(1) The general assembly finds that:
In an effort to address the growing opioid addiction problem throughout the nation,on July 22, 2016, President Obama signed into law the federal "Comprehensive Addiction and Recovery Act of 2016", also referred to as "CARA";
CARA authorizes qualified nurse practitioners and physician assistants in community- and office-based practice settings to prescribe certain medications used in the treatment of opioid addiction as a means of increasing access to treatment for opioid-dependent patients;
Opioid addiction has emerged as a significant public health concern in Colorado,with over ten thousand deaths attributed to drug overdose since 2000 and the annual rate of drug overdose deaths doubling from 7.8 deaths per one hundred thousand people in 2000 to 15.7 deaths per one hundred thousand people in 2015, a rate significantly higher than the national rate;
Southeast Colorado comprises six percent of the state's population and accounts foreighteen percent of admissions for heroin treatment, the Pueblo county jail sees over one thousand seven hundred opioid protocol prisoners each year, and the Pueblo fire department used an opioid antagonist to halt an opioid-related drug overdose event one hundred forty times in 2015;
In Routt county, drug overdose death rates have increased nearly six-fold from 2014 to 2016, and over sixty-five percent of these deaths were related to prescription opioids;
Despite the prevalence of opioid addiction and opioid-related overdose events in Pueblo and Routt counties, only three doctors in Pueblo county and one doctor in Routt county are able to provide medication-assisted treatment to opioid-dependent patients in those counties;
Medication-assisted treatment, which includes the use of medication and behavioraltherapies to treat individuals with opioid addictive disorders:
Has proven to be clinically effective and to significantly reduce the need for inpatientdetoxification services for individuals with opioid addictive disorders;
Provides a comprehensive, individually tailored program of treatment for opioiddependent patients;
Is intended to achieve full recovery;
Can contribute to lowering a person's risk of contracting HIV or hepatitis C byreducing the potential for relapse; and
Has improved patient survival rates, increased retention in treatment, decreased illicit opioid use and other criminal activity among individuals with substance abuse disorders, increased patients' ability to attain and retain employment, and improved birth outcomes among pregnant women who have substance use disorders;
(h) In order to increase access to addiction treatment in areas of the state where opioid addiction is prevalent, it is necessary to establish a pilot program to award grants to:
Organizations or practices with nurse practitioners and physician assistants to enablethem to obtain the training and ongoing support required to prescribe medications, such as buprenorphine and all other medications and therapies approved by the federal food and drug administration, to treat opioid use disorders; and
Community agencies to provide behavioral therapies, in conjunction with medication treatment, to treat individuals with opioid use disorders; and
(i) Since the pilot program will provide access to treatment to individuals with substance use disorders, the use of retail marijuana tax revenues to fund the pilot program is authorized under section 39-28.8-501 (2)(b)(IV)(C).
(2) The general assembly further finds that:
(a) Since its creation, the pilot program has achieved numerous successes toward program goals as follows:
(I) With regard to the program goal of increasing the number of advanced practice providers able to prescribe medications to treat individuals with opioid use disorders in Pueblo and Routt counties:
Two medication-assisted treatment (MAT) programs in Pueblo county were selectedto receive funding and one MAT program was started in Routt county;
As of August 2018, four providers certified to prescribe MAT medications wereadded to the two MAT programs in Pueblo county and six MAT medication-certified prescribers are available in the Routt county program; and
Through July 1, 2018, fifty providers received education on opioid use disorders andrelated issues in assessment and treatment; and
(II) With regard to the program goal of increasing access to MAT services in Pueblo and Routt counties:
Pueblo county increased MAT services from a total of ninety-nine clients treatedthrough its two MAT programs in 2017 to five hundred seventy-six clients treated through the two programs through October 2018; and
Routt county had very limited MAT services available in 2017 and, through Octoberof 2018, provided MAT services through its new MAT program to fifty clients;
Given the successes of the program in expanding access to MAT services in Puebloand Routt counties, the pilot program should be extended and made available to additional areas of the state that are experiencing significant public health concerns due to the prevalence of opioid addiction and overdose incidences and inadequate numbers of providers;
In the San Luis valley, which has approximately fifty thousand residents and consistsof the counties of Alamosa, Conejos, Costilla, Custer, Huerfano, Mineral, Rio Grande, and Saguache, opioid overdoses have been increasing since 2010, with recent reports of more than ten overdoses per one hundred thousand in population yearly in each of the counties in the valley;
Huerfano county, which has about six thousand six hundred residents, had six overdose deaths in 2016, a rate of 152.6 per one hundred thousand in population, which was the highest overdose rate for any county in the state;
Many other counties in the state are also experiencing high incidences of overdoseand lack available, qualified providers to meet the addiction treatment needs in the county;
Given the prevalence of opioid overdoses in the San Luis valley and other areas ofthe state, it is necessary to extend the pilot program established pursuant to this part 8 for an additional two years, expand its availability to critical-need areas of the state, and increase its funding in order to increase access to addiction treatment in these areas where opioid addiction and overdose incidences are at significant levels.
Source: L. 2017: Entire part added, (SB 17-074), ch. 226, p. 870, § 1, effective May 22. L. 2019: (2) added, (SB 19-001), ch. 173, p. 2002, § 1, effective May 14.
Cross references: For section 303 of the federal "Comprehensive Addiction and Recovery Act of 2016", see Pub.L. 114-198.