DOVER, DE –The number of prescriptions written in Delaware for opioid pain medications has fallen since the enactment of new prescribing regulations by the Department of State earlier this year.

Statistics from the Division of Professional Regulation, which licenses controlled substance prescribers, show a 12-percent drop in opioid prescriptions statewide compared to the first quarter of 2017. The number of Delaware patients being treated with opioid medications has also declined by 8 percent over the same time period, the division reports.

“Limiting the availability of prescribed opioids that end up being diverted, sold and illegally abused is an important part our fight to stem the tide of opioid addiction in Delaware,” said Gov. John Carney. “Opioid prescription rates remain too high in Delaware, but this is an issue we will continue to address in a comprehensive way.”

The new regulations, which took effect April 1, were designed to help prescribers more closely monitor and control the use of opioids by their patients.

“A significant reduction in the number of pills being prescribed means a better chance that fewer end up on the street,” said Secretary of State Jeff Bullock. “Just as important, fewer people being prescribed opioids is a sign that medical professionals in Delaware may be changing their prescribing practices and relying less heavily on highly addictive opioids when better alternatives exist. Seven months into our new regulatory framework for opioids, we are seeing the results we had hoped for.”

Key elements of the new regulations are aimed at controlling the amount of opioids given to new patients and aggressively monitoring their treatment. First-time opioid prescriptions may not exceed a one week supply under the new rules. If further opioid prescriptions are deemed necessary, further action is required, including a physical exam with discussion of relevant patient history and the risks of opioids, and a check of the statewide Prescription Monitoring Program (PMP) database. In addition, the state’s new PMP Advisory Committee has begun the process of analyzing the practices of individual prescribers to ensure that they are following state laws and licensing standards.

“Although these are early results, they are encouraging,” said Attorney General Matt Denn. “The Secretary of State and the Division of Professional Regulation deserve a lot of credit for putting these new regulations into effect – they placed Delaware in the top tier of states nationally with respect to requiring the responsible prescription of opioids.”

The regulatory reforms complement efforts organized across state government and in cooperation with Delaware’s community of public health organizations and anti-addiction advocates.

“Each overdose death in our state represents a life lost. Gone are the hopes and dreams of someone’s child, brother or sister. We know that reducing the amount of opioids being prescribed is crucial toward saving lives and a key step in combatting the addiction epidemic,” said Lt. Gov. Bethany Hall-Long.

The newly established Behavioral Health Consortium, created this year by the General Assembly and chaired by Lt. Gov. Hall-Long, is working to develop an action plan that will prevent and treat substance use disorder, expand and improve mental health treatment and recovery and provide support for family members of loved ones who are battling addiction or coping with mental health issues.

The state’s Addiction Action Committee, also created by the General Assembly this year, is actively considering two other initiatives relating to the prescription of opioid drugs: possible legislation requiring health insurance coverage of alternatives to opioids for pain management, and possible state responses to the co-prescription of opioids and benzodiazapenes.

“We are grateful to the Division of Professional Regulation for enacting these new regulations,” said Dr. Karyl Rattay, director of the state’s Division of Public Health. “The bottom line is that precious lives will be saved by fewer people becoming addicted or having access to these dangerous drugs. We must continue our efforts to support safe opioid prescribing while ensuring individuals have access to alternative and more effective approaches to pain management.”

The Department of Health and Social Services also has boosted resources to help individuals struggling with addiction. Educational materials about identifying and fighting addiction can be found at HelpIsHereDE.com. Individuals who are suffering from addiction can also call DHSS’ 24/7 Crisis Hotline to be connected to treatment options. In New Castle County, call 800-652-2929, or Kent and Sussex Counties, call 800-345-6785.

Attorney General Matt Denn announced Wednesday that the Delaware Department of Justice has retained a national group of attorneys and experts to investigate and, if appropriate, file suit against opioid manufacturers, opioid distributors, and other entities that may have contributed to the opioid epidemic impacting Delaware.

