SB 20-LIST U-47700 AS A CONTROLLED SUBSTANCE  1:36:57 PM CHAIR COGHILL announced the consideration of SB 20. [This is the first hearing and CSSB 20(HSS) is before the committee.] 1:37:27 PM SENATOR KEVIN MEYER, sponsor of SB 20, introduced the bill speaking to the following sponsor statement: SB 20 would update the State of Alaska controlled substance list by adding two drugs. First, SB 20 would classify U-47700, a synthetic opioid commonly known as pink or U4, as a schedule IA controlled substance. Secondly, SB 20 would add Tramadol, an opioid pain medication available through prescription as a schedule IVA controlled substance. U-47700 was a research chemical created and patented in the United States in the 1970s. It was never tested on humans and was not manufactured for public consumption. Drug labs in China now produce this drug and sell it online to people who purchase it as an inexpensive alternative to other drugs. This synthetic opioid is eight times more potent than morphine and according to the Drug Enforcement Administration (DEA) it is the cause of 46 overdose deaths from 2015 to 2016. The State of Alaska Epidemiology Bulletin has attributed U-47700 to three drug overdose deaths in Alaska. Tramadol was created by a German drug company in 1962. Tested for over 15 years, it was approved for the foreign market in 1977. Tramadol is widely prescribed for pain relief and became available in the United States in 1995. Because of its low dosage- approximately one tenth the strength of morphine- Tramadol was thought to be a benign pain reliever. However, as prescriptions have risen in the United States there are more and more reports of Tramadol dependency, abuse, withdrawal, and stealing of this prescription medication. The DEA [Drug Enforcement Agency] temporarily scheduled U-47700 as a schedule I controlled substance in 2016. Tramadol was classified as a schedule IV controlled substance in August of 2014. Should SB 20 pass, Alaska State Statutes will be up-to-date with the federal scheduling of these two substances. This bill will allow drug enforcement agencies to limit the unlawful sale, use, purchase, possession, manufacture, transport or delivery either drug in the State of Alaska. SENATOR MEYER related that Senator Giessel amended the bill in the Senate Health and Social Services Committee, adding Tramadol to the controlled substance list. He highlighted that the bill is in keeping with the Governor's recent disaster declaration on the opioid epidemic in Alaska. CHAIR COGHILL listed the individuals available to answer questions and then recognized Ms. Marasigan. 1:43:21 PM CHRISTINE MARASIGAN, Staff, Senator Kevin Meyer, said the Senator outlined that SB 20 adds the opioid U-47700, also known as pink, and Tramadol to the controlled substances list. She noted additional people available to answer questions. 1:38:59 PM SENATOR KELLY joined the committee. SENATOR WIELECHOWSKI asked if Tramadol would still be available by prescription if the bill were to pass. MS. MARISIGAN answered yes. SENATOR WIELECHOWSKI asked if it would be a class C felony to unlawfully possess Tramadol, if the bill were to pass. MS. MARISIGAN answered yes. SENATOR WIELECHOWSKI asked how that compares to other opioids the legislature acted on in Senate Bill 91. MS. MARISIGAN replied the classification for U-47700 would be like other opioids, whereas Tramadol would have a lower classification. SENATOR WIELECHOWSKI expressed interest in receiving more specific information on how these drugs would be ranked compared to those addressed in Senate Bill 91. CHAIR COGHILL asked if the penalty for unlawful possession of controlled substances listed in AS 11.71.140(c) would be based on dosage. MS. MARISIGAN said that's her understanding but she would defer to Kaci Schroder from the Department of Law. CHAIR COGHILL asked if other states have added both U-47700 and Tramadol to their controlled substance lists. MS. MARISIGAN explained that, because it is so lethal, several states placed U-47700 on emergency schedule before the Drug Enforcement Agency placed it on a temporary schedule for 18 months. Once that time is up, the DEA will need to decide to either extend the temporary schedule or pass the law to make it a controlled substance. The Drug Enforcement Agency listed Tramadol in 2014 on the recommendation of the Opioid Task Force. When Tramadol was first introduced in the U.S. it didn't appear to present a problem because the opioid dosage was so small. However, as recently as 2010 some pharmacy reports indicate that up to 16,000 people are adversely affected by this drug, and other experts have said that the drug is being diverted. CHAIR COGHILL asked to hear from the Alaska State Troopers on that point. 