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Five Still Standing: Remaining Opioid Bills Moving Through the Capitol

If you’ve paid attention to the headlines recently, you know that hundreds of Coloradans are dying from drug use every year.

Colorado’s legislators and policymakers have struggled to respond to the rising drug overdose death rates over the past two decades. But the issue has taken on a new level of urgency. Colorado set a record in 2016 with 912 overdose deaths, and preliminary 2017 data show the number increasing to 959.

Colorado has taken a number of steps to address the issue. It has convened a prescription drug monitoring program, the Colorado Consortium for Prescription Drug Abuse Prevention, and expanded insurance coverage of substance use treatment.

Some progress is being made, including a leveling off of prescription opioid death rates, which reached a high of 6.1 deaths per 100,000 in 2014 and dropped to 5.3 per 100,000 in 2016. Prescription opioids are pain relievers such as oxycontin, hydrocodone, and oxycodone.

But those rates remain too high, and overdoses from other drugs are rising at alarming rates. Heroin death rates have increased four-fold since 2010, as have methamphetamine death rates. Deaths due to benzodiazepines, which are muscle relaxants, have more than doubled since 1999.

Amid this crisis is a growing recognition that the legislature can play a role in addressing it. A bipartisan Opioid and Other Substance Use Disorders interim study committee met regularly from July through October last year and produced a package of six bills that were introduced in the current session.

Bills in Progress

The CHI team has been tracking them closely. Here’s a look at where they stand:

Senate Bill (SB) 24 aims to expand access to behavioral health care providers in Colorado by including them in scholarships and loan repayment programs. It passed out of a Senate health committee and awaits a hearing in the Appropriations Committee due to its $2.8 million price tag. It will likely be waiting until legislators have a chance to review the full budget, which is set to be introduced in the House at the end of this month.

A seven-day opioid prescribing limit, which was proposed last session, is included this year in SB 22. The bill has received greater backing this year. A broad set of providers would be affected by the proposed limit. The group currently includes podiatrists, dentists, physician assistants, advance practice nurses, optometrists and veterinarians. It has cleared the full Senate and been introduced in the House, where it awaits a hearing in Health, Insurance and Environment. The assignment to a health committee, rather than the “kill committee” of State, Veterans and Military Affairs, means this bill is likely to make it all the way to the governor’s desk.

The Senate State Affairs committee had little love on Valentine’s Day for SB 40, a harm reduction bill that included a safe injection facility pilot as one of its provisions. Such facilities allow people to use illegal drugs in a hygienic and supervised setting. Despite overwhelmingly favorable testimony and unanimous bipartisan consent in the interim committee, the Republican-led Senate State Affairs voted 3-2 along party lines to kill it.

The three remaining bills are scheduled to be heard in the House Public Health Care and Human Services Committee tomorrow (March 13). Among other provisions, House Bill (HB) 1003 makes permanent the interim study committee that met last year and allows school-based health centers to apply for grants to cover behavioral health services, including substance use disorder (SUD) treatment. HB 1007 aims to improve payment and coverage for SUD treatment, including prohibiting insurers from requiring that they approve the first prescription of buprenorphine, a popular drug for medication-assisted treatment, before it is prescribed to a patient.

The committee will also hear HB 1136, which proposes adding residential treatment options for SUD to Colorado’s Medicaid program, Health First Colorado. This bill has the largest fiscal impact of the proposals — requiring an additional $34 million in state funds annually by fiscal year 2020-21. It aims to address a significant gap in the services available to Health First Colorado enrollees, most of whom are not eligible to receive residential SUD treatment under the current benefits. Whether legislators are willing to write the check for those services remains to be seen.

This package of bills is the most comprehensive effort yet from Colorado’s General Assembly in tackling the drug overdose epidemic. But there are many hurdles still to clear, and one of the bills has already been discarded. Here at CHI, we’ll be watching closely as the remaining bills move through the legislature.

Find Teresa Manocchio on Twitter: @CHI_Manocchio

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