“The goal is very simple,” Attorney General Denn said. “We will make sure that any entities responsible under Delaware law for creating this crisis help us solve it, and that they stop any practices still going on that are contributing to this crisis.”

The lead law firm retained by Delaware, Fields PLLC, has already filed national litigation against the opioid industry on behalf of the Cherokee Nation. The other firms working with Fields are Gilbert LLP, Connolly Gallagher LLP, and Dolt, Thompson, Shepherd & Conway. The team includes both Delaware attorneys and attorneys with subject matter expertise from around the country, including former Kentucky Attorney General Jack Conway. Former Deputy Assistant DEA Administrator Joseph Rannazzisi, who led the DEA’s Diversion Control Division and recently focused national attention on Congressional action to water down federal drug interdiction laws, will serve as a consulting member of the team

“Deaths from opioids have escalated dramatically over the past twenty years and become the public health crisis of the 21st Century,” said David Humes, board member of Delaware advocacy group atTAcK Addiction. “Should the investigation show evidence of wrongdoing, these firms must be held accountable and penalized for those deaths, the devastation they have caused families and provide treatment to those still in the throes of addiction.”

The selection of the law firms took place pursuant to a publicly-posted Request for Proposals, which prompted fourteen responses. The retained law firms, which were selected by a committee that included DOJ attorneys and a representative from the Department of Health and Social Services, will bear the expense of the investigation and litigation and will be compensated from any eventual recovery that the state may receive.

“I appreciate the hard work that the selection committee did in finding such an experienced and talented team to pursue these claims against the opioid industry,” Attorney General Denn said. “This will give us an ideal combination: the ability to act quickly and decisively as an independent state, along with the legal expertise and investigative resources necessary to pursue a matter of this magnitude involving companies with enormous resources.”

Under the retention agreement with the law firms, the Delaware Department of Justice will retain decision-making authority over all facets of the investigation and any litigation, including decisions about filing and settling lawsuits.

DOVER – With hundreds of lives being lost to drug overdoses each year in our state, Delaware will hold a Drug Take-Back Day on Saturday, October 28, 2017, to help reduce the risk of prescription medications being diverted for misuse. Delawareans can discard their expired or unused medications at 22 locations statewide between 10:00 a.m. and 2:00 p.m.

Organized by the Drug Enforcement Administration (DEA) and the Department of Health and Social Service (DHSS), the twice-a-year event has resulted in more than 70,000 pounds of medication being collected in 14 events. Properly discarding unused medications reduces the risk of addiction, keeps prescription medications out of the hands of people who may abuse them, helps prevent drug overdoses and protects groundwater.

“With the recent suspected overdose deaths in Kent County, people across the state are wondering what they can do to reduce the impact of addiction,” said DHSS Secretary Dr. Kara Odom Walker. “One concrete thing that everyone can do is to use Drug Take-Back Day as an opportunity to turn in your expired or unused medications. Tragically, in more than 80 percent of the 308 fatal overdoses in Delaware last year, the presence of one or more prescription drugs was detected.” National studies show that almost two-thirds of people who misuse prescription drugs get them from friends and family, including by raiding medicine cabinets, purses and drawers.

As of Oct. 18, 2017, there have been 180 suspected drug overdose deaths in Delaware. In 2016, 308 people died from drug overdoses, compared to 228 in 2015 and 222 in 2014.

In addition to the 22 participating sites in Drug Take-Back Day activities, there are also 21 permanent medicine drop-off locations across the state available year-round. In April, Walgreens became the first private Delaware retailer to install safe medicine disposal boxes. Six of Delaware’s permanent drop-off sites are in Walgreens pharmacies. The remaining 15 are located in local law enforcement agencies.

“Drug Take-Back Day is an important day to drop off medications, but we want people to be aware that they can safely dispose of unused and expired medications all year round,” said Division of Public Health (DPH) Director Dr. Karyl Rattay. “The permanent locations are an important tool in our fight against addiction, along with providing access to the drug overdose-reversing medication naloxone and getting those struggling with addiction into treatment.”

