And #8 overall.

car crash fatalities.(46(471 in 2013, nationwide)

Overdose deaths now

EXCEED

LEGISLATIVE HEARINGSThe heroin and opiate epidemic has touched every corner of the state ofPennsylvania. The epidemic knows no racial, economic, age or gender boundaries.

In an effort to tackle the crisis and address this public health epidemic, the HouseDemocratic and Republican Policy Committees joined forces with the PA HOPECaucus to host hearings across the state. Information gathered at the hearingswill be used to help address prevention and treatment efforts at the legislative andadministration levels.

Additional information about the hearings is available at www.pahouse.com/PolicvCommittee or www.oahooecaucus.com.

PREVENTION AND EDUCATIONDrug education is said tobe a key component ofprevention efforts. Thereare three types of research­based programs designed toprevent use for varying agegroups: universal programs,selective programs, andindicated programs.

According to the NationalInstitute on Drug Abuse,universal programs addressrisk and protective factorscommon to those in a similarcommunity or educationalsetting. Selective programstarget those that havean increased risk of druguse. Indicated programs aredesigned to reach those youthwho are already using drugs.

Efforts in research-basedprograms require a multi-layer approach that includesimplementation by schoolsand communities. Schools andcommunities that invest andexpand in evidence-basedprograms to reflect the evolvingclimate are proven to see areduction in substance abuse.

ISSUE SPOTLIGHTHEROIN/OPIATE EPIDEMIC

District Office:1350 5th Avenue

Coraopolis, PA 15108(412) 264-4260

Fax: (412) 269-2767

45TH LEGISLATIVE DISTRICT

STATE REPRESENTATIVE

ANITA ASTORINO

KULIK

PNSCENTERSOFEXCELLENCE

Need help to navigate

care system and stay

engaged in treatment

HEALTH CARE PROVIDERS

www.dhs.pa.gov I1~YouiD

PATIENT

FAMILY MEMBERS

INCLUDING

• COMMUNITY-BASED CARENAVIGATORS

• COMMUNITY-BASED RESOURCES

(FOOD, HOUSING,JOBS)

CENTER OF EXCELLENCE TEAM

May have co-occurring

behavioral and physicalhealth conditions

CENTER OF EXCELLENCE PATIENTS

-+

" Care

coordination

• Transitionall

follow-up care

• Patient

and family support

Have an opioiduse disorder

• Referral to

community/social

support services

• Comprehensivecare management

These centers coordinate care for people with Medicaid.

Treatment is team-based and "whole person" focused, with the

explicit goal of integrating behavioral health and primary care.

d\- pennsylvania,., DEPARTMENT OF HUMAN SERVICES

SERVICES

WHAT IS A

Center OF exree&nre?

Act 139 was designedto help reduce deathsresulting from opioid/heroinoverdoses by allowing firstresponders-includinglaw enforcement, firefighters and EMS-and other organizations acting under the purview of health careprofessionals to administer naloxone to those experiencing an overdose.

Governor Tom Wolf and theGeneral Assembly secureda total of $20.4 million fortreatment facilities to bettercombat the opioid/heroinepidemic.

• $10 million in behavioralhealth funding• $5 million in MedicalAssistance funding• $5.4 million in federalfunding

In the PA Department ofHuman Services' first phase,funding will be directed to20 Opioid Use DisorderCenters of Excellence totreat an estimated 4,500individuals that do notcurrently have access totreatment. Providing accessto treatment for thosestruggling with addiction intheir most vulnerable timesis key. Oftentimes, thoseplagued with addiction areturned away because of alack of space in treatmentfacilities. This investmentwill help to address thatproblem and providetreatment to those whoneed it most at those mostcritical times .

The PA Department of Drug and Alcohol Programs describes naloxone as a medication that blocks theeffects of opioids on the brain, restores breathing and reverses the effects of opioids on the brain andrespiratory system to prevent death.

Community members, family and friends are also eligible to secure a naloxone prescription and administerthe drug. Training on how to administer it is available at getnaloxonenow.org.

The law also includes a "Good Samaritan" provision that provides criminal and civil protections for anyonewho witnesses an overdose and calls the authorities.