1:48:10 PM CAPTAIN MICHAEL DUXBURY, Support Services, Alaska State Troopers, Department of Public Safety (DPS), Anchorage, Alaska, stated that he is the supervisor for the Alaska Statewide Drug Enforcement Agency. He reported that a significant amount of Tramadol and other drugs are being sent to Western Alaska for illegal use. A significant concern is that while the DEA has scheduled the drug, it is at a dosage that makes it difficult to impossible for local law enforcement to a federal case. Adding the drug to the state schedule will give some ability to stem the tide of abuse and diversion to Western Alaska and other locations throughout the state. SENATOR WIELECHOWSKI asked what the current penalty is for illegally possessing Tramadol and if it would become a class A misdemeanor if SB 20 were to pass. CAPTAIN DUXBURY said he believes that is correct. Under current law, possession without a prescription falls into a diverted situation and there is little enforcement. Placing it on the schedule will provide opportunity for some enforcement. CHAIR COGHILL asked what the usual dose is for prescription use as opposed to the dose for diversionary use. CAPTAIN DUXBURY explained that when the drug is used for diversionary purposes it is sold in bulk, not in a labeled prescription bottle. He deferred the question about the dose of an individual prescription to a medical professional. CHAIR COGHILL asked Captain Lowden if he could answer. 1:52:05 PM CAPTAIN DAN LOWDEN, Deputy Commander, Central Office, Department of Public Safety (DPS), Anchorage, Alaska, said Captain Duxbury is the expert and he has been deferring to him. CHAIR COGHILL asked if increasing the penalty for illegal sale of these two drugs based on volume would make it easier for law enforcement. CAPTAIN DUXBURY confirmed it would be easier. CHAIR COGHILL said he'd ask the Department of Law to opine on that, and noted that his staff had directed attention to the appropriate statute. SENATOR WIELECHOWSKI questioned why the fiscal notes from the Department of Public Safety (DPS) and the Department of Corrections (DOC) were zero instead of indeterminate. "Is the assumption that we will not arrest anyone because of this?" MS. MARASIGAN said the individual departments could address the fiscal notes. Addressing the question about penalties based on volume or quantity, she explained that distribution of more than a gram or more than 25 tablets of a schedule IA drug is a class C felony. Possession of any amount of a schedule IA controlled substance is a class A misdemeanor. SENATOR WIELECHOWSKI asked if it was her understanding that the federal government would pick up the cost if somebody was imprisoned under federal law. MS. MARASIGAN deferred the question to the Department of Law. CHAIR COGHILL suggested the Department of Law respond to the last two questions. 1:55:15 PM KACI SCHROEDER, Assistant Attorney General, Criminal Division, Department of Law, introduced herself. SENATOR WIELECHOWSKI asked why the fiscal notes from DPS and DOC are zero rather than indeterminate; and if the federal government would pay the costs of imprisonment if this were left as a federal violation. MS. SCHROEDER confirmed that if the federal government were to decide to prosecute either substance, they would be responsible for the costs of the prosecution and imprisonment. The issue with putting these drugs on an Alaska schedule is that the state must dedicate resources to control the substances. The advantage is that the state would have control over enforcement. CHAIR COGHILL asked if the state penalty is commensurate to the federal penalty. MS. SCHROEDER offered her understanding that federal penalties have a broader range and are harsher than state penalties. "But the state is closer to the ground and it has better enforcement capabilities." CHAIR COGHILL asked what insight she has about the fiscal note. MS. SCHROEDER said the Department of Law submitted a zero fiscal note because it doesn't anticipate asking for any additional positions to prosecute these offenses. CHAIR COGHILL asked Senator Wielechowski if he wanted more specifics. SENATOR WIELECHOWSKI asked for someone to explain what would happen under existing law if someone was caught with Tramadol. He assumed that the local police or a Trooper could arrest the person and it would be up to the federal government to prosecute using federal judicial resources and federal correction