Delawareans seeking help for drug addiction, medical providers seeking information on patient education and treatment resources, or individuals searching for information about naloxone training classes and how to use the medicine, can visit www.HelpIsHereDE.com. The website, Delaware’s one-stop-shopping resource for information about education, prevention and treatment options for addiction, also features short testimonial videos from Delawareans in long-term recovery, parents who lost adult children to overdoses, a treatment provider and a police officer.

On Drug Take-Back Day, drugs for disposal must be in a container such as a pill bottle, box, blister pack, or zipped plastic bag, with personal information removed. Liquid medications must be in their original containers. Needles, aerosols, biohazard materials, medical equipment, and batteries will not be accepted.

For more details and a list of permanent collection sites, visit DPH at http://dhss.delaware.gov/dph/hsp/hhdrugtakeback.html or 302-744-4546, ext. 4; and the DEA at https://apps.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e1s1.

Delaware’s Drug Take-Back Day sites for Oct. 28, 2017 from 10:00 a.m. to 2:00 p.m. are:

New Castle County
Christiana Care Surgical Center, 4755 Ogletown Stanton Road, Newark, DE 19718
Daniel S. Frawley Stadium, 801 Shipyard Drive, Wilmington, DE 19801
Delaware City Police Department, 407 Clinton St., Delaware City, DE 19706
Delaware State Police Troop 2, 100 La Grange Ave., Newark, DE 19702
Middletown Police Department, 130 Hampden Road, Middletown, DE 19709
New Castle County Airport, 151 N. DuPont Highway, New Castle, DE 19720
New Castle County Police Department, 3601 N. DuPont Highway, New Castle, DE 19720
Newark Police Department, 220 South Main St., Newark, DE 19711 (permanent collection site)
Wilmington VA Medical Center, 1601 Kirkwood Highway, Wilmington, DE 19805

Kent County
Atlantic Apothecary, 103. S. Dupont Blvd., Suite 2, Smyrna, DE 19977
Camden Police Department, 1783 Friends Way, Camden, DE 19934
Cheswold Police Department, 691 Main St., Cheswold, DE 19936
Delaware State Police Troop 3, 3759 S. State St., Camden, DE 19934
Felton Police Department, 24 East Sewell St., Felton, DE 19943 (permanent collection site)
Milford Police Department, 400 N.E. Front St., Milford, DE 19963 (permanent collection site)

Sussex County
City of Lewes Board of Public Works, 129 Schley Ave., Lewes, DE 19958
Dagsboro Police Department, 33134 Main St., Dagsboro, DE 19939
Delaware State Police Troop 4, 23652 Shortly Road, Georgetown, DE 19947
Delaware State Police Troop 7, 18006 Coastal Highway, Lewes, DE 19958
Laurel Police Department, 205 Mechanic St., Laurel, DE 19956 (permanent collection site)
Milton Police Department, 101 Federal St., Milton, DE 19968
Ocean View Police Department, 201 Central Ave., Ocean View, DE 19970 (permanent collection site)

For further information on addiction recognition, prevention and treatment, visit www.helpisherede.com.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

Public Health asks OB/GYNs to screen pregnant women for substance use disorder

DOVER – Delaware and the nation are struggling with an addiction epidemic, a fact that is well known. Less well known is that the addiction epidemic is impacting pregnant women and their infants in increasing numbers. In 2016, there were 431 reports of substance exposed infants to the Department of Services for Children, Youth and Their Families, a sharp increase from the previous year.

The two most common substances found at birth in Delaware are marijuana and opioids, both of which are tied to either short and/or long term negative consequences for the infant. Alcohol exposure, which has the most well-documented long term negative impacts on an infant, is virtually impossible to detect immediately following birth but remains a serious problem throughout the country.

