Arizona Governor Doug Ducey is claiming the state has seen progress on getting the opioid crisis under control even as the rate of overdoses continues to spike.  Heroin and prescription opioids caused fatal overdoses in Arizona to increase twenty percent in 2017 compared with 2016.  A total of 949 people in the state died of an opioid-caused overdose in 2017, the Arizona Department of Health Services (ADHS) reported earlier this month.Heroin accounted for 51 percent of the spike in the past five years, killing 344 people in 2017, and it accounted for 36 percent of opioid-overdose deaths.  Prescription and synthetic opioids accounted for 605 deaths last year.  If the trend continues as predicted health officials warned more than 1,000 people will fatally overdose on opioids by the end of 2018.“Arizona is faced with an opioid crisis.  The numbers are staggering,” Dr. Cara Christ, director of ADHS, said, acknowledging the spike at a news conference alongside Ducey and members of the Arizona Department of Public Safety.  She also noted “significant measurable progress,” however, in terms of patient referrals to behavioral health or substance abuse treatment after an overdose, as well as a forty percent drop in the number of opioid prescriptions filled at Arizona pharmacies in 2017.

Photo by Claudia Soraya on Unsplash

The results from the Arizona Opioid Epidemic Act are expected to continue to be realized in the years to come.  The Act includes new opioid prescribing and dispensing laws designed to curtail the crisis, with these specific provisions in place effective April 26, 2018:

• A five-day limit on the first fill of an opioid prescription (with some exceptions, including for infants being weaned off opioids at the time of hospital discharge).

• A dosage limit of less than 90 MME (morphine milligram equivalent) for new opioid prescriptions, with some exceptions.

• Regulatory oversight by the Arizona Department of Health Services on pain management clinics to ensure that opioid prescriptions are provided only when necessary and to prevent patients from receiving multiple prescriptions.  This provision also includes enforcement mechanisms.

• A “Good Samaritan” law to encourage people to call 9-1-1 in an overdose situation.

• Three hours of education on the risks associated with opioids for all professions that prescribe them.

• A requirement that opioid prescriptions must be issued electronically, with a delayed effective date (1/1/19 for urban providers and 7/1/19 for rural providers).

• A red prescription container cap to alert the health consumer that opioids have risks.

• Directs counties and cities to require structured sober living homes to develop policies and procedures that allow individuals to continue receiving medication-assisted treatment while living in the home.

• Each county must designate at least one location where citizens can drop off legal or illegal drugs and receive a referral to a substance use treatment facility.

“We’ve said that there is a real challenge here,” Ducey said, acknowledging an “ongoing crisis” in the state.Arizona will begin to license pain management clinics in 2019 and it plans to monitor its real-time “surveillance data” that relies on healthcare providers and first responders to report overdoses.The state’s official opioid report was released this month and is based on medical examiner investigations and death certificates.  A state review included in this report found that just 36 percent of people who died from opioids had a prior opioid-related encounter at a hospital or emergency medical provider in the five years before their death.  For the second year in a row, there were more than 51,000 “opioid-related encounters” at Arizona hospitals.  That puts the estimated cost for opioid-related encounters in hospitals at more than $431 million.

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Arizona governor cites progress as opioid overdoses continueDespite best efforts, fatal opioid overdoses — especially heroin — surged againNew Arizona Opioid Epidemic Act To Expand Treatment and Prevention Options