HARRISBURG — In a sometimes-personal address, Gov. Tom Wolf today urged final passage of several measures that he hoped would slow an opioid-driven overdose epidemic that last year took nearly 3,500 lives in the state.
"We've all held parents' hands as they've cried," Wolf told a packed House chamber in a rare joint session of the Assembly. "We've hugged those in recovery who've risen above this disease - and we've heard their stories. Parents and those suffering from the disease of addiction have broken down telling us about the difficulty of finding treatment options."
After the speech, Sen. Gene Yaw (R., Lycoming), who, with the Center for Rural Pennsylvania, has led nearly a dozen hearings on the opioid crisis, said he gave the governor credit for understanding the nature of the epidemic. But he cautioned that any attempt to improve the situation would take time.
"I will feel very fortunate if we can make a difference in this problem in 10 years," Yaw said.
Senate Majority Leader Jake Corman (R., Centre) noted that members of the opposing party usually highlight their differences after a governor delivers an address.
"Obviously, today is a completely different issue that I think we all are united in," he said.
Senate Minority Leader Jay Costa (D., Allegheny) described the proposals the governor touted as "low-hanging fruit" that did not seem to be controversial. He said the legislature should hold a special session in January on opioids legislation.
"I do see that this issue is going to continue to be a major part of our conversations in January, February, March, April, and May," he said.
Wolf called the addiction crisis "an invisible problem" with concrete ramifications. He told lawmakers about a close friend who lost a child to addiction and was so heartbroken that he shared the news not by speaking, but in a hand-delivered letter to the governor.
"People have buried their childhood friends," Wolf said.
The governor said he wants to limit - with some exceptions - prescriptions of opioids to one week's worth of pills for minors and patients seen in the emergency room.
"We've all heard too many stories - too many horror stories - about high school athletes whose futures are robbed by addiction that begins with prescription painkillers," he said. "Of course, those suffering from crippling pain need relief, and we must be careful to protect the ability of sufferers of long-term pain or victims of trauma to receive appropriate medication."
A bill by Yaw, which passed the Senate Wednesday, would generally bar medical providers from prescribing more than a seven-day supply of any opioid to a minor, or face potential discipline against their licenses. If more than a week's worth of opioids was needed, the prescriber would first assess whether the young person had a mental health or substance abuse disorder, and discuss the risks with a parent or guardian.
The Pennsylvania Medical Society, which represents doctors, has helped to write prescribing guidelines, but has generally opposed legislation setting prescribing rules. A spokesman said Wednesday in an email that the society was reviewing the proposals, and looks "forward to working with elected leaders in finding solutions that work."
Wolf also wants to compel doctors to check the new patient drug history database every time they prescribe a controlled substance.
"Our current law is not strong enough," he said. "It only requires doctors to check the system the first time they prescribe to a patient, or if they believe a patient is suffering from the disease of addiction."
He also proposed that legislators tell insurers to cover abuse-resistant formulations of painkillers, mandate opioid education in schools, and create a system under which patients can formally declare that they do not want to be prescribed opioids. Wolf wants medical schools, as a condition of state funding, to teach good painkiller prescribing practices, and doctors, as a condition of licensing, to take regular refresher courses.
"The opioid epidemic did not start overnight and we will not fix it overnight, or even in this session," he said. "But by acting on these bills - and by putting other ideas on the table - we can continue to stem the tide of opioid abuse in Pennsylvania. We can make progress for the families we have met - the parents who have cried on our shoulders."
A Pittsburgh Post-Gazette investigation published in May showed that the state lagged many of its neighbors in efforts to monitor patient drug histories, teach doctors the dangers of opioids, promulgate guidelines for the use of painkillers, and discipline physicians who prescribed them wantonly.
The investigation found that over five years, 608 doctors were disciplined for narcotics-prescribing practices in the states that include most of Appalachia - but just 53 of those were in Pennsylvania.
Wider distribution of the medicine naloxone, encouraged by Wolf's administration, has resulted in 1,502 "saves" in potentially fatal overdoses since November 2014. The Board of Medicine approved opioid-prescribing guidelines for several medical specialties.
Last month, the state became the 49th in the nation to operate a prescription drug monitoring program, through which doctors must check a patient's medication history before adding a controlled substance. The budget includes $20 million in new funding for treatment, including 45 Centers of Excellence meant to treat 10,000 people annually.