MONTGOMERY — Alabama should offer immunity to drug users who report a friend's overdose, raise court fees to pay for opioid-related costs and distribute anti-overdose drugs to more people, members of a state task force on opioids said Tuesday.
Gov. Kay Ivey tasked the Alabama Opioid Overdose and Addiction Council earlier this year with coming up with solutions to the state's opioid crisis. The panel is supposed to suggest new legislation by the end of the year, but lawmakers are already concerned about the cost of some proposals, such as the plan to distribute anti-overdose drugs.
"I hate to sound like I'm being cold about it, but somebody's got to pay for it," said task force member Rep. Elaine Beech, D-Chatom, at the task force meeting at the attorney general's office in Montgomery.
Overdose deaths in Alabama and across the country have burgeoned over the past decade, according to the Centers for Disease Control and Prevention. In 2015, overdoses overtook gun violence and car accidents as a leading cause of death, with 52,000 deadly overdoses.
Public officials attribute the problem to the rise of opioids, the family of painkillers that includes heroin and prescription drugs such as Oxycontin. Lax rules on prescription drugs helped feed an addiction epidemic, officials say, and illegal drugs such as heroin filled the market after states clamped down on prescribers.
As opioid abuse and overdose deaths across the country continue to increase, an event Saturday in Anniston aims at preventing the spread of drug abuse locally by allowing people to drop off unused and expired prescription drugs.
The task force and its subcommittees — now more than 50 doctors, public officials and addiction counselors — have yet to write any new proposals in bill form, but members discussed several proposals Tuesday.
Jefferson County Health Officer Mark Wilson said the state's Mental Health Department has 5,200 two-dose packs of the anti-overdose drug naloxone on hand — drugs that need to be distributed where they can be best used. Naloxone, sometimes known by the brand name Narcan, blocks the effect of opioids and can be used to rapidly reverse an overdose. Emergency medical technicians carry the drug, and police agencies across the state are trying to supply it to their officers.
Wilson said the state should consider enlisting drug treatment organizations to distribute Narcan to laypeople who might use it — and to give classes on how to administer the drug properly.
Wilson also suggested a change to state law to allow immunity from prosecution for drug crimes for anyone who calls to report an overdose.
"Our experience...is that people who overdose on heroin or fentanyl tend to be using the drug in the presence of other people," he said.
When an overdose happens and someone calls 911, he said, "everybody scatters, and the person who experiences the overdose is left alone to die."
Wilson also suggested that doctors consider prescribing Narcan when they prescribe opioids. Some on the task force said that could be of limited use, because many users have moved on to illegal opioids.
"I don't know that we're going to get the drug cartels to distribute naloxone with their heroin," said Jerry Harrison of the Alabama Academy of Physicians.
Darrell Morgan, director of the Alabama Board Pardons and Paroles, headed the task force's subcommittee on law enforcement. He said the subcommittee wants the state to reduce the amount of fentanyl a suspect must be caught with to invoke a trafficking charge. Morgan said the state should also create a new court fee for defendants facing fentanyl trafficking.
Alabama in the past has often relied on court fees to pick up the cost of the court system. Most of the cost of a traffic ticket consists of fees, not the fine; the state long ago added a special fee to drug cases to offset the effect of drugs on the court system. Morgan didn't say how high the court fee should be set.
Task force members also called for better data collection on drug overdoses and naloxone use. At present, the state's Prescription Drug Monitoring Program, in which prescribers report their prescriptions of controlled drugs, is the best way to track the problem.
State Sen. Jim McClendon, R-Springville, said even the monitoring program may be in danger of running out of money, with grants set to expire. He said lawmakers next year will have to think about how to pay for it.
"A dollar surcharge on the number of opioid prescriptions going out?" McClendon said. "I don't know how that would work but we might be able to handle it."
Lawmakers urged the panel to produce legislative suggestions soon. The Legislature convenes in January.