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Attorneys General Urge Passage of the Comprehensive Addiction and Recovery Act of 2015 to Address Nationwide Epidemic of Heroin and Opioid Addiction and Abuse

Kilmartin to Lead Attorneys General Conference on Opioid Abuse, Addiction and Overdose Epidemic

Kilmartin Secures Rebate on Naloxone

As states continue to address the epidemic of heroin and opioid-based painkiller abuse and addiction and its devastating effect on public health and safety in communities, Attorney General Peter F. Kilmartin and attorneys general from 37 states plus the District of Columbia today sent a letter to the leadership of the Committee on the Judiciary for the United States Senate and House of Representatives urging passage of the Comprehensive Addiction and Recovery Act of 2015 (S. 524/HR 953).

The Comprehensive Addiction and Recovery Act would provide states with the necessary tools to more effectively confront the growing challenge of heroin and opioid abuse and addiction.

Attorney General Peter F. Kilmartin announced the advocacy of the attorneys general for the Act at a press conference on Tuesday at the Providence Center, where he also announced that the opioid crisis would be the focus of the upcoming National Association of Attorneys General (NAAG) Eastern Region meeting in October. Kilmartin serves as chair of the NAAG Eastern Region. In addition, Kilmartin announced that his Office reached an agreement with Amphastar Pharmaceuticals, Inc. under which the company will offer a rebate on each dose of Naloxone, the drug that counters the effects of opioid overdose, purchased.

AGs Urge Passage of the Comprehensive Addiction and Recovery Act of 2015 Attorney General Kilmartin spearheaded the attorneys general initiative to support the Act as a personal commitment to the late Jim Gillen, a well-known and outspoken advocate for addiction recovery in Rhode Island. Kilmartin and Gillen spoke at length about the resources needed to properly assist those struggling with addiction and recovery at a roundtable discussion at Anchor Recovery Center, which was attended by Senator Sheldon Whitehouse, the lead sponsor of the Act.

"There was no one more knowledgeable than Jim on how to effectively address addiction and recovery, and I am honored and humbled to serve as an advocate in his memory to push for the passage of this critically important Act," said Attorney General Kilmartin. "I also commend Senator Whitehouse for his leadership on this issue and his unwavering support to provide states with the resources they need to battle this epidemic."

"To tackle the addiction and overdose crisis in Rhode Island and communities nationwide, everyone who deals with this problem needs to be involved – from health care providers, to educators, to law enforcement. That's why I'm especially grateful to Attorney General Kilmartin and his counterparts for joining me in this effort," said Whitehouse. "This bill will give law enforcement leaders like our attorneys general better tools to address drug-related crime and addiction among offenders, and better support those who are following the difficult but noble path to recovery. Thank you to Attorney General Kilmartin and the NAAG for their support."

According to the Centers for Disease Control and Prevention, drug overdoses now surpass automobile accidents as the leading cause of injury-related death for Americans between the ages of 25 and 64. More than 100 Americans die as a result of overdose in this country every day – more than half of them caused by prescription drugs or heroin.

"We know that addiction is a treatable disease, but we also know that only about 10 percent of those who need treatment are receiving it. And, while heroin and opioid abuse are the primary concern for states right now, we must move beyond simple responses to drug trends and emerging threats, and concentrate on improving addiction treatment and recovery nationwide," said Attorney General Kilmartin.

In the letters, the attorneys general write, "Law enforcement has always been on the frontline when it comes to drug crises, but we cannot arrest ourselves out of this current epidemic. Research shows the best way to address this challenge is though a strategy that includes prevention, law enforcement, reduction of overdose deaths, evidence-based treatment, and support for those in, or seeking, recovery." The Comprehensive Addiction and Recovery Act of 2015 will:

• Expand prevention and educational efforts – particularly aimed at teens, parents and other caretakers, and aging populations – to prevent the abuse of opioids and heroin and to promote treatment and recovery;

• Expand the availability of Naloxone to law enforcement agencies and other first responders to help in the reversal of overdoses to save lives;

• Expand resources to identify and treat incarcerated individuals suffering from addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence-based treatment;

• Expand disposal sites for unwanted prescription medications to keep them out of the hands of children and adolescents;

• Launch an evidence-based opioids and heroin treatment and intervention program to assist in treatment and recovery throughout the country; and

• Strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.

"Only through a comprehensive approach that leverages evidence-based law enforcement and health care services, including treatment, can we stop and reverse current trends," added Attorney General Kilmartin.

Dale K. Klatzker, Ph.D., President of the Providence Center, commented, "Working together to increase access to treatment and recovery support services for this chronic disease is critical. Together, we have made strides, but more still needs to be done. The steps outlined in the Comprehensive Addiction and Recovery Act of 2015 connects treatment and recovery - offering more effective and comprehensive solutions. We are proud to work with our partners to address this public health crisis."

