News

By Mary Hladky

    Facing an epidemic of drug overdose deaths, Florida lawmakers passed a number of bills in the recently completed legislative session that take steps to rein in the problem.
    “I think the Legislature has really developed an understanding of the impact of substance abuse disorders and mental health … and an understanding of the epidemic we are facing with heroin and opioids,” said Mark Fontaine, executive director of the Florida Alcohol and Drug Abuse Association. “These bills together show a deliberate effort by the Legislature to start addressing how we can be more effective to deliver care, respond to the opioid/heroin epidemic and coordinate services.”
    The legislative action comes as drug overdose deaths have surged in Palm Beach County, the state and the nation.
    The number of deaths jumped to 368 in the county last year, a 62.8 percent increase since 2013, according to data released by the Palm Beach County Medical Examiner’s Office in late February.
    Palm Beach County Chief Medical Examiner Dr. Michael Bell has said he thinks the mixing of heroin with fentanyl is causing the increase in drug overdose deaths.
    Nationally, drug overdose deaths have increased 137 percent since 2000, claiming nearly 500,000 lives, the Centers for Disease Control and Prevention reported in January. The biggest driver is the increased use of heroin and opioid pain relievers.

Drugs outlawed by category
    One of the most significant new laws in Florida is the Designer Drugs Enforcement Act, proposed by Attorney General Pam Bondi.
    The law bans categories of drugs, such as those related to synthetic marijuana, rather than individual chemical compounds. It is aimed at solving the perpetual problem of illicit drug makers tweaking the composition of a drug so that it is not on the list of illegal substances.
    “It advances the ability to classify dangerous substances as being illegal even before they appear,” said James Hall, a Nova Southeastern University epidemiologist who studies substance abuse and drug outbreaks.
    In the past, it could take years to recognize the threat of a new compound and await legislative action to outlaw it.
    “We have had over 300 new drugs appearing in the illicit market in the last 10 years,” Hall said.

Delivery of services reformed
    Lawmakers also approved wide-ranging reforms in a single bill aimed at improving the delivery of mental health and substance abuse treatment services.
    One key provision is a “no wrong door” policy so people who need treatment can get it regardless of whether they have committed a crime or have a personal crisis. It creates central receiving facilities intended to channel people to emergency care and intervention services.
    It also “aligns” the legal processes for assessment, evaluation and receipt of services under the Baker Act and the Marchman Act. The Baker act allows for involuntary examination or commitment of those with mental illnesses who may be a threat to themselves or others. The Marchman Act allows for involuntary commitment of those undergoing a substance abuse crisis.

Some other new laws
    • A pilot program for Miami-Dade County that will allow drug addicts to exchange their dirty needles for free, clean ones. The aim is to reduce new HIV and hepatitis C infections caused by sharing needles and to give drug users information about treatment programs and other resources.
    Hall said the hope is to expand the program statewide. “That has been identified as a critical need with the rise in opioid deaths across the state,” he said.
    The bill was stalled for three years in the legislature because some say it would encourage drug use, although studies have shown that is not the case, he said.
    • A requirement that pharmacies sell lock boxes for prescription drugs to prevent drugs from getting into the wrong hands and to display signs saying the boxes are available for purchase.
    • A tool to combat prescription opioid abuse by making it easier for physicians to prescribe abuse-deterrent prescription opioids. These pills are more difficult to crush by addicts who want to smoke, snort or inject the drugs. Crushing drugs bypasses time-release properties, making overdose more likely.
    While Hall and Fontaine are glad to see the new legislation, they said much work remains to be done.
    “Florida has not kept up with the demand for treatment,” Hall said. “Until we address addiction through treatment and prevention programs and intervention and counseling, the cycle will continue.”
    Fontaine agrees.
    “We remain behind the rest of the country in funding for mental health and substance abuse treatment in proportion to the population,” he said. “Some of the other states have taken a more aggressive approach to the heroin epidemic.”
    Substance abuse, especially the rising use of heroin, has become an urgent topic at the national level and addressed by both Republican and Democratic presidential candidates.
    In March, the U.S. Senate passed a broad drug treatment and prevention bill 94-1. The measure authorizes money for treatment programs for addicts, including those in jail. It also strengthens prescription drug monitoring programs and expands the availability of the drug naloxone, which helps reverse overdoses.
    But a fight continues over extra funding for the programs, and the fate of the legislation in the U.S. House is uncertain.
    Also in March, the Centers for Disease Control and Prevention released new guidelines for prescription painkillers, recommending that doctors try pain relievers such as ibuprofen before prescribing highly addictive pills.
    The guidelines are intended to change the practices of doctors dating back 20 years when they began prescribing opioids for routine pain. Since then, opioid painkillers such as OxyContin, Percocet and Vicodin have become the most widely prescribed drugs in the country.