When hospital emergency department directors met several years ago, they began discussing this new issue. Carl Schiessl, director of regulatory advocacy at the Connecticut Hospital Association, said an individual, or a family with someone in crisis, often will go straight to an emergency room before any other option, since it's open and staffed 24 hours a day, but he said that after the emergency is mitigated, the hospital then needs to consider how to get the patient the best treatment to eradicate the problem of addiction.
"It's seen all across the state and not just in localized regions"
Not only is the epidemic issue felt across different age groups, but it's seen all across the state and not just in localized regions, from Windham County to Fairfield County. In the face of those trends, Connecticut's emergency medicine physicians were among the first in the nation to recognize that the prescribing practices were an issue. The group voluntarily adopted a guideline in 2015 for how emergency departments would prescribe opioids and worked with state officials to create new legislation.
Gov. Dannel P. Malloy has put forward and signed legislation aimed at curbing the growing opioid epidemic in Connecticut. The governor’s bill-signing ceremony to ensure higher education and free resources came days after the Office of the Chief Medical Examiner reported that an average of nearly three Connecticut residents are dying every day from accidental drug intoxication in 2017. The state is now on pace to hit more than 1,000 opioid-related deaths per year, which would 2016’s record of 917 deaths.
"Examiner reported that an average of nearly three Connecticut residents are dying every day from accidental drug intoxication in 2017."
A new bill being proposed requires first responders to carry overdose-reversing drugs such as naloxone, limits initial opioid prescriptions to seven-day supplies in cases involving acute, non-chronic pain, makes changes to a prescription monitoring program designed to help prescribers identify patients who could be misusing drugs, and charged the state’s Alcohol and Drug Policy Council with developing plans to reduce the number of opioid-induced deaths in Connecticut.
Other measures are being used to curtail the epidemic. As deaths continued across the state, officials have also bolstered drug disposal efforts as a way to head off the potential for addiction that prescription opioids represented. Recently, state officials said that drug disposal boxes, located across Connecticut, collected 333,803 pounds of unused medication 2016. This is was a sharp increase from the previous year.
"Connecticut, collected 333,803 pounds of unused medication 2016."
Among other measures was a requirement that medical professionals generate all prescriptions electronically. The proposal would also allow home health care nurses to destroy unused medication. The proposal would also allow people to include a form stating that they do not want to receive opioids in their medical files. For those being prescribed opioids, the proposed legislation would require that those patients receive information about the risk of addiction. Along with these measures, the proposed legislation would remove barriers blocking state agencies from sharing data and foster cooperation between these Connecticut institutions.
Unfortunately, these attempts at reform had been made before and been met with tepid response. In 2013, a public act required prescribers in Connecticut to register with the prescription monitoring program that started in 2008. By 2014, half of the prescribers in Connecticut still had not registered. Those who did found the system time-consuming and had difficulty using the registration portal.
"By 2014, half of the prescribers in Connecticut still had not registered."
Regarding the electronic prescription monitoring initiatives, it does not include data from neighboring states, so many patients, especially those who live in towns that border New York, can go back and forth between doctors with neither side sharing the knowledge.
Of course, abusers of prescribed opiates will switch to heroin and fentanyl when the opioid is no longer available. In a trend seen all across the nation, Connecticut is no exception. With the tightening control on prescription painkillers, people are driven to switch to heroin or fentanyl, which is cheaper and far more available. From 2014 to 2015, the number of times fentanyl was found in the bloodstream of overdose victims increased 150 percent. In 2016 it was responsible for one-quarter of all drug overdoses. Drug overdose deaths involving heroin continued to climb sharply, and heroin overdoses more than doubled from 2012 to 2015.
"The citizens of Connecticut have to rely on first-responders being able to administer Narcan"
Connecticut faces a lack of viable treatment options for people caught up in the epidemic. Little has been done in terms of creating treatment and prevention options. Hospitals typically don't have treatment or rehabilitation beds. For now, the citizens of Connecticut have to rely on first-responders being able to administer Narcan and slow but steady progress of legislation to bring the state closer to strictly monitored opioid distribution so the epidemic can be slowly eradicated.