Thomas Joyce, Associate Director of Anchor Recovery Community Center, added, "Local and national practices demonstrate that recovery support services, like the ones we offer at Anchor Recovery Community Center, have been successful at engaging those living with substance use disorders. We see recovery in action every day and are excited to see the development and expansion of recovery support services as a key part of the Comprehensive Addiction and Recovery Act of 2015. We commend Senator Whitehouse and Attorney General Kilmartin for their work on and dedication to building healthy communities."

"If we are going to be successful in ending this crisis, once and for all, prevention must play a very important role. We need to take care of those who are in the recovery process, and we need to educate people so they don't start down the path of abuse and addiction," said Nancy DeNuccio, of the Ocean State Prevention Alliance.

AGs Tackle Opioid Addiction Crisis at Upcoming Eastern Region Meeting

Attorney General Kilmartin also announced that the opioid addiction and overdose crisis will be the topic for the upcoming NAAG Eastern Region meeting scheduled for October 28th and 29th in New York City.

Speakers will include attorneys general, law enforcement experts, policy makers, and other stakeholders. Attendees and presenters will examine national and local trends in heroin and prescription opioid trafficking and abuse and explore opportunities for collaboration among the attorneys general and other law enforcement partners. Participants will learn how to most effectively generate and capture intelligence, including through the use of social media.

Attendees will also hear examples of investigations in which collaboration has led to success and will learn more about civil enforcement approaches and policy initiatives to combat heroin trafficking as well as effective prescription drug monitoring programs.

Dr. Traci Green, Associate Professor of Epidemiology and Associate Professor of Emergency Medicine at Brown University and Director of the Injury prevention Center at Boston Medical Center, will provide an overview of the problem and trends being seen by the medical community as well as opportunities for intervention.

Dr. Green chairs the Drug Overdose Prevention and Rescue Coalition for the Rhode Island Department of Health, and serves as an advisor to Governor Raimondo's Overdose Prevention and Intervention Task Force. Her research focuses on drug related injury, and novel methods for opioid overdose prevention and intervention.

"There is an enormous opportunity to change the course of the opioid addiction epidemic in New England. I look forward to speaking at the NAAG Eastern Region meeting, and sharing what we are seeing in Rhode Island, as well as what we are learning from our research on overdose prevention and what works," said Dr. Green.

United States Attorney Peter Neronha will also serve on a panel looking at how police and prosecutors generate and capture intelligence on individuals who traffic heroin and other opioid-based drugs.

"Rhode Island is not along in facing the opioid crisis – it is a regional and national crisis. Rather than try to solve the problem state by state, it is more effective and can have a greater impact if we pool resources and collaborate on solutions," said Attorney General Kilmartin. "We have put together a very strong agenda looking at the issue of opioids abuse and addiction from a medical and recovery perspective as well as a law enforcement and prosecution perspective."

AG Kilmartin Announces Agreement with Naloxone Manufacturer for Rebates

With the cost of the Naloxone, the drug that reverses an opioid overdose, more than doubling in the past year from approximately $17 per dose to approximately $39 per dose, Attorney General Kilmartin reached an agreement with Naloxone manufacturer Amphastar Pharmaceuticals, Inc. that will require the company to offer a $4 rebate for each Naloxone kit (syringe dosage only) purchased in Rhode Island by state agencies, municipal governments, state and municipal law enforcement agencies, emergency medical service agencies or non-profit community based programs.

To achieve greater savings, Attorney General Kilmartin also announced he will formally request that a line item be placed in the FY '17 budget calling for a statewide Naloxone bulk purchasing trust fund.

The agreement is a result of a request made by Attorney General Kilmartin to Amphastar in August 2015. In that request, Kilmartin recognized that the increased cost of the medication was prohibitive for many communities.

"For Rhode Island to successfully continue its overdose prevention work, the cost of Naloxone must be low and predictable. This agreement helps secure the affordability and availability of Naloxone kits and, as such, will save lives," said Attorney General Kilmartin. "While this rebate will help municipalities and non-profit organizations in the near term contain costs associated with purchasing Naloxone, we should look to take advantage of additional cost savings from bulk purchasing by creating a statewide trust fund."

Naloxone use in Rhode Island is increasing. In 2014, emergency medical providers administered more than 1,600 doses in the pre-hospital setting. The Rhode Island entities that dispense Naloxone to the community have distributed 2,500 doses between January 2014 and May 2015. Rhode Island's community-based overdose prevention programs distributed 950 doses for the same time period, which is more than double the doses distributed in prior years. And, in 2015, the legislation was signed that requires Rhode Island public middle, junior and high schools to maintain Naloxone on school premises.

Rhode Island's newly established model program for emergency departments dispense Naloxone to patients surviving an overdose, distributing 250 kits in the first six months of inception. The Department of corrections has more than 5,000 inmates in overdose prevention and response and is poised to distribute Naloxone to at-risk inmates upon release.

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