Legislature(2015 - 2016)BELTZ 105 (TSBldg)
04/01/2015 01:30 PM Senate JUDICIARY
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| SB23 | |
| HCR3 | |
| SB82 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 23 | TELECONFERENCED | |
| *+ | SB 82 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | HCR 3 | ||
SB 23-IMMUNITY FOR PROVIDING OPIOID OD DRUG
1:33:23 PM
CHAIR MCGUIRE announced the consideration of SB 23. "An Act
relating to immunity for prescribing, providing, or
administering opioid overdose drugs."
1:33:38 PM
DR. PAULA COLESCOTT, MD, Addiction Specialist, Providence
Breakthrough, testifying via teleconference, spoke about
unintentional drug overdoses from prescription opiates and
heroin. [Due to a poor connection, the testimony was
indiscernible. The sponsor noted that Dr. Colescott supported
the legislation.]
1:35:46 PM
SENATOR JOHNNY ELLIS, Alaska State Legislature, sponsor of SB
23, said he and former Senator Dyson talked about the growing
problem of opioid addiction for over a decade. It has reached
epidemic proportions in the state and the problem is growing.
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. According to the Anchorage Police
Department, heroin-related overdoses are claiming more young
lives than traffic fatalities. The 2014 Alaska State Troopers'
Drug Report identified an increase in heroin abuse and the
continued use of other opiates as significant concerns for law
enforcement.
He reported that the abuse and overdose epidemic was largely
driven by addiction to prescription opioids such as OxyContin,
Oxycodone, and Vicodin. Because these drugs have grown more
expensive over time, abusers and addicts have sought cheaper
alternatives, such as black tar heroin which is imported to
Alaska by the Mexican drug cartel.
SENATOR ELLIS said that heroin abuse crosses all economic levels
and has left no community untouched. This trend is troubling
because prescription opioids are popular among young Alaskans.
According to 2011 data from the Centers for Disease Control and
the Prevention Youth Risk Behavior Survey, 15.8 percent of
Alaska students reported having used prescription drugs without
a prescription. These drugs are more popular among high school
students than alcohol, tobacco, and marijuana. Fortunately,
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 a person who has
overdosed, but medical professionals are wary of prescribing
Naloxone and lay persons are wary of administering it due to
potential civil liability.
SB 23 removes the civil liability from doctors and trained
bystanders. He expressed hope that Alaska would be the 29th
state to provide this protection. The bill has attracted
bipartisan support along with 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 Treatment Center, and countless families and
addicts. He noted that during a previous committee hearing, Rick
Svobodny testified that the Department of Law (DOL) and the
Administration support the legislation.
CHAIR MCGUIRE stated her intention to become a co-sponsor.
1:43:58 PM
SENATOR COGHILL moved to adopt the proposed committee substitute
for SB 23, labeled 29-LS0058\E, as the working document.
SENATOR COSTELLO objected for discussion purposes.
1:44:37 PM
MATTHEW MOSER, Staff, Senator Johnny Ellis, described the
changes in version E. Bill sections 1 and 2 change the
definition of "opioid overdose program" so that it is not
limited to state, federal or municipally funded programs. Sec.
09.65.340(a)(1)(A) authorizes health care providers to prescribe
an opioid overdose drug directly or to a person who is in a
position to administer an opioid overdose drug to a person at
risk of experiencing an opioid overdose. Sec. 09.65.340(a)(1)(B)
authorizes an employee or volunteer of an opioid overdose
program, or other person in a position to administer the opioid
overdose drug, to receive a supply, possess, and supply opioid
overdose drugs to persons at risk of experiencing an opioid
overdose.
SENATOR COSTELLO removed her objection and version E was before
the committee.
CHAIR MCGUIRE asked if the Alaska State Troopers and local
police would be authorized to carry the opioid overdose drug in
their care kits.
MR. MOSER replied it's already a common part of the EMT tool kit
and he suspects this would allow troopers to carry it.
SENATOR COGHILL asked how broad the interpretation will be for
"at risk" in this context.
SENATOR ELLIS replied it's a good question, but it doesn't
matter because there are no negative side effects if a person is
administered Naloxone when they're not in jeopardy of heroin or
opioid overdose.
SENATOR COGHILL asked what it takes to be trained to administer
the overdose drug.
MR. MOSER explained that the drug may be administered as a nasal
spray or by injection that is similar to an EpiPen, which is
commonly used for allergic reactions. The lay person would also
be made aware of the symptoms of an overdose.
SENATOR ELLIS added that the prescription EpiPen with Naloxone
has the injection instructions are on the pen. That is basically
when the training would occur. He said that for years he and
former Senator Dyson pointed out to their colleagues the gross
underfunding of the Methadone clinics in Fairbanks and
Anchorage. Those programs are still underfunded and the waiting
lists are even longer in light of the current epidemic. He said
he's heard from some parents who are taking desperate measures
to help their teenage daughter or son at home because they can't
get them into a treatment program.
