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Opioids

This 2017 photo shows an arrangement of pills of the opioid oxycodone-acetaminophen in New York. 

A state legislative committee voted Friday to move forward with two bills aimed at slowing opioid abuse and deaths in Wyoming.

Two other proposals will receive further legislative consideration later this year.

The four bills were the product of Wyoming’s Opioid Addiction Task Force, which was created by the Legislature in March. Lawmakers on the task force told members of the Joint Labor, Health and Social Services Committee, which met Friday in Casper, that the proposals focused on education and prevention. The opioid group originally had nine pieces of legislation but “whittled” them down to four.

By 6 p.m. Friday, the health committee had endorsed two of those four. One expands some language in a bill passed in 2017 that attempts to distribute narcan — which can stop an opioid-related overdose in its tracks — to more people, like first responders and ordinary people whose relatives may be at risk. The new language would also broaden who has to report narcan usage to the state Department of Health.

The committee quickly moved the bill along, with 13 of 14 members — Casper’s Rep. Joe MacGuire was out of the room — voting in favor.

By another vote of 13-1 — with Cheyenne’s Sen. Anthony Bouchard voting against — the committee approved a bill that places restrictions on opioid prescriptions. The proposal would limit physicians to writing a 14-day script for “opioid naive patients,” or people who hadn’t had an opioid prescription in the previous 45 days.

The bill also leaves the door open for exemptions for certain patients, like those with chronic pain or who are receiving cancer treatment.

MacGuire, who raised concerns with several of the bills, said he was concerned about people who live in rural Wyoming and can’t get to a doctor every two weeks to have their prescriptions refilled.

Gillete Republican Rep. Scott Clem said the bill was aimed at limiting how many pills can be given to someone suffering from “acute pain” — like a broken arm. Rep. Albert Sommers, a Pinedale Republican who co-chaired the opioid task force, said studies show that the chance of addiction or misuse jumps if a patient is on opioids for more than seven days.

More legislation

The committee set aside another bill to consider at its next meeting, with Sen. Charlie Scott — a Casper Republican — remarking that it wasn’t ready for “prime time.” The proposal is the most far-reaching of opioid legislation considered by lawmakers Friday. For starters, it would require a broad range of health care providers to receive three hours of narcotic-related training every two years.

It would also require, after Jan. 1, 2022, that all controlled substance prescriptions be written electronically. Providers writing those scripts would also be required to screen patients in the state’s prescription monitoring system (there’s the potential for exceptions, like in emergency situations). Finally, it would allow information from that monitoring system to be released to the state Medicaid director.

Rep. Marti Halverson, R-Etna, asked how that last provision was constitutional. Sommers and the other lawmakers from the task force explained that Medicaid would want to identify patients with substance abuse issues, an explanation that didn’t seem to impress Halverson.

On the subject of continuous education, MacGuire asked if there were any providers in the state who didn’t know to be careful with opioids. Republican Sen. Fred Baldwin, who works in health care, said learning more about the drugs had changed his prescribing habits and that three hours every two years is “not much.”

Other questions were raised about the education requirements, and a dentist told the committee that having to check every patient who’s receiving a controlled substance would be “disruptive” to his practice. That concern was raised last year, when Rep. James Byrd tried to pass similar legislation.

In the end, Republican Rep. Eric Barlow — the committee chairman — decided to set aside the bill until the committee’s next meeting.

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Broadening criminal law

The committee also set aside a bill that would expand the criminal code involving controlled substances. The measure would broaden who was guilty of “drug-induced homicide” to anyone who delivered a controlled substance to someone who later died “as a result of the injection, inhalation, ingestion or administration” of the drug. Previously, the statute only applied to those who gave a controlled substance to a minor who later died.

The bill would similarly expand the definition of drug-related felony child endangerment. Currently, the statute mentions only methamphetamine as being illegal to have in the presence of children. But the proposal would expand that to all controlled substances except for marijuana.

That raised broad concern, both because of how expansive the definition would become but also because the health committee is leery of taking up changes to criminal code. Barlow and Sen. Brian Boner, a Republican who represents Converse and Platte counties, both asked the task force whom in law enforcement the group had worked with to shape the recommendation, and MacGuire suggested the proposal may prompt constitutional challenges.

Concern continued into public comment. A defense attorney told the committee that the broad definition would probably lead to a rush of new children into the foster care system, and a man who works with drug addicts warned the bill may prompt people to avoid calling 911 as someone overdosed if there was a child in the house. Ultimately, the committee decided to send a note to legislative leaders and ask them to reroute the legislation through the Joint Judiciary Committee.

During that bill’s discussion, MacGuire asked a broader question: Is the opioid situation in Wyoming as bad as it is elsewhere? Indeed, health officials have said Wyoming has generally avoided the worst of the crisis, which has ravaged rural areas in the East and Midwest.

Dr. Alexia Harrist, the state’s health officer and a member of the task force, said that while Wyoming has avoided the worst of the epidemic, now was an opportunity to ensure that continued. She noted that the state’s opioid-related overdose rate rose from 1.4 per 100,000 more than a decade ago to 7.3 per 100,000 in 2016.

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Follow education reporter Seth Klamann on Twitter @SethKlamann

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Education and Health Reporter

Seth Klamann joined the Star-Tribune in 2016 and covers education and health. A 2015 graduate of the University of Missouri and proud Kansas City native, Seth worked for newspapers in Milwaukee and Omaha before coming to Casper.

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