Legislature(2015 - 2016)BUTROVICH 205
03/18/2015 01:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB23 | |
| SB55 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 23 | TELECONFERENCED | |
| *+ | SB 55 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 23-IMMUNITY FOR PROVIDING OPIOID OD DRUG
1:33:07 PM
CHAIR STEDMAN announced the consideration of SB 23.
SENATOR JOHNNY ELLIS, Alaska State Legislature, sponsor of SB
23, introduced the bill. He said fatal drug overdoses have
increased more than six-fold in the past three decades and now
claim the lives of over 36,000 Americans every year. Specific to
this bill is heroin use and, in Alaska, heroin use is here in
force. Heroin-related overdoses are claiming more young lives
than traffic fatalities, according to the Anchorage Police
Department. The 2014 Alaska Troopers' Drug Report identified an
increase in heroin abuse and the continued use of other opiates
as significant concerns. He noted he and former-Senator Dyson
have brought this issue before the legislature over the years;
the need for more Methadone clinic funding, the appearance of
new drugs, and the rise in drug-related burglaries.
SENATOR ELLIS maintained that the abuse and overdose epidemic is
largely driven by addiction to prescription opioids, such as
OxyContin, Oxycodone, and Vicodin. These drugs have grown more
expensive over time so the abusers and addicts seek out a
cheaper alternative, such as black tar heroin imported to Alaska
by the Mexican drug cartel.
He said the face of heroin is also changing; heroin abuse is
across all economic levels, is at an epidemic level, and has
reached every corner of the state. No community is left
unscathed. These highly addictive drugs are extremely deadly.
This trend is troubling because prescription opioids are popular
among young Alaskans.
He pointed out that opioid overdose is reversible through the
timely administration of the medication naloxone, but that
medication is often not available when needed. Friends and
family members are often the ones who are best situated to save
the life of the person having the overdose. Currently, medical
professionals are wary of prescribing naloxone and lay persons
are wary of administering them due to potential civil liability.
1:37:37 PM
He summarized that the bill is a simple Good Samaritan bill that
removes the civil liability from doctors and trained bystanders.
He concluded that SB 23 is an attempt to help reverse the opioid
overdose epidemic and he hopes that Alaska becomes the 29th
state to have this provision. It is a life and death situation.
1:38:30 PM
AMORY LELAKE, Staff, Senator Johnny Ellis, Alaska State
Legislature, provided the sectional analysis of SB 23:
Section 1. Amends AS 09.65 by adding a new section
(09.65.340) to give immunity for prescribing,
providing, or administering an opioid overdose drug
Subsection (a) exempts a person from civil liability
if providing or prescribing an opioid overdose drug if
the prescriber or provider is a health care provider
or an employee of an opioid overdose program and the
person has been educated and trained in the proper
emergency use and administration of the opioid
overdose drug
Subsection (b) except as provided in (c) exempts a
person who administers an opioid overdose drug to
another person who the person reasonably believes is
experiencing an opioid overdose emergency if the
person
1. Was prescribed or provided the drug by a health
care provider or opioid overdose program and
2. Received education and training in the proper
emergency use and administration
Subsection (c) does not preclude liability for civil
damages that are a result of gross negligence or
reckless or intentional misconduct
Subsection (d) defines
1. "health care provider" as a licensed physician,
advanced nurse practitioner, physician assistant,
village health aide, or pharmacist operating within
the scope of the health care provider's authority;
2. "opioid" includes the opium and opiate substances
and opium and opiate derivatives listed in AS
11.71.140
3. "opioid overdose drug" means a drug that reverses
in whole or part the pharmacological effects of an
opioid overdose
4. "opioid overdose program" means a program operated
or otherwise funded by the federal government, the
state, or a municipality that provides opioid overdose
drugs to persons at risk of experiencing an opioid
overdose or to a family member, friend, or other
person in a position to assist a person at risk of
experiencing an overdose.
1:42:28 PM
CHAIR STEDMAN asked if the committee had any questions.
MS. LELAKE read from the sponsor statement:
States across the country have enacted laws to
increase access to treatment for opioid overdose as a
way to combat increasing opioid overdose rates. Senate
Bill 23 provides immunity from civil liability to
health care providers who prescribe and bystanders who
administer opioid overdose drugs like naloxone in
cases of opioid overdose.
Naloxone (also known by the brand name Narcan) is a
medication called an opioid antagonist and is used to
counter the effects of opioid overdose, from drugs
like OxyContin, morphine, or heroin. Naloxone is
extremely safe and effective at reversing opioid
overdose.
Specifically, naloxone is used in opioid overdose to
counteract life-threatening depression of the central
nervous system, allowing an overdose victim to breathe
normally. Naloxone is not a controlled substance, has
NO abuse potential, and has zero effect if
administered to someone with no opiates in their
system.
Naloxone, much like an epi pen for severe allergic
emergencies, comes in the form of a nasal spray or is
injected in a muscle or vein. The efficacy of naloxone
is fundamentally time dependent.
Death from overdose typically occurs within 1 to 3
hours, although earlier in some cases, leaving a brief
window of opportunity for intervention. Naloxone takes
effect immediately and can last between 30 and 90
minutes.
Naloxone is both safe and effective. For more than
three decades, naloxone has been used by emergency
medical personnel to reverse overdoses. It is
regularly carried by medical first responders and can
be administered by ordinary citizens with little or no
formal training.
Data from recent pilot programs demonstrate that lay
persons are consistently successful in safely
administering naloxone and reversing opioid overdose.
