ENROLLED 2016 Regular Session HOUSE CONCURRENT RESOL UTION NO. 113 BY REPRESENTATIVE LEBAS AND SENATORS MILLS AND THOMPSON A CONCURRENT RESOL UTION To establish the Louisiana Commission on Preventing Opioid Abuse to study and make recommendations regarding both short-term and long-term measures that can be taken to tackle prescription opioid and heroin abuse and addiction in Louisiana, by using the best practices and evidence-based strategies for its prevention, treatment, and enforcement. WHEREAS, opioid pain medication presents serious risks, including overdose and opioid or substance use disorder; and WHEREAS, drug overdose is the leading cause of accidental death in the United States, with forty-seven thousand fifty-five lethal drug overdoses occurring in 2014; and WHEREAS, opioid addiction is driving the epidemic, with eighteen thousand eight hundred ninety-three overdose deaths related to prescription pain relievers and ten thousand five hundred seventy-four overdose deaths related to heroin occurring in 2014; and WHEREAS, from 1999 to 2014, more than one hundred sixty-five thousand persons died from overdose related to opioid pain medication in the United States; and WHEREAS, of the twenty-one and one-half million Americans aged twelve years or older that had a substance use disorder in 2014, one million nine hundred thousand had a substance use disorder involving prescription pain relievers and five hundred eighty-six thousand had a substance use disorder involving heroin; and Page 1 of 7 HCR NO. 113 ENROLLED WHEREAS, eighty percent of new heroin users started out misusing prescription painkillers, and as a consequence, the rate of heroin overdose deaths nearly quadrupled from the year 2000 to 2013; and WHEREAS, an estimated twenty percent of patients presenting to physician offices with noncancer pain symptoms or pain-related diagnoses, including acute and chronic pain, receive a prescription for an opioid; and WHEREAS, in 2012, two hundred fifty-nine million prescriptions were written for opioids, which is more than enough to give each American adult a bottle of pills; and WHEREAS, in 2011, the Drug Abuse Warning Network estimated that more than four hundred twenty thousand emergency department visits were related to the misuse or abuse of narcotic pain relievers; and WHEREAS, individuals often share their unused pain relievers, unaware of the dangers of nonmedical opioid use; and WHEREAS, according to the National Institute of Drug Abuse, most adolescents who misuse prescription pain relievers are given them for free by a friend or relative; and WHEREAS, Louisiana ranks among the top states for the number of narcotic prescriptions written; and WHEREAS, approximately six hundred seventy-five Louisiana residents die from prescription opioid overdoses each year; and WHEREAS, more than five percent of adult Louisianians engage in the nonmedical use of opioids, resulting in fifteen deaths per every one hundred thousand residents each year; and WHEREAS, nationally, the Centers for Disease Control and Prevention estimates that heroin-related deaths have increased thirty-nine percent between the years 2012 and 2013, with a similar spike in emergency heroin overdose treatments and deaths reported in the New Orleans area, causing city health officials to declare a public health advisory in January 2016 because of increases in heroin and opioid abuse; and WHEREAS, though prescription opioids are generally safe when used as prescribed, and opioid drugs are essential for end of life, chronic, and palliative care pain relief, the overuse and abuse of prescription opioids can lead to long-term detrimental health complications, dysfunction, addiction, and death; and Page 2 of 7 HCR NO. 113 ENROLLED WHEREAS, in addition, individuals that are addicted to opioids are shifting to heroin, as prescription opioids become less available and are more expensive; and WHEREAS, prescription opioid abuse and heroin abuse has also led to an increased burden on law enforcement, higher incarceration rates, greater court costs, and elevated healthcare costs from drug-related emergency department visits and treatment admissions; and WHEREAS, opioid abuse and addiction are public health priorities that affect families, communities, public safety, and the economy; and WHEREAS, it is time for statewide response and comprehensive strategy to address opioid abuse and addiction, which will require a collaborative and dedicated effort by Louisiana's healthcare providers and healthcare leadership, as well as coordination between governmental and private sector resources. THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby establish the Louisiana Commission on Preventing Opioid Abuse to study and make recommendations regarding both short-term and long-term measures that can be taken to tackle prescription opioid and heroin abuse and addiction in Louisiana, by using the best practices and evidence-based strategies for its prevention, treatment, and enforcement. BE IT FURTHER RESOLVED that the purpose of the commission is to assess the extent and impact of opioid abuse, including heroin, on public health care and the medical and legal systems in Louisiana, and to recommend both short- and long-term measures, including evidence-based, medication-assisted treatment to achieve and maintain abstinence from all opioids and heroin, to reduce opioid abuse, related addictions and deaths, and the costs of opioid abuse. BE IT FURTHER RESOLVED that the commission shall be composed of representatives assigned from relevant state agencies, interested state medical provider associations, and other relevant and interested parties, including but not limited to all of the following: (1)The secretary of the Department of Health and Hospitals or his designee. (2)The assistant secretary of the Department of Health and Hospitals, office of behavioral health, or his designee. Page 3 of 7 HCR NO. 113 ENROLLED (3)The executive director of the Louisiana Workforce Commission or his designee. (4)The commissioner of insurance or his designee. (5)The secretary of the Department of Public Safety and Corrections or his designee. (6)The president of the Louisiana State