TOPEKA — Topeka pharmacist Vicki Schmidt finds research reports and anecdotal accounts of rising deaths from opioid and heroin overdose sufficient proof of a crisis in Kansas.
“Every day there’s a new headline,” she said. “It’s a crisis that we should have seen coming. It’s just exploding.”
Topeka politician Schmidt, chairwoman of the Legislature’s joint committee devoted to oversight of the state’s 400,000-client Medicaid system, said the Kansas Department of Health and Environment should be working with the three private insurance companies managing KanCare to take an active role in responding to the epidemic. The Republican senator put the question to Mike Randol, KDHE’s director of Medicaid, at a recent Statehouse hearing.
Randol said the agency was in early stages of collecting data and analyzing best practices in other states.
“I don’t have specifics,” Randol said. “It is a program we’re wanting to develop.”
Schmidt’s advice on the life-saving front, from the perspective of a senator-pharmacist, was: “We just need to do more.”
A KDHE report indicates prescription opioid drug overdose deaths in Kansas climbed 28 percent from 2013 to 2015. In that same period, the report said, heroin deaths escalated by 71 percent in Kansas. Throughout the nation, people addicted to prescription medicines have turned to heroin as an inexpensive alternative.
The state recorded 329 opioid overdose deaths two years ago, said Jody Reel, a Kansas pharmacist affiliated with the Kansas Pharmacists Association. Reel said nearly half of overdose fatalities were tied to medications such as morphine, hydrocodone, oxycodone and fentanyl.
Tim Keck, secretary of Kansas Department for Aging and Disability Services, said increases in opioid-related abuse paralleled rising availability of opioids by prescription. Kansas stood as the 16th-highest opioid prescribing state in the country, he said.
“Opioid addiction and abuse is a growing problem in Kansas,” Keck said. “We are working to address this critical public health issue before it gets any worse.”
KDADS announced $3.1 million in grants to support prevention and treatment. It’s the first installment from a two-year allocation from the federal government. Eighty percent of funding is for treatment and recovery, with the rest earmarked to prevention, early intervention and public education.
In April, the 2017 Legislature and Gov. Sam Brownback approved a bill making it legal for emergency medical responders, law enforcement personnel or firefighters to administer life-saving drugs approved by the U.S. Food and Drug Administration. For example, naloxone or an equivalent can be administered to inhibit the influence of a heroin or prescription drug overdose.
Kansas had been among only three states that forbid administration of the treatment option to people needing intervention before reaching a hospital.
Fred Farris, a detective sergeant in the Lenexa Police Department, said he had the misfortune of witnessing death by overdose during 27 years in law enforcement and seven years as a firefighter. He said first-responders could have used naloxone, also known as Narcan, to save lives.
“While not every death could have been averted, a great many could have,” Farris said. “I have seen firsthand the rapid effects of Narcan.”
Concern has been expressed that broader availability of overdose medication might encourage addicts to push the envelope in anticipation of being revived.
“While it may be argued that opioid antagonists have no potential for abuse, it is more accurate to state that Naloxone has no potential for addiction or dependency,” said Alexandra Blasi, of the Kansas Board of Pharmacy. “Some groups have noted that Naloxone has a street value, and that there is potential for individuals to plan to overdose and later administer the antagonist. Education, protections and record keeping are important for public safety and continued access to these important medications.”
The state Board of Pharmacy is responsible for developing by Jan. 1 the rules and regulations for implementation of the law allowing for use of opioid antagonists by first responders.