Tag opioids

City & State: Albany’s checklist of health care bills

By Rebecca Lewis, 12/10/18

Single-payer health care may be one of the biggest debates in Albany in 2019, but it’s just one of a number of high-profile issues dealing with medical matters. Here are summaries of several health care issues expected to be at the top of the agenda.

✓ Reproductive Health Act

Although the Reproductive Health Act has passed in the Assembly the past two years, it has yet to come up for a vote in the state Senate. A priority for many Democrats in the chamber – and, importantly, for Gov. Andrew Cuomo, who said he wants it done in January – the bill would update the state’s abortion laws and codify federal protections into state law. Although abortion rights are guaranteed under the landmark Roe v. Wade U.S. Supreme Court decision, the laws on the books in New York were passed in 1970, three years before that decision. Although the state’s laws were considered progressive at the time, they have not been updated since. Democrats have argued that if a bloc of conservative judges on the Supreme Court overturned Roe v. Wade, abortion rights in the state would revert back to those passed in 1970. State Sen. Gustavo Rivera told City & State that he hopes the legislation will be addressed early in the upcoming session now that it has the votes to pass. “I would be willing to move that very quickly because I believe that it is very important, particularly with what’s happening on the national level,” said Rivera, who is likely to be named chairman of the state Senate Committee on Health.

✓ Single-payer health care

Perhaps the most expansive and expensive item on Democratic lawmakers’ agenda – and among the most controversial – is the New York Health Act, which would establish a single-payer health care system in the state and is estimated to cost $139 billion in 2022. Many incoming lawmakers campaigned on the promise that they would get it done, but even if it does pass, massive changes likely won’t happen right away. A single-payer system means that a single entity covers the cost of all health care, which is still delivered by private or nonprofit providers. Everyone pays into a single plan run by the government, which in turn is the only provider of coverage paying claims. Assemblyman Richard Gottfried’s bill has proposed one public option and a ban on the sale of private insurance unless it offers additional coverage not included in the state plan. One major obstacle the New York Health Act must overcome is a less than enthusiastic governor. Although Gov. Andrew Cuomo has expressed support for single-payer health care as a concept, he has repeatedly said that it would be better implemented at the national level. Other critics have raised concerns about the cost, although a study performed by the Rand Corp. that found total health care spending could be lower under the New York Health Act than if the status quo were to continue.

✓ Recreational and medical marijuana

The state has been slowly inching closer to legalizing recreational marijuana. Most notably, Gov. Andrew Cuomo has been coming around on the issue. Although he used to consider marijuana a “gateway drug,” the Cuomo administration this year released a report in favor of legalization, set up a working group to draft legislation and hosted a series of listening sessions across that state to gain public input. Although legislation to legalize the drug has never passed either chamber, public support has grown substantially, and candidates, such as former gubernatorial candidate Cynthia Nixon, campaigned on the promise of legalization. The state Legislature now appears poised to pass legislation that would regulate and tax marijuana.

However, the future of the state’s existing medical marijuana program remains in limbo. Assemblyman Richard Gottfried, who sponsored the bill creating the medical marijuana program and has been one of its strongest advocates, said that in the coming session, strengthening and expanding the program will be “a major focus,” as will ensuring that it continues to run smoothly alongside potential recreational legalization. “So how we do that, I don’t know yet. But I know there is a lot of concern and brainpower being focused on it,” Gottfried told City & State. State Sen. Gustavo Rivera said he hopes that recreational legalization would also open the door for additional research to increase and expand the drug’s medical efficacy.

✓​​​​​​​ Opioid epidemic

As the opioid epidemic continues to take lives across the state, state Sen. Gustavo Rivera told City & State that the state Senate intends to resume its work with the Task Force on Heroin and Opioid Addiction – first created in 2014 – and that state Senate Republicans could participate as well. When led by Republicans, the task force did not include Democrats. Additionally, Rivera said that the state Legislature will continue to explore the concept of harm reduction. The idea accepts that drug use will always be a part of society, but that society can take steps to cut down on the negative consequences of drugs. Namely, Rivera hopes to have productive conversations about a bill he sponsors to create safe injection sites, a highly controversial proposal to create legal locations where illegal drug users can get high in a supervised environment. “I believe that there is plenty of evidence-based programs that can be expanded and be created,” Rivera said. New York City Mayor Bill de Blasio championed a pilot program to open four such sites in the city, but the idea still faces major hurdles.