Responding to input from OB/GYN providers, the Division of Public Health (DPH) today announced new guidance and educational materials on the dangers of substance abuse while pregnant, and how to screen pregnant women for potential addiction and connect them with treatment. The materials will be available starting today at www.helpisherede.com/Health-Care-Providers#obgyn-resources.

“Pregnant women often do not realize the extent to which even minimal alcohol and drug use can harm their baby,” said Dr. Karyl Rattay, DPH director. “We also know that women struggling with addiction are less likely to access prenatal care and are significantly more likely to have an unplanned pregnancy. We want to work with the medical and treatment communities to increase awareness about the dangers of substance use while pregnant and connect those struggling with addiction to treatment.”

Delaware’s law, the Medical Practice Act, requires certified medical providers to give written, verbal and posted warnings to pregnant women regarding possible problems, complications, and injuries to them and/or to the fetus from consuming or using alcohol or cocaine, marijuana, heroin, and other narcotics during pregnancy (Delaware Code, Title 24, Chapter 17 (Medical Practice Act), Subchapter V, §1769A).

Under House Concurrent Resolution 44 – sponsored by Representative Ruth Briggs King and Senator Ernie Lopez – the General Assembly has designated September 17 – 23 as “Awareness Week for the Prevention, Recognition, and Treatment of Prenatal Substance Exposure in Infants and to Support Healthy Families in Delaware.”

“Little things have a big impact on unborn and newborn infants. We must protect the health and welfare of the most innocent and vulnerable to enable them to have a healthy outcome,” said Rep. Briggs King. “Delaware is faced with many challenges in our war on heroin and opioid addictions. Families and their futures depend on us to be leaders; therefore, it is imperative that we develop and deploy a strategy. When we know better, we do better. The sooner we share, learn, and act, the faster we see positive results.”

Delaware first began to address this issue last year. In 2016, it was one of the states selected for Substance Exposed Infants In-Depth Technical Assistance (SEI IDTA), funded by the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, and the Administration on Children, Youth and Families, and provided by the National Center on Substance Abuse and Child Welfare. The Delaware Child Health Protection Accountability Commission, Department of Health and Social Services, Department of Services for Children, Youth and their Families, March of Dimes, Delaware Healthy Mother and Infant Consortium (DHMIC), Fetal Alcohol Task Force, Connections, medical providers, and many others have begun work to:

• Survey birth hospitals and obstetricians and gynecologists on their experiences and needs to help them address the addiction epidemic.
• Increase screening of reproductive age women who may be at risk for substance abuse addiction, and increase links to treatment and home visiting services.
• Educate physicians on the signs and symptoms of addiction in pregnant patients, and how to refer patients to treatment.
• Reduce stigma around maternal substance use, and highlight the role of addiction as a chronic disease and the importance of connecting families to support, not punitive measures.
• Develop a system where infants born substance exposed and their families receive the medical treatments and supports they need as part of the federally-required “Plan of Safe Care” process. The revised federal rule requires states to address the health and substance use disorder treatment needs of the infant and family.
• Link to the Delaware Contraception Access Now (Delaware CAN) program to help women get access to effective contraception immediately postpartum.

“The Child Protection Accountability Commission Committee on Substance Exposed Infants Task Force sought the federally funded In-Depth Technical Assistance in response to the addiction epidemic and the impact it is having on our infants and families in Delaware,” said Jennifer Donahue, Esq. and co-chair of the SEI IDTA with Public Health. “We are now in the process of building a system of care that is better equipped to help pregnant women struggling with addiction, and, following the birth, to ensure that mothers and infants have the services, treatment, and supports they need to thrive as a family unit.”

Added Dr. David Paul, DHMIC Chairman and Christiana Care Heath System Chair of Pediatrics, “We have seen a sharp increase in newborns struggling with neonatal abstinence syndrome and have worked hard to standardize our medical care, minimize length of hospital stay and assure safe transition from hospital to home in this population of infants. By engaging multiple stakeholders throughout the state, we are making great strides in improving outcomes and assuring that babies with neonatal abstinence syndrome start their life as safely and healthy as possible.”