SENATOR COGHILL asked what the procedure is for getting a
prescription.
MR. MOSER replied it would be available through a prescription
from a doctor or an opioid overdose reversal program. He offered
to follow up with information from a program in Massachusetts
that reported about 2,000 overdose reversals.
1:55:10 PM
CHAIR MCGUIRE referenced the presentation the committee heard
[on 2/4/15 about medication assisted treatment (MAT),
specifically Vivitrol, to treat opioid addictions. It blocks the
effects of opioids and removes the pleasure index.]
MR. MOSER replied it sounds like a promising tool to address the
addiction itself as opposed to Naltrexone that treats an
overdose.
SENATOR ELLIS added that his staff member Amory LeLake is the
expert and she would follow up with specifics.
CHAIR MCGUIRE said she understands that the group that delivered
the MAT presentation is looking at a million dollar grant for
the treatment of opioid addiction.
SENATOR ELLIS agreed that Vivitrol holds promise for the future.
He noted that a doctor in the MatSu Valley is currently
prescribing Vivitrol within his practice.
CHAIR MCGUIRE said she found it particularly interesting that
someone with an opioid addiction could receive an injection of
Vivitrol when they leave prison and they would be protected from
the craving for 30 days. They wouldn't be looking for their drug
dealer immediately.
SENATOR ELLIS agreed that without treatment in prison or the
community the addict would be looking for their dealer right
away.
1:58:41 PM
KATE BURKHART, Executive Director, Advisory Board on Alcohol and
Drug Abuse and Alaska Mental Health Board, stated support for SB
23 on behalf of the boards. She said the bill speaks directly to
the concerns raised by physicians engaged in medication assisted
treatment to help people recover from opioid addiction. These
physicians asked if it was within their professional ethics to
prescribe this medication when it could be viewed as promoting
illicit drug use. SB 23 provides the guidance these physicians
were looking for. Prescribing this drug is within the scope of
practice to take care of their patients. It will save lives.
2:03:07 PM
KARA NELSON, Director, Haven House, Executive Committee, Juneau
Reentry Coalition, and Member, Juneau Recovery Community,
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 pointed out that addiction
does not discriminate. She testified how important one saved
life is. She said the bill will keep people from worrying about
going to jail for trying to save a life. It is not a criminal
issue. She described her work with Haven House. She stressed
that Narcan is very important to recovery and so is community
support. Vivitrol is a good product but it has to be surrounded
with recovery-oriented systems of care, she said.
2:18:27 PM
CHAIR MCGUIRE thanked Ms. Nelson for coming forward.
SENATOR COGHILL referenced page 3, lines 2-3, and noted that an
opioid overdose drug may be prescribed directly or by standing
order or protocol to a person at risk. He asked if "protocol to
a person at risk" includes an addict who says he/she is trying
to recover and needs to have the drug available in case of
relapse.
MR. MOSER said that's his understanding. The standing order of
protocol can also relate to a pharmacist who has authority from
a physician to prescribe the drug. He suggested that Ms.
Burkhardt might be able to supplement the answer.
2:20:26 PM
MS. BURKHARDT said her reading of prescription by standing order
or protocol would allow the medical director of a treatment
program to have a standing order that all patients that are
receiving treatment for opioid addiction could receive the
prescription. It would also allow a physician to prescribe the
drug individually.
SENATOR COGHILL expressed satisfaction with the explanation.
SENATOR COSTELLO interpreted the language on page 2, line 13, to
mean that a person who received education and training in the
administration of the drug would not be civilly liable, but an
untrained person who had no training doesn't have that
protection.
MR. MOSER agreed that proper education and training is a
required component of administering the drug.
MS. BURKHARDT added that the training that's anticipated is very
similar to the patient education a person receives for other
prescription medications. She noted that the EpiPen for allergic
reactions was referenced earlier.
SENATOR COSTELLO said she was envisioning a bystander
administering the drug.
MR. MOSER offered his belief that the civil liability is
extended to both the physician and someone who has received
training to administer the drug. He noted that other states have
removed the civil liability altogether. He said it speaks to the
safety of the drug that it's been available in Italy without a
prescription since the 1990s.
CHAIR MCGUIRE described the bill as a first step.
2:26:19 PM
SENATOR COGHILL motioned to report the CS for SB 23(JUD) from
committee with individual recommendations and attached zero
fiscal note.
2:26:51 PM
CHAIR MCGUIRE announced that without objection, CSSB 23(JUD) is
reported from the Senate Judiciary Standing Committee.