✓​​​​​​​​​​​​​​ Nurse staffing ratios

The issue of nurse staffing levels within hospitals has long been a priority of the New York State Nurses Association, a powerful union in the state. However, a bill on the subject has never passed the state Senate and rarely passes the Assembly. The main component of the bill would create a set ratio of patients per nurse to ensure that nurses are not overworked by caring for too many people, and to ensure that patients are receiving adequate care. However, other powerful interests have also opposed the legislation, including business groups and hospitals, who argue that while the bill addresses real problems with how care is administered, nurse staffing ratios are the wrong remedy. Like many pieces of legislation that have languished under Republican control of the state Senate, Democratic control of the chamber could give the bill a better chance to become law. “We’ve passed it before and I trust we will do it again,” said Assemblyman Richard Gottfried, who has long been a supporter of nurse staffing ratios. “And it’s very exciting that we now have a shot at having that pass the state Senate.”

Times Union: Capital Region hospital ERs join pilot to reduce opioid use

By Bethany Bump, October 24

ALBANY — A group of 17 upstate New York hospitals, including nine in the Capital Region, are embarking on a pilot program to reduce the use of opioids in their emergency departments.

The Iroquois Healthcare Association is spearheading the $500,000 Opioid Alternative Project, which was funded in this year’s state budget as part of wider efforts to curb the state’s opioid epidemic. The regional trade organization representing upstate hospitals and health systems modeled the pilot after a successful program in Colorado.

“Emergency rooms are often the first contact patients have with opioid painkillers,” said Gary Fitzgerald, president of the association. “As such, upstate New York hospitals are in a strong position to reduce opioid use, particularly as their emergency departments provide care for increasing patient populations vulnerable and at risk for opioid abuse and addiction.”

The Colorado pilot was established last year, and involved training physicians, nurses and other staff at 10 separate emergency departments in treatments other than opioids for certain pain diagnoses, such as acetaminophen for urinary stones or ketamine for musculoskeletal pain. It didn’t prohibit the use of opioids where appropriate, but encouraged clinicians to instead try evidence-based alternatives when presented with certain conditions.

Results exceeded expectations. Participating hospitals were able to decrease opioid use in their emergency departments by 36 percent over a six-month period compared to the same period one year earlier, while simultaneously holding patient satisfaction scores steady, according to a report published this year by the Colorado Hospital Association. The goal had been to reduce opioid use by 15 percent.

In New York, clinicians from participating hospitals met last month to establish their own protocols for alternative treatments, said Jessica Morelli, vice president of the Iroquois Healthcare Alliance.

Details are still being finalized, she said, but they broadly agreed to use alternatives to opioids such as acetaminophen, ibuprofen, ketamine, lidocaine and even caffeine for diagnoses ranging from urinary stones, back pain, sprains, minor fractures and dislocations, tooth pain, headaches and abdominal pain.

The protocols will lay out a “menu” of first- and second-line therapies, she said. Second-line therapies are treatments for when first-line options don’t work.

Participating hospitals in the Capital Region include Albany Medical Center, Ellis Hospital in Schenectady, Glens Falls Hospital, Nathan Littauer Hospital in Gloversville, Saratoga Hospital, St. Mary’s Healthcare in Amsterdam, Albany Memorial Hospital, St. Peter’s Hospital in Albany, and Samaritan Hospital in Troy.

“I am excited to be part of a regional approach to curbing opioid use,” said Dr. Adam Rowden, an emergency medicine physician at Albany Medical Center. “One of the best ways to prevent opioid misuse and dependence is to decrease their use and minimize exposure to patients not currently taking them. These guidelines are evidence-based and treat pain while minimizing the risks for opioids.”

Funding for the project will go toward clinician training, as well as data collection for the duration of the pilot, Morelli said.

State lawmakers who helped secure the funding expressed hope that the pilot can eventually provide a model for other emergency departments.

“Emergency departments are on the front line of the opioid crisis,” said Assemblyman Richard Gottfried, a Democrat who chairs the Assembly health committee. “These 17 hospitals can be models for broader training of emergency physicians to utilize opioid alternatives when clinically appropriate.”