“Like many states across the nation, Delaware has experienced a sharp increase in the number of babies who have been born substance exposed,” said Trenee Parker, deputy director of the Division of Family Services in Delaware’s Department of Services for Children, Youth and Their Families. “We are more committed than ever to address the varied needs of this vulnerable population and to continue to work collaboratively with our system partners, advocates, and families to ensure healthy outcomes for Delaware’s children and their families.”

To find the screening materials and more information about substance use disorders, addiction, and where to find treatment, visit the Help is Here website at www.helpisherede.com, or call DHSS’ 24/7 Crisis Services Hotline at 1-800-652-2929 in New Castle County, or 1-800-345-6785 in Kent and Sussex counties. If someone is too drowsy to answer questions, is having difficulty breathing, or appears to be so asleep they cannot be awakened, call 9-1-1 immediately.

Data indicates that the unplanned pregnancy rate of women struggling with addiction is very high – up to 90 percent in one study. Through the Delaware CAN initiative, any woman who wants access to effective contraception can get it for free. To find Delaware CAN participating providers, visit www.upstream.org/delawarecan or call DPH’s Family Planning office at 302-744-4552.

A person who is deaf, hard-of-hearing, deaf-blind or speech-disabled can call the DPH phone number above by using TTY services. Dial 7-1-1 or 800-232-5460 to type your conversation to a relay operator, who reads your conversation to a hearing person at DPH. The relay operator types the hearing person’s spoken words back to the TTY user. To learn more about TTY availability in Delaware, visit http://delawarerelay.com.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations. DPH, a division of DHSS, urges Delawareans to make healthier choices with the 5-2-1 Almost None campaign: eat 5 or more fruits and vegetables each day, have no more than 2 hours of recreational screen time each day (includes TV, computer, gaming), get 1 or more hours of physical activity each day, and drink almost no sugary beverages.

New laws expand access to substance abuse treatment, remove insurance barriers, and strengthen oversight of prescriptions

WILMINGTON, Del. – Governor John Carney on Tuesday signed into law Senate Bill 41, House Bill 91, and House Bill 100, a bipartisan package of legislation that will expand access to substance abuse treatment, strengthen oversight of opioid prescriptions, and combat Delaware’s addiction crisis.

Governor Carney signed the legislation during a ceremony that included remarks from Attorney General Matt Denn, members of the General Assembly, and Delaware advocates for improved access to substance abuse treatment – including families who have lost loved ones to Delaware’s opioid epidemic.

“Far too many Delawareans, and Delaware families, have been affected by this crisis,” said Governor Carney. “These new laws represent a significant step forward in our efforts to combat Delaware’s addiction epidemic. To the Delaware families who have lost loved ones to addiction, and who are now fighting to prevent others from experiencing the same fate, your work is nothing short of inspiring. To the Delawareans who are using your own experience with substance abuse to help others, know that you are making a difference. We will continue to follow your lead. Thank you to Attorney General Denn and members of the General Assembly for your continued urgency on this issue.”

“The credit for these bills should go to the Delawareans who have overcome substance abuse, and the families who lost loved ones to drug overdoses, who stepped forward and shared their thoughts about where the system was failing and how it could be improved,” said Attorney General Matt Denn. “We listened and tried to turn their suggestions into laws, but the ideas came from those families, and after giving us the ideas they stood shoulder to shoulder with us to make sure the bills were passed.”

“I truly feel that every life matters,” said MaryBeth Cichocki, who lost her son to opioid addiction, and advocated for the new laws. “We are all one injury or surgery away from the disease that continues to take the lives of those we love. As long as I breathe, Matt will continue to live.”

“We are grateful for all those responsible for the passing of these bills,” said Don Keister, a founder of atTAcK Addiction, whose son lost his battle with addiction. “When families need help, it’s important that services are available without additional delays. If these laws had been around when our son was battling this disease, he may still be alive today.”

