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Calling opioid crisis a disaster, Wolf trims red tape to speed aid to patients

Simply declaring addiction a disaster brings vital focus to the issue, say professionals who deal with opioid-caused tragedy daily

Kimberly Ruediger holds her son Gabriel Ruediger, as they participate during an October candlelight vigil at the Camden Waterfront Stadium in remembrance of those who have died from drug overdoses.
Kimberly Ruediger holds her son Gabriel Ruediger, as they participate during an October candlelight vigil at the Camden Waterfront Stadium in remembrance of those who have died from drug overdoses.Read moreFile/ Joseph Kaczmarek

Gov. Wolf on Wednesday set into motion a plan that equates the opioid crisis with disasters like hurricanes and twisters, and that pares away red tape to speed help to people suffering from addiction.

"I don't take this action lightly. We know that this crisis has taken far too many lives," the governor said at an afternoon news conference in his reception room in the state Capitol.

He quoted statistics indicating Pennsylvania has the fourth-highest drug overdose death rate in the nation. Preliminary numbers suggest that 5,260 Pennsylvanians died of drug overdoses in 2017.

"Those who we have lost are not just numbers," Wolf said.

While the disaster declaration includes no new dollars to battle addiction, it focuses on streamlining the bureaucracy that's so much a part of drug treatment — accelerating the treatment center admission process, giving nurses and nurse practitioners more latitude, and lightening licensing requirements for some treatment centers. It also creates an Operational Command Center at the state Emergency Management Agency to bring officials from across government together every week to assess progress.

The governor, a Democrat, said the declaration is "not a silver bullet." Health professionals and government officials agreed, but applauded the plan for what it could do to help people struggling with addiction.

"Just calling a disaster a disaster is drawing attention to the problem, and that in itself is a real value,"  Philadelphia Health Commissioner Thomas Farley said. "I'm really pleased."

Farley expects the final tally of fatal drug overdoses of all kinds in the city in 2017 to hit around 1,200, up from 907 the previous year.

"To put that in perspective," Farley said, "when the AIDS epidemic was at its worst in 1994, there were 935 deaths. That gives you a sense of the magnitude of the crisis."

The emergency declaration will remove bureaucratic barriers, Farley said. For example, according to current rules, people seeking methadone must get their dose in the same place they receive counseling. By waiving that rule under an emergency declaration, officials can allow a person to get methadone at a more convenient spot, Farley said.

"Any little barrier can make a difference for a person getting treatment," he added. "So many are ambivalent about treatment."

Responding to the declaration, Mayor Kenney said in a statement, "I commend Gov. Wolf for taking this bold step.  His announcement makes clear that this epidemic threatens the commonwealth as much as any natural disaster. I look forward to working with the governor in the coming weeks and months, along with our partners in the state legislature, to mobilize the resources and additional tools needed to address the scourge of opioids.  We cannot afford to wait."

Alicia Taylor, communications director for the city's Department of Human Services, said the emergency declaration will waive fees for people seeking treatment to secure their birth certificates, and will end the need for face-to-face visits with physicians to get into treatment.

"When they stand alone, some of the rules and regulations don't seem like a big deal," Taylor said. "In the grand scheme, they are. When you put them all together, this is a very big move."

Another change: nonfatal drug overdoses will be reported to the state Health Department, so that the person could be contacted later and encouraged to get into treatment, Farley said.

That's important because many people who experience non-fatal overdoses go on to die from a subsequent overdose, Farley said.

Deb Beck, president of the Drug and Alcohol Service Providers Organization of Pennsylvania, said that "a laser focus on addiction is very welcome."

She expects to see faster intake for patients at drug treatment centers, and possibly also fewer insurance-related delays, Beck added.

Another change – allowing emergency responders to leave behind an extra dose of naloxone, a lifesaving reversal drug, with people who have overdosed but are reluctant to enter treatment – "is a great idea," she said.

Bill Stauffer, executive director of Pennsylvania Recovery Organization Alliance, said the declaration must include a comprehensive plan "to include recovery organizations like ours. We would have preferred to have been included before this, but we're hopeful to be included now. I credit the governor for taking this seriously."

Delaware County Council Chairman John McBlain said he welcomed the new plan.

"It is the largest public health crisis we face in Delaware County," he said, where about 200 people died in 2016 of overdoses. "It is not a criminal problem, it is a disease."

The county has an active task force that was created years ago and has brought together people in recovery, providers, hospitals, law enforcement, and even Realtors, who were the first to alert local officials to the trend of drugs being taken from bathroom cabinets during open houses.

"I think it can be helpful at the state level," McBlain said of Wolf's proposal to pull together a diverse group as part of his emergency plan. Other steps, such as regulating physicians who overprescribe drugs, can only be handled on the state level. Delaware County was the first in the state to sue drug companies that manufacture addictive painkillers, he added.

"The number of pills that comes into the system is just grotesque," McBlain said.

Under the new state disaster declarationm the additional response would include:

  1. Creation of an Opioid Operational Command Center at the Pennsylvania Emergency Management Agency.

  2. Expanded access to the prescription drug-monitoring program to state and local agencies.

  3. Overdose and neonatal abstinence syndrome would become reportable conditions.

  4. Procurement rules for emergency purchases would be waived.

  5. Better access to rescue medicines for families, first responders and others in a position to save someone who is overdosing.

  6. Expanding space in narcotic treatment programs to speed access to treatment.

  7. Waiving certain licensing requirements for hospitals that want to offer drug and alcohol treatment, and reducing licensing rules for some treatment centers, based on past performance.