Medical Society or his designee. (7)The executive director of the Louisiana State Board of Medical Examiners or his designee. (8)The executive director of the Louisiana Board of Pharmacy or his designee. (9)The president of the Louisiana Academy of Family Physicians or his designee. (10)The executive director of Louisiana Addictive Disorder Regulatory Authority or his designee. (11)The president of the Louisiana Chapter of the American College of Emergency Physicians or his designee. (12)The president of the Louisiana Association of Drug Court Professionals or his designee. (13)The president of the Louisiana Association of Nurse Practitioners or his designee. (14)The president of the Louisiana Association of Substance Abuse Counselors and Trainers or his designee. (15)The president of the Louisiana Council of the Emergency Nurses Association or his designee. (16)The president of the Louisiana Dental Association or his designee. (17)The president of the Louisiana Health Information Management Association or his designee. (18)The president of the Louisiana Hospital Association or his designee. (19)The president of the Louisiana Orthopaedic Association or his designee. (20)The president of the Louisiana Primary Care Association or his designee. (21)The president of the Louisiana Psychiatric Medical Association or his designee. Page 4 of 7 HCR NO. 113 ENROLLED (22)The president of the Louisiana Psychological Association or his designee. (23)The executive director of the Louisiana State Board of Nursing or his designee. (24)The executive director of the Louisiana State Board of Practical Nurse Examiners or his designee. (25)The executive director of the Louisiana State Nurses Association or his designee. (26)The chancellor of the Louisiana State University Health Sciences Center at New Orleans or his designee. (27)The chancellor of the Louisiana State University Health Sciences Center at Shreveport or his designee. (28)The president of the Louisiana Society of Health System Pharmacists or his designee. (29)The president of the Louisiana Association of Chiefs of Police or his designee. (30)The executive director of the Louisiana District Attorneys Association or his designee. (31)The executive director of the Louisiana Sheriffs' Association or his designee. (32)The executive director of the Society of Interventional Pain Physicians of Louisiana or his designee. (33)The president of the Pharmaceutical Research and Manufacturers of America or his designee. (34)The president of the Louisiana Independent Pharmacies Association or his designee. (35)The president of the Louisiana State Coroner's Association or his designee. (36)The president of the Louisiana Osteopathic Medical Association or his designee. (37)The president of the Louisiana Association of Self Insured Employers or his designee. (38)The president of the Louisiana Academy of Physician Assistants or his designee. Page 5 of 7 HCR NO. 113 ENROLLED BE IT FURTHER RESOLVED that the duties of the commission shall include but not be limited to all of the following: (1)Identify and evaluate the causes of opioid abuse in Louisiana. (2)Evaluate responsible use of opioid medications, including an assessment of the feasibility and desirability of a statewide adoption of the recent "Guidelines for Prescribing Opioids for Chronic Pain" promulgated by the Centers for Disease Control and Prevention on March 18, 2016. (3)Evaluate and recommend reasonable alternatives of medical treatment to mitigate the overutilization of opioid medications, including but not limited to integrated mental and physical therapy health services. (4)Recommend policies and procedures for more effective interagency, intergovernmental, and medical provider communication, cooperation, data sharing, and collaboration with other states, the federal government, and local partners, including nonprofit agencies, hospitals, healthcare and medical services providers, and academia to reduce opioid abuse. (5)Evaluate and recommend policies and procedures for improved access and more effective opioid abuse treatment and prenatal care for pregnant women with substance abuse problems, including but not limited to clarifying current services available for these women, increasing the number of providers properly trained to provide care to this group, and effective ways to achieve treatment over incarceration. (6)Evaluate medical professional training needs and the efficacy of educational materials and public education as an outreach strategy to raise public awareness about the dangers of misuse and abuse of opioid drugs. (7)Assess alternatives to incarceration and medical treatment of opioid-addicted individuals suffering from severe substance abuse disorders. (8)Recommend any appropriate changes to relevant legislation, administrative rules, or pharmaceutical use to mitigate opioid abuse. Page 6 of 7 HCR NO. 113 ENROLLED BE IT FURTHER RESOLVED that the commission is assigned to the Department of Health and Hospitals, with staff support to be provided from existing personnel within the department and additional persons assigned to assist from participating members of the commission. BE IT FURTHER RESOLVED that the commission shall be co-chaired by the executive director of the Louisiana State Board of Medical Examiners or his designee and the executive director of the Louisiana Board of Pharmacy or his designee. BE IT FURTHER RESOLVED that the commission shall meet upon call of the co- chairmen no less than bimonthly, and shall provide a report of its initial findings and recommendations to the governor and the Legislature of Louisiana no later than February 1, 2017, and any further reports or recommendations thereafter as requested by the governor, the legislature, or advised by the commission. BE IT FURTHER RESOLVED that legislative authority for the commission shall continue through July 1, 2017. BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the secretary of the Department of Health and Hospitals, the executive director of the Louisiana State Board of Medical Examiners, and the executive director of the Louisiana Board of Pharmacy. SPEAKER OF THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE Page 7 of 7