Legislation signed into law on Tuesday will take a number of steps to expand access to substance abuse treatment, target barriers to insurance coverage, and improve Delaware’s response to the addiction epidemic.

The package will:

• Prevent private insurers from using pre-authorization and referral requirements to delay access to substance abuse treatment;
• Require insurance companies to cover 14 days of substance abuse treatment before conducting a “utilization review” that can delay treatment;
• Limit insurance companies from denying substance abuse treatment based on “medical necessity” grounds;
• Allow the Department of Justice to use consumer protection funds to advocate for those being denied coverage based on “medical necessity” grounds;
• Establish a new committee to help oversee opioid prescriptions, and strengthen the oversight of over-prescription.

“Even with limitless support, battling addiction is incredibly difficult. But it shouldn’t be made harder by insurance companies and health care providers standing in the way of critical treatment,” said Senate Majority Leader Margaret Rose Henry, the lead Senate sponsor of House Bill 100. “I am grateful to Governor Carney for signing this important legislation into law, so Delawareans never again have to worry about whether they’re covered by insurance before seeking substance abuse treatment that could save their lives.”

“Delawareans who take the initiative to seek treatment for substance abuse shouldn’t have to wade through red tape to get the help they need,” said Senator Stephanie Hansen, the prime sponsor of Senate Bill 41. “I appreciate the Attorney General’s leadership in helping us pass this important legislation, which ensures that insurance companies are forbidden from imposing pre-certifications, screenings, prior authorizations or referrals for those ready to make the potentially life-saving decision to get help.”

“In light of the scourge of addiction, we need to get these people appropriate treatment, when it’s needed,” said Senator Dave Lawson. “Current coverages are insufficient.”

“These measures are necessary first steps towards addressing the needs of a significant portion of the more than 90,000 Delawareans currently suffering from addiction. We mustn’t fail to provide safety-nets for those in need of immediate treatment, and we must work to ensure current policies align with the increasing needs of Delawareans affected by addiction,” said Senator Anthony Delcollo. “Lastly, we cannot continue to operate in a vacuum when addressing addiction, and I am committed to working with my colleagues to aggressively pursue solutions to improve the lives of almost 100,000 Delawareans affected by this horrific disease.”

“If people struggle and stumble as they seek treatment, they should have the ability to come back and get treated again. Addiction is a disease, just like cancer and diabetes, and should be considered as one when it comes to medical treatment. Delawareans struggling with addiction should be extended a helping hand when they seek treatment, not have the door shut in their faces,” said Representative Helene Keeley, the prime sponsor of House Bill 100. “These combined efforts provide us with the necessary resources to battle the opioid epidemic in the First State and remove the stigma associated with substance abuse.”

“These bills will help save lives in Delaware and I am proud to be part of this effort to combat the disease of addiction. Substance abuse treatment helps people reintegrate into society and lead productive lives,” said Representative Michael Mulrooney, the prime sponsor of House Bill 91. “If we deny people suffering from substance abuse the treatment they need, it can lead them to relapse and either end up in the criminal justice system or worse.”

“This package of legislation represents best practices that we are implementing in Delaware in order to strategically address our concerns in battling the heroin and opioid epidemic,” said Representative Ruth Briggs King. “And, we are not done yet. Other bills, such as the substance-exposed infant legislation is working its way through Legislative Hall and should be our next primary focus in this ongoing effort to combat this epidemic.”

“These bills are key to fighting the opioid epidemic in Delaware because they address a very important component of this process – making sure adequate treatment is available to those who need it,” said Representative Tim Dukes. “Without access to treatment, all our efforts may as well be considered for nothing.”

“Collectively, these bills also add to the public awareness that addiction is a disease, that it can be treated, and people do recover,” said Dr. Kara Odom Walker, Secretary of the Department of Health and Social Services. “With addiction, we know that when people are ready for treatment, the window can be small in terms of connecting them to that critical care. At the Department of Health and Social Services, we will do everything in our power to connect that person to the treatment they seek.”

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