facilities. MS. SCHROEDER deferred to DPS to talk about the extent to which they can enforce federal law but under current law the state absolutely could not prosecute those offenses. CHAIR COGHILL asked either Captain Duxbury or Captain Lowden to talk about working with and taking on the responsibility of both state and federal law. CAPTAIN DUXBURY said the Department of Public Safety has a solid relationship with the Drug Enforcement Agency, but these drugs need to be placed on the state schedule of controlled substances. The amount of the drug needed to make a federal case is large compared to the small amount that can devastate the lives of people in these small Alaskan villages. He noted that they regularly use state statute to enforce drug laws and deter folks from making money out of other people's misery and weakness. He also discussed the problem that Alaska is a poly- drug-use area. CHAIR COGHILL said he hadn't really thought about how many drugs will be added to each other, but if it's possible to identify one drug more clearly than another it makes enforcement easier. CAPTAIN DUXBURY said he agrees with the statement. CHAIR COGHILL asked if law enforcement is alert to U-47700 and if it can be readily identified. CAPTAIN DUXBURY said it is readily available for purchase on the internet and from several smoke shops. To date three deaths have been attributed to U-4770. The Troopers and those they collaborate with are working to keep children from experimenting with pink and other drugs because they take away the ability for youth to become productive members of society. 2:04:39 PM CHAIR COGHILL said he understands that enforcement is more difficult if the drug isn't specifically named. CAPTAIN DUXBURY said pink is being marketed toward youth and people with little money and he believes that the only way to get a handle on the drug epidemic is through collaboration, education, and legislation. He noted that pink doesn't have as much potential for chemical change as Spice, but still "there are several people that don't mind making their profit off of other people's misery." CHAIR COGHILL asked DR. Butler if he had anything to add regarding communication. JAY BUTLER, Chief Medical Officer, Division of Public Health, Department of Health and Social Services (DHSS), stated that part of the outreach has been to the clinical community to ensure that people are aware that what may look like a prescription opioid or heroin overdose may be something different altogether. Also, some of the traditional drug tests may not identify some of the newer agents. He mentioned the deaths attributed to U-47700 statewide and nationally and opined that the comparatively high number in Alaska is due to the fact that Alaska has been more aggressive than other states in its toxicologic testing through the state medical examiner's office. Another factor is that users sometimes aren't aware that what looks like a prescription opioid may be counterfeit. He provided an example and said his office will continue to work with colleagues in public safety and the Department of Law. 2:09:34 PM CHAIR COGHILL asked Mr. Dym if there is a way for the police to identify U-47700 without going through a long testing process. ORIN DYM, Manager, Scientific Crime Detection Laboratory, Department of Public Safety (DPS) said there is no field instrument to test for U-47700, but the lab can turn controlled substance analyses around in about 7 days. He added that the lab can test for both U-47700 and Tramadol. CHAIR COGHILL asked Captain Duxbury if law enforcement can readily identify the drug. MR. DYM replied a full analysis is necessary. In the only instance that the lab analyzed U-4770 it was a counterfeit tablet. The markings indicated it was oxycodone and the analysis showed it was U-4770. CHAIR COGHILL said he brought it up as a warning to the public. "If they are willing to destroy your life, they're also willing to take your money by foolery." CAPTION DUXBURY said the other concern is that the mixture of more powerful opioids with counterfeit drugs can be more potent and potentially deadly. 2:14:02 PM CHAIR COGHILL commented on the need for appropriate tools in state law. SENATOR MEYER opined that progress is being made on illegal drug use but as long as there is demand there will be people willing to make the product. He concluded that public education is imperative in helping stop the demand and having laws in place will keep some people from going into the business of supplying opioids illegally. 2:17:05 PM CHAIR COGHILL held SB 20 in committee for further consideration.