Pharmacists, social workers and other health care officials weighed in on a state bill that would establish a surcharge on the manufacture and distribution of opioids — including legal and illegal pain relievers such as morphine, codeine and heroin — at a public hearing of the state Finance, Revenue and Bonding Committee this Monday.
The bill, titled S.B. No. 5 and sponsored by state Sen. Joseph J. Crisco Jr., would use the money raised from the 6.35 percent surcharge to provide grants to Connecticut prevention and treatment programs for opioid abuse. The bill comes in response to a national opioid epidemic and an increase in the number of prescriptions for opioids written in Connecticut over the past two decades. 2015 saw a 56 percent increase in the use of Schedule II drugs, which consist primarily of opioids, since 2009, according to data from the Connecticut Department of Consumer Protection. In Connecticut, 723 people died of a drug overdose in 2015 — double the number of overdose deaths in 2012.
“The opioid prescription problem is not new,” said pharmacology professor Robert Heimer GRD ’88, who has been studying opioid use in Connecticut for 25 years. “It’s been a problem for probably 15 or 18 years. But with the increasing number of overdose deaths outside the urban centers, there seems to be some urgency on the part of state officials to act on this.”
Gov. Dannel Malloy responded to the issue last year by signing a bill strengthening prescription monitoring and prescribing practices. As the finance committee held its public hearing on Monday, Sen. Chris Murphy visited abuse treatment centers and met with law enforcement officials to discuss addiction in the state.
The public hearing revealed conflicting opinions about the new bill among health care workers and officials. Pharmacists and pharmaceutical company representatives generally opposed the bill on the grounds that it would overburden pharmacists and manufacturers. They also argued that the bill’s taxation process — which would be the first of its kind in Connecticut — is complex and would be difficult to implement.
David Benoit, a pharmacist and member of Connecticut pharmacy support organization Northeast Pharmacy Services, said the bill could create a “barrier to care” by driving up the cost to patients for prescription opioids. Benoit also noted that restricting access to opioid medications could cause patients to use illegal, nonprescribed opioids such as heroin.
“[W]e are equally interested in the sound prescribing of opioids,” Benoit said. “We would like to see a significant reduction in nonmedical uses of opioids. However, we are concerned that constraining access and the supply of these medications leads to an expansion of heroin abuse, which is at least equally undesirable.”
But representatives of abuse treatment and prevention programs generally favored the bill, providing counterarguments to the testimony of pharmacists and pharmaceutical representatives.
In her testimony, Connecticut Prevention Network President Ingrid Gillespie said the prescription of opioids, and not the restriction of access to opioids, leads to heroin use. Gillespie cited a statistic from the American Society of Addiction Medicine that 80 percent of new heroin users became addicted after misusing prescription pain relievers. She noted that data reveals a correlation between opioid sales and overdose deaths.
“Contributing to the rising death rate has been an overall increase in the availability of prescription medications, especially opioid analgesics,” Gillespie said. “The rates of sales for opioids, opioid-related deaths and treatment admissions have all increased between 1999 and 2010.”
She said Connecticut is facing an “opioid crisis,” adding that the Department of Mental Health & Addiction Services lacks sufficient funding to fight this problem.
There were 34 opioid deaths per 1,000 residents in New Haven between 2012 and September 2015.