The problem is, friends or family members of overdose
victims, not emergency medical personnel, are most
often the actual first responders and are best
positioned to intervene within an hour of the onset of
overdose symptoms.
As a result of rising opioid abuse and overdose, in
2001, New Mexico became the first state to amend its
laws to make it easier for medical professionals to
prescribe and dispense naloxone without liability
concerns, and for lay administrators to use it without
fear of legal repercussions.
At the urging of organizations including the US
Conference of Mayors, the American Medical Association
and the American Public Health Organization, a number
of states have addressed the epidemic by removing
legal barriers to the timely administration of
naloxone.
These changes come in two general varieties: The first
is the approach in SB23 - which encourages the wider
prescription and use of naloxone by removing the
possibility of negative legal action against
prescribers and lay administrators who prescribe the
drugs to those who may be able to use to reverse
overdose.
So far, 27 states and the District of Columbia have
made this important change.
The second change encourages bystanders to become Good
Samaritans by summoning emergency responders without
fear of arrest or other negative legal consequences.
Thankfully, the legislature wisely took that critical
step last year by passing Representative Lance
Pruitt's "Make the Call" Good Samaritan bill, House
Bill 369. Alaska is among 21 states to have passed
similar legislation in recent years. Based partly on
these changes to state law, at least 188 community-
based overdose prevention programs now distribute
naloxone.
As of 2010, those programs had provided training and
naloxone to over 50,000 people, resulting in over
10,000 overdose reversals. A recent evaluation of one
such program in Massachusetts, which trained over
2,900 potential overdose bystanders, reported that
opioid overdose death rates were significantly reduced
in communities in which the program was implemented
compared to those in which it was not.
Given the safety and effectiveness of naloxone, many
public health advocates question why naloxone is not
available over the counter. I point this out because
its status as a prescription medication does not mean
it is dangerous or difficult to use. Italy, for
example, has had naloxone available over the counter
since the 1980s without any reported negative
consequences.
It is understandable that regulators did not foresee
the utility of naloxone as a public health
intervention carried out by people who are not medical
professionals. But, in the midst of our current
epidemic of accidental deaths related to illicit and
prescription opioids, these restrictions are
untenable.
One very important thing to point out, Mister
Chairman, is that Senate Bill 23 is not the result of
a rash of lawsuits over providing or administering
lawsuits. I spoke with national experts who told me I
would be hard pressed to find any case law related to
this issue. SB23 simply removes an unintended barrier
to this life-saving drug.
Finally, Mister Chairman, Senate Bill 23 is not a
replacement for substance abuse treatment. Drug
enforcement and rehabilitation are also critical
components of this war on addiction. SB23 simply gives
doctors and bystanders to overdoses the peace of mind
that they will not be held civilly liable for doing
the right thing, and perhaps more importantly, Mister
Chairman, gives families and loved ones of addicts a
life-saving tool against the heartbreak caused by
opioid overdose.
SB23 is supported by The Alaska State Medical
Association, The Alaska Police Department Employees
Association, the Alaska Mental Health Trust Authority,
the Alaska Mental Health Board and Advisory Board on
Alcoholism and Drug Abuse, the Narcotic Drug Treatment
Center, and countless families and addicts who could
not be here today.
1:49:32 PM
SENATOR STOLTZE objected to the idea that the bill is a "Good
Samaritan" effort. He noted SB 23 is related to civil immunity
and asked if there was any relationship to criminal immunity.
MS. LAKE stated that the bill is only related to civil liability
and relates to the Good Samaritan Act in that it is about
accessing medical personnel for fast treatment.
CHAIR STEDMAN opened public testimony.
1:51:31 PM
DR. PAULA COLESCOTT, Addiction Specialist, Providence
Breakthrough, testified in support of SB 23. She said she has
been involved with the overdose population for over eight years.
She agreed that there is an avalanche of opioid use and
overdose. Patients report that their friends try to resuscitate
overdoses by putting them in a tub of cold water and it doesn't
work. She spoke of the brain damage as a result of overdose.
She opined the bill gives a green light to first responders and
physicians who are trained to save the life of someone who is
experiencing an accidental overdose. She described cases of
overdose.
She said naloxone is a safe method of preventing overdoses. She
highly encouraged approval of the bill. She concluded that the
American Society of Addiction Medicine has published a public
policy statement which agrees with the rescue of overdoses.
1:56:38 PM
KATE BURKHART, Executive Director, Advisory Board on Alcohol and
Drug Abuse and Alaska Mental Health Board, testified in support
of SB 23. She said she agrees with the previous testimony. She
said she has received numerous letters of support for this bill.
She described how SB 23 provides protection and policy guides to
physicians and family members.
1:59:05 PM
KARA NELSON, Member, Juneau Recovery Community, and Director,
Haven House, testified in support of SB 23. She described her
personal history with drug addiction and overdose. She related
how important the drug naloxone is. She shared a personal story
of overdoses. She pointed out that addiction does not
discriminate. She testified how important one saved life is. She
said the bill will keep people from being afraid of going to
jail when saving a life. She concluded that it is a public
issue, not a criminal issue.
She described her work with Haven House and the fears people
have. She noted that Narcan is so important to recovery.
2:04:29 PM
CHAIR STEDMAN closed public testimony.
SENATOR STOLTZE named supporters of the bill and wished to hear
from the criminal division. He supported the direction of the
bill away from criminal ramifications.
CHAIR STEDMAN held SB 31 in committee.