts of the synthetic opioid, often mixed with heroin, can be deadly when inhaled or absorbed through the skin.

“It’s more than an epidemic. It’s become chemical warfare,” Pomm said. “It’s become a gnarly system that’s entwining every aspect of our society.”

Making matters worse, users can purchase fentanyl on the internet, Volusia County Sheriff Michael Chitwood told the committee.

Correcting the “legal” side of opioid abuse is only part of the problem, said Kenneth Scheppke, medical director for Palm Beach County Fire Rescue and a medical director for emergency medical services in Broward County.

“If we don’t address the treatment side, the addicts will turn to a different source. They will turn to street drugs,” he said.

While the use of naloxone is rapidly increasing, reviving patients who’ve overdosed — some of whom receive more than one dose of the drug in a single day — does nothing to cure the problem.

Palm Beach County has launched a pilot program in which emergency-room patients who’ve overdosed on opioids are connected while in the hospital with a detox program, using the drug buprenorphine, also known as Suboxone, that reduces cravings and eases withdrawal symptoms without getting patients high.

Patients in the program also receive behavioral counseling, which experts agree is a critical part of treating addiction, in combination with medications like Suboxone.

The pilot program, with 50 participants, has a 76 percent success rate, according to Scheppke.

The program is a stark contrast to the “revolving door” encountered by most users.

Patients overdose, are saved by Narcan and sent to the emergency room, where they are released to go home and relapse again.

“Nothing’s really done,” Scheppke said. “What we have basically is the patients treating themselves as best as they can.”

Monday’s testimony struck a chord with Senate Health Policy Chairwoman Dana Young, who made an impassioned pledge at the close of the 2½- hour meeting.

“You said it was easier to get high than to get treatment. That needs to stop. That needs to stop today. And it is within our power as a legislature to make that happen. While it can be exhausting and frustrating to deal with this issue, I will tell you that we are not exhausted, as a committee, as a Senate, as a legislature. We are determined to tackle this problem any way we can,” Young, R-Tampa said.

Young told reporters she was impressed by Scheppke’s pilot program and that it was “abundantly clear” that the Legislature needs to fund medically assisted treatment programs statewide.

“I have no idea how much that’s going to cost, but we need to figure it out, and we need to find the money to do it,” she said.

by Dara Kam, The News Service of Florida


10 Responses to “Florida Lawmakers Hear Grim Picture Of Opiod Epidemic”

  1. Barry on October 12th, 2017 2:23 pm

    It’s amazing that you hear about the 100 people in the US that die each day, but you don’t hear about the thousands of people who take their pain meds responsibly. The news media only reports the bad. Good news is boring, and no one wants to hear about it. Watch the news tonight and see. There won’t be anything good mentioned. The only way we pain sufferers will ever be considered, is to bombard our politicians with emails and phone calls.

  2. lynn on October 12th, 2017 9:36 am

    Thank you North Escambia for adding my comments. I was being impatient. I don’t take my pain meds on a regular basis. I take them when no OTC will help, when hot showers or baths won’t help or just lying down to relieve stress will not help and I just can’t stand it anymore. There has to be a better way than to make people suffer. If I had a lot of money I would be able to have more options but I don’t. People who live with chronic pain fill isolated from everyone because they stay by themselves a lot because of their pain. It never ends. People don’t want to hear about your pain. They don’t understand at all. So now what? What do we do? You are going to take the only relief I have away. I have had nerve blocks and physical therapy. The only relief I have is pain meds. I refuse to have surgery. I have to work to have insurance and take care of myself. I have almost lost my job because of the amount of time I have taken off. The doctors say I need to be on disability. But I have no way of doing that either. Who will pay the bills? It takes to long to get on disability and I would prefer not too anyway. So go a head take it away. I pray God gets me through.

  3. Opinion on October 11th, 2017 4:49 pm

    It seems to me if people want to do drugs and over dose they make that decision, it is like a rattlesnake, you knew what it was when you picked it up.

    Legalize it and let them kill themselves if that is their choice in life.it doesn’t have to be, they did it to themselves.

    Let doctors prescribe pain meds to people in pain. Patients should regulate it and take it like it is needed

    If families do not want to be affected by drug abusing family members lock the door and tell them to hit the road.

    If they are homeless and on the streets well that is what their choices made for their life.

    They had Paregoric and home remedies laced with heroin back in the day and it helped out many a housewife and family

    Prohibition doesn’t work and the makers of Narcan are trying to profit from it on taxpayers dime. again claiming the victim mentality that is so popular these days.

    If you decide to take an addictive substance and you become addicted..oh well sucks to be you.

  4. Cathy on October 11th, 2017 3:33 pm

    I worked in Pain Management for 15 yrs. I like the fact the things are changing with Opiod . When you have patients whom count the days and times before next refill
    this a problem, there does need to be stiffer guidelines on Opoids and prescribing.
    many of the Opiods end up on the street or in teenagers hands.

    We need to cut down on the death rate of Opiods overdose 100 per day in the USA this is so sad..New guidelines,should include insurance authorization for MRI and injections and physical therapy, pain physiologist ,maybe yoga or gym membership.to help control the pain.
    Opiods for chronic pain should be given for cancer patients or terminal patients only

  5. Old user on October 11th, 2017 12:54 pm

    Methadone and suboxone is worse than it all nothing but a legal dope slinger, why can’t everybody just try medical marijuana it all be happy place. Plus community benefits for sales increase on food.

  6. anne 1of2 on October 11th, 2017 9:17 am

    Has anyone noticed Puerto Rico isn’t stacked with dead bodies from not taking a prescribed drug? It’s all about money.

  7. lynn on October 11th, 2017 9:08 am

    Why didn’t you put my response in? What was wrong with it? Because I hoped the people making these decision hurt as bad as I do for the rest of their lives?

  8. sisterofuser on October 11th, 2017 8:34 am

    As the sister of a highly addicted person, who is currently taking Suboxone, it is not the magical drug to make you not want any other drugs. This drug is taken to get high, I was told its much better than oxycodone. It is legal and after the first month, medicade…. tax dollars, pay for it. At a cost of around $400.00 monthly. wake up America…..This affects almost every person alive. I don’t have an addiction, because I was educated on what drugs can and will do to a person., just like the rest of America . Is it right I have to work and pay taxes so people that choose to use drugs can get state benefits and stay high on my dollar.

  9. Lynn on October 11th, 2017 8:17 am

    I would like to say it is so unfair that people with real pain have to suffer because people choose to abuse their pain meds. We are the ones who pay for their bad choices. The knew they were getting addicted but chose not to do anything but take more. They could have spoke with their doctors about this but chose not to. So now because of all these bad choices I will continue to suffer because it is almost impossible to get any pain relief legally anymore. The doctor makes you jump threw hoops of physical therapy that out of pocket cost $60 a week, that is $240 a month. I don’t even make $15 a hour. I can’t afford it but if I don’t do this then I can’t get my meds. Now they want to make it were chronic pain sufferers can only get 7 days of meds? Now with copays I will have to see my doctor every 7 days? That another $80 a month. That is $320 a month. This is so wrong! I hope all these people making these decisions hurt every day of their lives and can get no help.

  10. Wth on October 11th, 2017 7:55 am

    Treatment ??? Methadone and suboxone
    Why are they still on these drugs 3-10 years later
    Rehab aka methadone clinics are packed everyday .
    Looks like to me opioids are gateway drug to methadone and suboxone !
    Legalized drug dealing !

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