LENGTH OF TREATMENT TIMELINE

2001Pain treatmentbecomes a priorityof the JointCommission, anonprofit settingstandards andaccrediting hospitalsand medical centers

1914The HarrisonNarcotics TaxActimposes a tax onthose making,importing or sellingderivatives of opiumor coca leaves;*Doctors were awareof the highly addictivenature of opioids

2016The FDA and CDCbegin taking steps toaddress the opioidabuse epidemic.Dr. Tom Frieden, acontributor to the NewEngland Journal ofMedicine, wrote that"We know of no othermedication routinelyused for a nonfatalcondition that killspatients so frequently"

19705Percocet & Vicodinenter the market;doctors are taught toavoid prescribing dueto high likelihood ofaddiction

2009The Joint

Commissionrescinds its

standard to assesspain in all patients

(Source: CNN)

1924Heroin becomes

illegal

2010OxyContin

reformulates pillsto deter abuse;

66% of thosesurveyed saidthey switchedto using other

opioids

1996Birth of OxyContin

Early 19005The Bayer Co.

produces heroinon a commercial

scale, touting it as a"wonderd rug."

19505 - 19605Nerve Block Clinics

are opened as ameans to manage

pain without surgery

DRUG TAKE-BACKLOCATIONSIn an effort to reduce prescription drug abuse andkeep our environment free from contaminants,prescription drug take-back locations are availablethroughout PA. The take-back locations offer a safeway to dispose of prescriptions that you no longerneed but are unsure of how to dispose of them.As PA works to tackle the heroin/opiate epidemic,it is imperative to keep prescription drugs out ofthe hands of vulnerable citizens. Visit https://is.gd/RxTakeBack to find the closest location.

The National Institute on Drug Abuse (NIDA) states thatthere is no fixed length of treatment for drug addictiontreatment. Individuals progress from addiction torecovery in varying stages. While program offerings varyfrom 7 Day Detox to 28 Day Stays, the NIDA declaresthat outpatient or residential treatments with less than 90days of treatment have limited effectiveness. Basically,the longer the treatment, the more successful thetransition from addiction to recovery.

Drug courts in PA combine intensive judicial supervision,mandatory drug testing, treatment and incentives tohelp offenders with substance abuse problems breakthe cycle of addiction and crime. On average, it takes 18months from sentencing to program completion.

Meanwhile, some treatment programs for physiciansand commercial airline pilots have five years of casemanagement to ensure successful recovery. Differenttreatments,includingmedication­assisted­treatment,will workfor differentpatients,so it isimportant todeterminethe besttreatmentfor theperson Inrecovery.

THE PA MEDICAL SOCIETY'S OPIOIDS FOR PAIN INITIATIVE:BE SMART. BE SAFE. BE SURE.

The Pennsylvania Medical Society is working to craftsolutions to help fight the war on opioid abuse. Accordingto an article from the Lancaster Medical Society, a multi­pronged approach involving physicians, patients andhealth care organizations is coming together to addressthe crisis. Their most recent initiative, Opioids far Pain:Be Smart. Be Safe. Be Sure. includes a call to action forphysicians and the following questions that patients areurged ta ask their physicians:

The Physicians Call to Action Patient Empowerment

All Pennsylvania physicians should takethese five steps:

1. Know the prescribingguidelines

2. Use Pennsylvania'sprescription drugmonitoring programonce it's up andrunning

3. Refer patients whohave a substanceuse disorder totreatment

4. Discuss alternatives to opioids withpatients

5. Ask patients to keep their pills safeand properly dispose of a prescribedmedication when they no longer need it

Patients should ask these seven questions whenprescribed a pill for pain:

1. Is this prescription an opioid?

2. At what level of pain should I take this prescription?

3. Do I have to take every pill in the prescription?

4. Where can I safely disposeof remaining pills?

5. What can I do to avoidaddiction?

6. What are possible warningsigns of dependence oraddiction?

7. What can I do if Ibelieve that I might havedeveloped a dependenceon this drug?

ABOUT HOUSE DEMOCRATICPOLICY COMMITTEERep. Sturla is chair of the House Democratic Policy Committee,which prepared this document. This Policy Committee holdspublic hearings and meetings across the state and servesas the catalyst to enacting major policy initiatives put forth bymembers of the House Democratic Caucus.

www.pahouse.com/Kulik

80%of heroin addicts started byabusing prescription meds.

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