We also learn, from the Healthy Americans website, that Alabama lags behind many other states in its recruitment of mental health professionals. The substance abuse counselors licensed and certified to treat opiate abuse in Alabama number fewer than 79 throughout the entire state.
How does Alabama compare to other states? While Vermont has seized a spot on the public’s radar in its fight against heroin and other opiate-related deaths, it is far from the worst state. With drug overdoses identified as the leading cause of injury-related deaths, Vermont has 9.7 such deaths per 100,000 people. But drug overdose deaths including those from opiate abuse in Alabama come in at 11.8 deaths per 100,000 people. When will it all stop?
It was not until 2012 that public health officials took a long, hard look at prescription opiate abuse in Alabama. An official from Express Scripts, a mail order pharmacy service, reported that 1.17 prescriptions for opiate medications were filled for every privately-insured person living in Alabama. Compare that to the national average of 0.67 prescriptions per person, and the figures become even more frightening.
Alabama’s failure to pay closer attention to the opiate epidemic sweeping the country pulls money out of taxpayers’ pockets, too. Just the cost of unnecessary medical testing that results from pharmacy fraud including diverted prescriptions amounts to 41 dollars for every dollar spent. That cost to Mr. and Mrs. Alabama Taxpayer doesn’t even factor in the cost of substance abuse treatment for opiate abuse in Alabama.
How Can Officials Reduce Opiate Abuse in Alabama?
There are ten identified steps that states can take to reduce deaths from opiates, and the Trust for America’s Health keeps report cards on all fifty states. Opiate abuse in Alabama might be reduced if state officials will engage in more of the steps. As of this writing, they only comply with five of the 10 recommendations.
- The existence of a prescription drug monitoring program (PDMP) is an important factor in preventing opiate abuse. In Alabama, and in 48 other states, prescribing health professionals—not only physicians but nurse practitioners and physicians assistants—and pharmacists have access to a website that will indicate how often a person fills opiate drug prescriptions and also who is prescribing them. Score a point.
- Alabama fails, however, to reinforce utilization of the PDMP. With no mandate to monitor prescription drug abuse, there are no teeth in the PDMP legislation. Point off.
- Doctor-shopping laws in various states prohibit a person from receiving opiate prescriptions from multiple prescribers. It’s illegal to go to a doctor and withhold the fact that you have a prescription for opiates from, say, your dentist or an orthopedic surgeon. Point up for Alabama—until you read the language, which, again, is weak.
- Alabama fails dismally in the category identified for state funding of substance abuse treatment. Alabama has some of the strictest requirements for Medicaid eligibility to begin with, and the governor stubbornly refused to consider Medicaid expansion. If he changes his mind, as indicated by Brian Lyman in the Montgomery Advertiser, the expansion would be linked to employment requirements and adjunctive support by private insurers. No point scored here.
- The next identified step in reducing deaths from opiate abuse in Alabama would require the education of prescribers. More information about the potential of addiction to prescription opiates and alternative ways to manage pain would be made available. While 22 states require prescriber education on this subject, Alabama does not. No point.
- Alabama also lacks a Good Samaritan law that protects people from arrest and prosecution if they request medical assistance when someone has overdosed and is in imminent danger of death. That includes a person who calls because of their own overdose, or a person who requests help for someone else. Another point not earned.
- Actually, there was Good Samaritan wording written into the rescue drug law that the governor signed in June 2015, but legislators had to remove that wording before the governor would approve the rescue drugs. Maybe down the road they can figure out how to get it approved. In the meantime, the governor approved the use and availability of naloxone—more commonly known as Narcan—to prevent deaths from opiate abuse in Alabama. Good show, Alabama gets the point.
- Alabama also requires all prescribers of opiate prescription drugs to perform physicals on their patients. That means the chances are improved that a primary care practitioner will become aware when a patient is abusing opiates or falls into a high-risk category for said abuse. Point up.
- There are 32 states that require pharmacists to look at patient photo IDs before they dispense narcotic medications. Alabama is not one of those states. No point scored.
- Alabama does, however, fall into step with 46 other states that mandate participation in pharmacy lock-in programs for identified abusers. That means that known serial doctor shoppers can be limited to the use of one pharmacy for the fulfillment of all controlled substance prescriptions. That scores a point for Alabama.
If you’ve been keeping track of Alabama’s participation in these drug-prevention suggestions, the score is 5—putting them behind 41 other states. There is still much to do, some of which costs the taxpayer little to nothing in terms of tax dollars. Measures reducing opiate abuse in Alabama have much room for improvement. Whenever you become aware of legislation pending within your local community, call your congressman to reinforce your support. And if you have questions, pick up the phone and call your local program for opiate abuse in Alabama. You’ll be glad you learned more about this subject—because it has an effect on us all.