With opioids killing more people than any other health crisis in Pennsylvania's modern history, Gov. Tom Wolf on Wednesday declared a disaster emergency that suspends regulations hindering access to addiction care.
It's the first time a disaster emergency has been declared for a public health crisis in the commonwealth. Usually, disaster emergencies are reserved for major weather events such as a hurricane or for a terrorist attack.
"I don't take this action lightly. We know that this crisis has taken far too many lives. It has broken far too many families. It has decimated far too many communities and it has gone on for far too long," Wolf said at an event formally announcing the declaration at the State Capitol in Harrisburg.
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The move eases some regulations that have been barriers to help for the addicted and their families. It will expire in 90 days as required by the state Constitution.
The opioid epidemic has hit the commonwealth hard over the past few years. Pennsylvania has the fourth-highest overdose death rate in the United States. Preliminary data shared by Wolf shows 5,260 people died from drug overdoses in 2017 — the highest tally ever recorded and a nearly 15-percent jump over the previous year.
The proliferation of illicit fentanyl, a synthetic opioid designed for use in medical settings that can cause an overdose in minuscule amounts, has been a principal cause in large jumps in overdoses and deaths. Cities and states across the country have been grappling with the same issue.
Last year, Philadelphia began implementing recommendations from Mayor Jim Kenney's Heroin Task Force, including increasing access to medicine-assisted treatment and court diversion programs. The Philadelphia Fire Department will launch an EMS unit this summer that's dedicated to responding specifically to drug overdoses in the city's Kensington and Fairhill neighborhoods. Officials have also been mulling establishing the nation's first safe-injection site, where users could take drugs in a monitored environment.
Philadelphia is home to the highest overdose numbers in the state, which city officials say may have hit 1,200 deaths last year. They're still certifying the final numbers.
The emergency disaster declaration waives a state requirement that a doctor must have a face-to-face interaction with a person before admitting them into a treatment program. Hospitals won't be required to get a separate license to offer treatment, either.
Jennifer Smith, secretary of the state Department of Drug and Alcohol Programs, said she'll be able to quickly say yes to removing requirements set on the state's 800 treatment providers.
"The declaration enables us to waive requirements on a broad basis without the need for those providers to submit specific requests to us," she said. New laws cannot be created under the emergency.
Fees to have a duplicate birth certificate produced will be waived. The certificates are often required as proof of residency for insurance and treatment programs and can be a surprising barrier to getting into treatment.
"Hopefully with this emergency declaration, we’re able to smooth things out so we can get people into treatment when they’re ready, which is the important thing," said Dr. Brian Work, an internist at Penn Medicine who volunteers at the addiction clinic Prevention Point Philadelphia.
Medics responding to overdose calls will be able to leave behind additional doses of naloxone, so drug users can prevent death if another overdose happens in the future.
Pharmacists will be asked to provide the overdose reversal drug widely, likely for free or at a reduced price. Currently, anyone can purchase naloxone at a Pennsylvania pharmacy.
The Pennsylvania physician general will reclassify fentanyl and similar drugs as Schedule 1 narcotics to limit access and open drug dealers to steep criminal penalties.
Better data collection is required under this declaration as well. It requires that overdoses and neonatal abstinence syndrome — the medical term applied to children born addicted to drugs — are added as reportable conditions and tracked by state and local entities. Often, health officials only have coroner data to rely on.
An Opioid Operation Command Center will launch within the state's emergency management agency and be staffed by employees of nine state departments including health, state police, and others.
Wolf has made the fight against the opioid crisis a major area of focus for his administration. The state launched a prescription drug monitoring program to cut down on doctor shopping and identify pill mills. His administration also provided funding to create treatment centers of excellence and increase access to the overdose reversal drug naloxone, known by the brand name Narcan.
Pennsylvania is the eighth state to declare the opioid crisis a disaster emergency. Alaska, Arizona, Florida, Maryland, Massachusetts, South Carolina and Virginia have previously made similar declarations.
Wolf acknowledged that the declaration is not a "silver bullet," but hoped it would streamline the state's attack. He didn't rule out signing another emergency declaration in three months should officials need more time to better address the crisis.