In the first effort of its kind in the state, Gov. Tom Wolf declared the opioid crisis a statewide disaster emergency in order to fight the scourge of addiction.

According to Wolf, Pennsylvania’s rate of drug overdose is 36.5 per 100,000, whereas the national average is 16.3 per 100,000.

The Prescription Drug Monitoring Program cites that opioid overdose-related emergency room visits have climbed 82 percent from the third quarter of 2016 to the third quarter of 2017. The Drug Enforcement Agency reported 4,642 fatal drug overdoses in the state in 2016, a 37 percent jump from the previous year.

“While we have made progress in combating the heroin and opioid abuse crisis and drastically expanded Pennsylvania’s response, we are still losing far too many Pennsylvanians,” Wolf said. “I am taking this step to protect Pennsylvanians from this looming public health crisis, and I am using every tool at my disposal to get those suffering from substance use disorders into treatment, save more lives and improve response coordination.”

The declaration, traditionally reserved for natural disasters, will make Pennsylvania the eighth state to pursue such a strategy.

A collaboration of all the state agencies, including the departments of Health, Drug and Alcohol Programs, the Pennsylvania Emergency Management Agency, the Pennsylvania Commission on Crime and Delinquency, and the Pennsylvania State Police, the measure contains 13 initiatives in the war on heroin and opioids.

The initiatives are:

• Enhancing coordination and data collection to bolster state and local response.

• Improving tools for families, first responders, and others to save lives.

• Speeding up and expanding access to treatment.

Coordination

One key move involves the establishment of the Opioid Unified Coordination Group, consisting of the heads of, or representatives from, the Department of Health, the Department of Human Services, the Department of Drug and Alcohol Programs, the Pennsylvania Emergency Management Agency, the Pennsylvania Commission on Crime and Delinquency, the Pennsylvania State Police, and any other executive branch agency the governor designates.

Pennsylvania Emergency Management Agency Director Richard D. Flinn Jr. will oversee a command center to track progress and enhance coordination of the health and public safety agencies.

Secretary of Policy and Planning Sarah Galbally said the addition of more voices will allow for better strategies.

Tools for families

State agencies will be offered more access to medications like naloxone and equipment used for treatment and law enforcement.

“We know those individuals who are revived have the potential of OD’ing again in a short period of time, and they also begin to go through withdrawal symptoms, making it more likely that they will use again, and again, suffer another overdose,” Galbally said. “While our ideal process is to get someone into treatment, we want to make sure that those who refuse transport through a warm handoff will have lifesaving medication on them.”

Pharmacists will also be able to partner with outside agencies, such as prisons or treatment programs, to provide naloxone after a person leaves a program.

A measure allowing for temporary rescheduling of fentanyl derivatives, with options to pursue permanent rescheduling, will help combat the increasingly present and potent opioid.

“One of the great outcomes in rescheduling is that it gives law enforcement more tools when they are cracking down and finding fentanyl derivatives mixed in with other drugs,” Galbally said.

Access to treatment

Officials are hoping loosening conditions could motivate more people to seek treatment.

Those interested in joining a Narcotics Treatment Program can now have an initial intake review conducted by a certified registered nurse practitioner or a physician assistant.

“It doesn’t negate the need for a clinical examination with the physician once the admission has occurred, but it definitely insures that there isn’t a lapse in time to get somebody into a treatment facility,” Galbally said.

Counseling for Narcotic Treatment Programs will remain at a central base, but medication-assisted treatment can now be administered at satellite facilities, making treatment more convenient for patients, and freeing up time at the main facilities.

Annual licensing requirements for high-performing drug and alcohol treatment centers will be reset to once every two years, allowing staff to serve patients without being buried in paperwork.

Funding

Outside of specific notes for increased spending found in the declaration, the initiatives are intended to be funded with budget money that was set aside specifically for some programs, along with available state and federal funding.

While most emergency declarations are focused on weather, and will often be lifted after a certain amount of time, the ongoing fight against heroin and opioids is sure to take longer than a few months. Galbally said that the declaration will serve as a starting point, and decisions to continue or adjust the strategy will be made as needed.

“Our goal is to continually process outcomes relative to the disaster declaration, and the governor will be briefed regularly relative to what needs to happen within 90 days and beyond 90 days, and we’ll keep our eye on that,” she said. “I think that one of our goals in identifying regulations that can be suspended is ‘Where can we make changes that will last beyond just a time-locked period?’”

Wolf and his cabinet hope that the changes will make a dent in the harrowing opioid problem.

“As we see additional reports coming out from the Coroner’s Association, from the DEA, relative to overdose deaths in Pennsylvania, we can’t leave any stone unturned,” Galbally said.

“This is another set of tools in his toolbox that will help his administration further address this epidemic.”