Morelli noted that the pilot applies strictly to opioid use within emergency departments, not to prescriptions that patients may leave the hospital with — though a number of hospitals have cut down on the dosage and duration of opioid prescriptions they hand out as the drug epidemic has worsened.

The Villager – Gottfried and O’Donnell: Combat Opioids with Pot

By Sydney Pereira,  July 26

Manhattan assemblymembers hope medical marijuana can help curb the state’s opioid crisis. Two recent bills aim to increase access to medical pot to reduce the abuse of the potentially deadly painkillers.

One bill, from Assemblymember Richard Gottfried, has passed both the state Senate and Assembly; it would add substance use disorder to the list of conditions legally treatable by medical marijuana, plus would allow the use of medical pot in place of opioids for pain management. Assemblymember Danny O’Donnell’s legislation would add opioid use disorder as a condition treatable by medical marijuana. O’Donnell’s bill passed the Assembly in early June.

Gotham Gazette: To Help New Yorkers Quit Opioids, Expand Access to Medical Marijuana Now

By Garry Croney, June 16

As a 67-year-old cancer survivor who suffers from chronic pain as a result of cancer treatments, medical marijuana has allowed me to resume a more normal life free of addictive opioid medications. I hope that lawmakers will now consider expanding the state’s medical marijuana program so that more New Yorkers will have the same access to these important treatments as an alternative to the powerful prescription painkillers that sparked the opioid crisis in our state.

My experience is all too typical of how so many people can easily find themselves reliant on prescription painkillers. Following my retirement from the U.S. Navy and a career in retail management, I was diagnosed with colorectal cancer in December 2015 and underwent chemotherapy, radiation therapy, and abdominal perineal resection surgery the following year. As a result of these treatments, I developed debilitating peripheral neuropathy and chronic lower spine pain and was unable to function normally.

Public Hearing – Opioid Overdose Reversal Drugs

NOTICE OF PUBLIC HEARING

SUBJECT:  Opioid overdose reversal drugs: assessing and improving access to and availability of drugs to prevent opioid overdose deaths.

PURPOSE:  The purpose of this hearing is to examine access to and availability of opioid overdose reversal drugs, such as naloxone, and to identify, if necessary, means by which to expand access and availability statewide.

New York City
Thursday, May 17
11:00 A.M.
Assembly Hearing Room
19th Floor
250 Broadway

Opioid antagonists, such as naloxone, are potentially life-saving prescription medications used to reverse overdoses caused by heroin and opioids. New York State has made progress expanding access to naloxone and similar drugs. In 2006, New York State passed a law authorizing non-medical personnel to administer naloxone to individuals who seek it. A 2014 law expanded this to allow the prescribing, dispensing, and distribution of opioid antagonists by a non-patient specific order. In addition, many first responders now receive training to administer naloxone.

Gay City News: De Blasio Moves on Safer Consumption Spaces to Curb Overdoses

By Nathan Riley, May 4

BY NATHAN RILEY | A multi-year push in New York City to offer drug users a safe place for consuming their drugs seems destined for success after Mayor Bill de Blasio announced his support for “overdose prevention centers.”

Public health advocates voiced enthusiasm as the news spread on May 3 that the administration had reached out to Dr. Howard Zucker, the state health commissioner, for a go-ahead to open four Safer Consumption Spaces in the Bronx, Manhattan, and Brooklyn.

Legislative Gazette: Some lawmakers say that a growing opioid epidemic reflects need for ‘safe injection’ sites

By Otto Kratky, 2/20/18

As a way to keep needles out of public spaces, and to prevent overdose deaths, Assemblywoman Linda Rosenthal and 18 co-sponsors are advocating for a bill that would provide safe injection facilities where opioid drug abusers can safely “use” in New York state.

Staff members at these facilities would provide sterile injection supplies, collect used hypodermic needles and syringes, and teach patients about safe consumption practices. Patients will also be able to access referrals to addiction treatment, job training, and other social services.

City & State – Lawmakers: Obamacare repeal a complex and complicated equation for New York

By Ashley Hupfl, 2/21/17

The potential repeal of the Affordable Care Act and the uncertainty over what might replace it have state lawmakers warning of a major budget hole in New York – and wondering how to remedy it.

At City & State’s State of New York Finance event on Tuesday, a panel of lawmakers and industry officials had more questions than solutions for how the state will prepare for and respond to a full repeal of the health care law, widely known as Obamacare.