SB 70-OPIOID OVERDOSE DRUGS  3:06:20 PM CO-CHAIR SNYDER announced that the first order of business would be CS FOR SENATE BILL NO. 70(HSS), "An Act relating to opioid overdose drugs; and providing for an effective date." 3:07:01 PM SENATOR DAVID WILSON, Alaska State Legislature, as prime sponsor, presented CSSB 70(HSS). He explained that CSSB 70(HSS) allows the state medical officer to continue to issue a statewide standing order for the opioid overdose reversal drug Naloxone, also called Narcan. He explained this is to remove a four-year sunset clause on a previous bill from 2017. By removing the sunset date, local and regional response programs, first responders, the Department of Public Safety (DPS), the Department of Corrections (DOC), and the public will continue to have the ability to directly distribute and have access to the life saving drug, Naloxone, he stated. SENATOR WILSON said Naloxone is not a controlled substance and has no potential for abuse. He stated that CSSB 70(HSS) would benefit the many friends and family of the people who would die of overdose without this life-saving medication. 3:09:21 PM JASMIN MARTIN, Staff, Senator David Wilson, Alaska State Legislature, presented the sectional summary of CSSB 70(HSS) which read as follows [original punctuation provided]: Section 1: Repeals language regarding the sunset of the original authorization. Section 2: Changes the reporting requirement to reference opioid overdose drugs distribution. Section 3: Repeals the sunset date of the original standing order authorization. Section 4: Immediate effective date. SENATOR WILSON commented that the Department of Health and Social Services (DHSS) had a presentation for the committee. 3:10:40 PM REPRESENTATIVE PRAX asked if there was an expense associated with the annual report from Section 2, and if the report was necessary and added value. SENATOR WILSON answered yes, and that in the original Senate Bill 91 from the Thirtieth Alaska State Legislature, there was a reporting mechanism. He explained that there was an attempt to remove the requirement, but the Senate Health and Social Services Standing Committee felt that the report was useful. 3:12:03 PM CO-CHAIR SNYDER observed that the language changed components of the report, so now it referenced the various Substance Abuse and Mental Health Services Administration (SAMHSA) grants, and specifically opioid overdose drug distribution. She asked if there were any particular metrics that might be lost with that wording change. SENATOR WILSON said that question had been asked previously, and it was his understanding that the same items would be measured. He said the difference was because of language associated with the emergency declaration. 3:13:19 PM REPRESENTATIVE MCCARTY said he thought this was put into place before COVID-19 and asked if the term "opioid epidemic" was a SAMHSA classification for grant purposes. SENATOR WILSON answered that in 2017 Governor Bill Walker introduced an emergency declaration on the opioid epidemic in Alaska. He said it was all SAMHSA funding. 3:14:39 PM REPRESENTATIVE SPOHNHOLZ commented that at the time that the legislature passed Senate Bill 91, there were still rising case counts as related to opioid overdoses, the country was in the middle of a national opioid epidemic, and that is why that language was utilized. She explained that there has been progress with the opioid epidemic and therefore the language is no longer used the same way. She said it was learned that having Naloxone available saves lives. REPRESENTATIVE MCCARTY stated that the sunset is based on the standing order. He asked if the chief medical officer could decide to change the standing order "without worrying about legislative action." SENATOR WILSON answered yes. He explained the idea of the sunset was because that is when the funds ended federally for the program. Because this was a successful program and there was a continuation of the federal funding, his office felt it was a good practice [and sought to continue the program]. He also shared that if a better drug or treatment were to become available, the Chief Medical Officer could update the protocol if needed. 3:16:59 PM CO-CHAIR SNYDER introduced a presentation from DHSS. 3:18:28 PM THERESE WELTON, Chief, Office of Substance Misuse and Addiction Prevention, Division of Public Health, Department of Health and Social Services, presented a PowerPoint, entitled "SB 70 Opioid Overdose Drugs" [hard copy included in the committee packet]. MS. WELTON introduced slide 2, which outlined the steps of an overdose, which she said takes only minutes to happen. She explained that if Naloxone is not immediately available, it may take over 20 minutes for Emergency Medical Services (EMS) to arrive, which may be too late. She moved slide to 3, which showed a graph of the increase in opioid deaths since 1999. 3:19:50 PM MS. WELTON moved to slide 4 and stated that "too many Alaskans have lost their lives to overdose" even though it is preventable with the administration of Naloxone. She shared that overdoses were one of the top ten leading causes of death in 2017. 