Spurred by stories of addiction from across the state, lawmakers this week are voting out of committees a wide-ranging bill aimed at minimizing the effects of opiate use on the health and safety of Vermonters.
The legislation, portions of which have been drafted in three separate committees, seeks not only to reduce supply and temper demand, but to mitigate the toll of narcotics even on addicts who may not be seeking help.
Rep. Bill Lippert, a Hinesburg Democrat and chairman of the House Judiciary Committee, said the issue became a priority for 2013 after campaigning lawmakers last year heard from constituents about the scope of the drug problems in their communities.
"We’re trying to combat this issue of opiate addiction and methamphetamine addiction and come at it from as many angles as possible," Lippert told fellow Democrats this week.
One element noticeably absent from lawmakers’ efforts: money. Budgetary pressures, they say, have limited expenditures in the bill to funding for a new coordinator position at the Department of Public Health. The person will be responsible for linking primary care doctors, psychiatrists and smaller outpatient facilities with drug treatment facilities scattered across the state. Health Commissioner Harry Chen said Wednesday that the coordinator will help reduce some of the long lines at drug treatment facilities by equipping satellite offices with the ability to administer methadone, buprenorphine and other addiction treatment services.
Rep. Ann Pugh, a South Burlington Democrat and chairwoman of the House Committee on Human Services, said the lack of money won’t prevent lawmakers from making headway on the narcotics issue.
The bill contains several provisions, including two aimed at what lawmakers call "harm reduction." Lippert’s committee has crafted language that would offer criminal immunity to drug users who seek help when a fellow addict overdoses. The provision comes at the request of prosecutors and health care officials who say patients are dying needlessly because of fear of retribution from law enforcement.
Pugh’s committee, meanwhile, is expected to approve a provision that would equip emergency workers, and even family members of addicts, with overdose antidote that can be administered nasally to an unconscious person.
The bill also looks to stem the supply of drugs by reducing the volume of narcotics prescribed by doctors. To do so, lawmakers are revisiting a prescription drug monitoring bill that lawmakers jettisoned last year over privacy concerns.
But unlike last year’s legislation, Pugh said, this version won’t give law enforcement access to patient drug data. Rather, lawmakers will require doctors to sign up for the database – only about a third do now – and to run the names of certain kinds of patients before issuing prescriptions for narcotic painkillers.
Specifically, doctors would have to check the names of people who say their prescription was lost or stolen, people on long-term narcotic treatment, or new patients complaining of chronic pain. The database would tell the doctors whether that patient is also getting prescription drugs from other providers elsewhere, or if the patient has been red-flagged as a "drug seeker" by another physician.
The bill also tries to curb production of methamphetamine by tracking sales of allergy and cold medications containing ephedrine. Vermonters already have to supply a driver’s license to buy the drug -which is used to manufacture meth – and can purchase it only in certain quantities. The bill would require the installation of a database – provided at no cost – that would track an individual’s purchases at different outlets. The measure is aimed at preventing people from accumulating enough ephedrine to make a batch of the drug.
The database, called NPLEX, was created and maintained by a coalition of over-the-counter drug manufacturers seeking to ease growing public anxiety about the link between ephedrine and methamphetamine. Privacy advocates have raised concerns about tracking citizens’ purchases, but Pugh said she’s been assured that information collected by the system is used only to alert store clerks to people stocking up on the drug.
Lawmakers will also incorporate into the bill heightened regulations over dealers in secondhand precious metals, though exactly what restrictions will be placed on buyers and sellers is still being worked out. Lawmakers are trying to stamp out the market for stolen merchandise without unduly affecting legitimate dealers.
The bill will also have the state study the impact of meth production on the dwellings in which it’s sometimes produced. Toxic residue from the process can sit unseen on surfaces in a home for years after the meth makers move out, causing health effects to the new inhabitants.