Oklahoma City — After more than six months of work, the Oklahoma Commission on Opioid Abuse laid out 31 recommendations for the Legislature, state agencies and local law enforcement on Tuesday afternoon.
Whether the report will prove to be anything more than interesting reading remains to be seen, however. Lawmakers will face a difficult budget situation when they return in February, even if better-than-expected revenues narrow the $600 million projected gap, and already have heard demands to build more prisons and raise teacher salaries.
Attorney General Mike Hunter and members of the Commission on Opioid Abuse outlined their recommendations, which included enacting a “Good Samaritan” law to shield a person who called 911 about an overdose from drug possession charges; requiring doctors to use electronic prescriptions, which are more difficult to forge, for opioids; and crimininalizing fentanyl trafficking.
As little as 3 milligrams of fentanyl could kill a person who hasn’t developed a high tolerance for opioids.
The recommendations also called for the Legislature to increase funding for drug and mental health courts. The courts, which aren’t available in every county, allow defendants to avoid prison time if they complete treatment and stay out of further legal trouble.
“If the state doesn’t invest in getting people well, in getting over the addiction, we’re not dealing with the problem,” Hunter said.
Sen. A.J. Griffin, a Republican who introduced a Good Samaritan bill last year, said she thought lawmakers could come together to take action on opioids this year.
“Legislators are people too, and there’s not an Oklahoman that has not been touched by this” issue, she said.
Rep. Tim Downing, a Republican, said the commission came up with a mechanism to fund at least some of the recommendations — a 10 percent sales tax on drug manufacturers and distributors when they sell opioids in Oklahoma. While it isn’t clear whether three-fourths of lawmakers would approve it, as required by the state constitution, a simple majority could send the issue to voters in November, he said.
Not all of the recommendations required legislative action, however. Oklahoma could improve its addiction treatment system if more primary care doctors, particularly in rural areas, agreed to offer medication-assisted treatment, said Dr. Layne Subera, an osteopathic physician. The treatment involves giving patients methadone or buprenorphine, drugs that quiet the brain’s craving for opioids without causing a high.
“If we can get more buy-in from the physician community, we can use the existing (medical) infrastructure,” he said. “It is really designed, from the ground up, to be a primary care therapy.”
Other recommendations included:
- Limiting initial opioid prescriptions for people younger than 21 to a seven-day supply. Providers could write another prescription if young patients needed longer pain relief.
- Developing a system to track fatal and non-fatal overdoses and to help spot patterns.
- Requiring medical clinic owners to register with the Oklahoma Bureau of Narcotics and Dangerous Drugs Control.
- Requiring all prescribers and pharmacists to complete continuing education about opioids and addiction.
- Creating a database of emergency room discharges to follow up on the care patients receive after an overdose.
- Encouraging pharmacists to offer naloxone, which can reverse an overdose, to patients using opioids.