3:20:18 PM The committee took a brief at-ease at 3:20 p.m. [Due to technical difficulties, the audio following the at-ease is not available Information from slides 5-7 has been provided from the secretary's log notes and committee packet documents.] MS. WELTON said overdose can cause significant medical impact on a person when that person does not receive timely administration of Naloxone. She emphasized that it takes just three minutes for a person who overdosed to experience brain damage, and eight minutes to die. She shared that it only takes three to four minutes for paramedics to arrive on scene in Anchorage, but in rural areas it can take much longer for first responders to arrive on the scene. She said that people who survive overdose with brain injury can have [many long-term complications]. MS. WELTON presented slide 5 and informed the committee members that in the U.S. and Alaska synthetic opioids appear to be the primary driver of the increases in overdose deaths, increasing 38.4 percent from the 12-month period leading up to June 2019, compared with the 12-month period leading up to May 2020. MS. WELTON presented slide 6 and said the World Health Organization (WHO), the U.S. Surgeon General, and the U.S. Society of Addiction Medicine have recommended that Naloxone is accessible to those closest to a person using opiates. MS. WELTON presented slide 7 and explained that the current standing order allows Naloxone to be dispensed to any individuals who are not prescribers, which is generally prohibited. She stressed that Naloxone is not a controlled substance, has no potential for abuse and is safe to use. She argued that by removing the sunset date, local and regional response programs, first responders, DPS and DOC, and the general public will continue to be able to use Naloxone. 3:23:54 PM MS. WELTON presented slide 8 and shared that all Naloxone distributed to community partners is 100 percent federally funded by the SAMHSA grant program. She shared this was used to form Project HOPE, which stands for Harm reduction, Opioid Prevention, and Education, which works to distribute and administer Narcan [the brand name for Naloxone] in Alaska with 127 community partners. Thus far Project HOPE has been part of 309 documented overdose-reversals, she shared. MS. WELTON presented slide 9 and said that administration of Naloxone provides opportunity for recovery, and she argued that saving lives saves costs. She said that 40 percent of the economic burden of the opioid crisis is driven by lost lifetime earnings; 33 percent is by excess healthcare spending; 15 percent is from lost productivity in the work force, and 6 percent is from criminal justice costs. MS. WELTON presented slide 10 and said the current standing medical order allows Naloxone to be dispensed to any individuals who are not prescribers, which is generally prohibited for medication. She reiterated that it is not a controlled substance and has no potential for abuse and is safe to use. She said that by removing the sunset date, [interested parties] will be able to distribute and use the life-saving drug Naloxone. She shared that the report in CSSB 70 (HSS) would still provide information on the opiate epidemic and the opiate overdose drug distribution. MS. WELTON closed her presentation with slide 11. She said without passage of CSSB 70(HSS) Naloxone would be available only to those with a prescription from a medical provider submitted to a pharmacy, which she argued makes the legislation imperative. 3:26:54 PM REPRESENTATIVE MCCARTY referenced slide 5. He observed the increase from 2018 to 2019 in opioid death rates in Alaska and asked if it was because of an increase in Fentanyl use. MS. WELTON answered that that is the preliminary thought. CO-CHAIR SNYDER commented that she wished to move the legislation out of committee after public testimony. 3:28:47 PM CO-CHAIR SNYDER opened public testimony on CSSB 70(HSS). 3:29:04 PM VENUS WOODS, Director, HIV Prevention and Education, Alaska AIDS Assistance Association ("Four A's"), testified in favor of CSSB 70(HSS). She said the legislation was important for Four A's and shared that the organization runs Anchorage's only syringe service program. She explained that the program provides overdose education and gives out Narcan kits. She said without SB 70, Four A's would no longer be able to give out the kits, and she believed overdose deaths would increase. 3:30:30 PM CO-CHAIR SNYDER closed public testimony. REPRESENTATIVE SPOHNHOLZ commented that the program has been very effective, and that it creates an opportunity anytime somebody doesn't die from an overdose to find a path to recovery. She said the program has become the standard nation- wide. She said it was initially [set to sunset after] four- years because it was a new thing that hadn't yet been done. She emphasized the program has proven to be effective, very safe, and is recommended by the U.S. Surgeon General, and therefore, she believed it made sense to move CSHB 70(HSS) from committee. [Discussion of CSSB 70(HSS) was concluded later in the meeting.] SB 70-OPIOID OVERDOSE DRUGS  4:33:32 PM CO-CHAIR SNYDER announced that the final order of business would be a return to CS FOR SENATE BILL NO. 70(HSS), "An Act relating to opioid overdose drugs; and providing for an effective date." 4:34:08 PM CO-CHAIR ZULKOSKY moved to report CSSB 70(HSS) out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSSB 70(HSS) was reported out of the House Health and Social Services Standing Committee.