Gov. Carney signs legislation to address Delaware’s opioid epidemic

 Gov. Carney signs three pieces of legislation to combat opioid addiction. (Zoë Read/WHYY)

Gov. Carney signs three pieces of legislation to combat opioid addiction. (Zoë Read/WHYY)

Gov. Carney signed three pieces of legislation Tuesday to address Delaware’s opioid crisis.

Don Keister’s son Tyler struggled with addiction on and off for several years. But when he relapsed in 2012, he sought help.

Tyler went out-of-state to receive the $1,000 a day detox his insurance didn’t cover, and transitioned into a rehab center. When he returned to Delaware to be with his family, he continued to battle his addiction.

Tyler entered a treatment facility in the state, but was released after three days. So he called several facilities in an attempt to receive treatment, and eventually found one in Media, Pa. But when Tyler arrived, he was turned away because he didn’t qualify.

Two weeks later, at 24, he died of a drug overdose.

On Tuesday, Gov. John Carney, D-Delaware, signed three pieces of legislation that aim to prevent more overdose deaths like Tyler’s by preventing overprescribing and by expanding access to treatment.

Keister, a board member for atTAcK Addiction, said he hopes the new laws will change lives.

“We can’t change the path for Tyler, but it’s our hope these new laws will help others find the treatment needed for their loved one, and by sharing his story we hope to break down the stigma of addiction,” he said.

Last year, there were 308 overdose deaths in Delaware—that’s up from 228 in 2015 and 224 in 2014. In 2015, Delaware’s drug overdose rate was the 12th highest in the country.

The new bills were brought to legislators by Attorney General Matt Denn, D-Delaware, over concerns about Delaware’s opioid epidemic.

“I stand here confident these new laws will save lives, because these laws were based on the ideas of people close to the issue, people whose own lives have been touched by this epidemic, many of whom dedicate every day to fighting it,” Denn said.

“Over and over they told us the same things—people with addictions were facing roadblocks getting into treatment, they were getting forced out of appropriate treatment too quickly and some healthy people were heading down the path to addiction, because they were being prescribed opioids in an irresponsible way.”

One measure, modeled after a new law in New York, would not permit pre-authorization and referral requirements imposed by private insurers to get initial treatment for substance abuse. It also would require insurance companies to cover 14 days of substance abuse treatment before conducting a “utilization review” that can delay treatment and limit insurance companies from denying substance abuse treatment based on “medical necessity” grounds.

Another bill addresses the issues of individuals being denied coverage, sent to an inadequate type of treatment or cut off from treatment after an inadequate period of time. It would allow the Department of Justice to tap into consumer protection funds to secure expert medical advice for those denied coverage, and to provide legal assistance in navigating the appeals process.

Denying coverage or limiting coverage is practiced by private, employer funded and Medicaid insurance, Denn said when the measures were announced in March.

On Tuesday, recovered addicts and family members of individuals who lost their battle with addiction spoke of several barriers to receiving treatment.

“I do know a lot of times it’s because of insurance issues, a lot of times there’s no doctor there to say, ‘Yes, you need to come on board,’ a lot of times it’s, ‘You don’t have enough in your system to need help,’ so the answer is to put more in your system to get help—that’s not an answer,” Keister said. “So there are so many things that keep these people from getting help, and if someone wants help they should get it right away.”

He said he believes if the bills were introduced in 2012, Tyler might have had a fighting chance.

“Would it have resolved the issue? Maybe, maybe not. We don’t know that, but at least it would have gotten him off the ground and begin him to get the help he needed,” Keister said.

A final piece of legislation establishes a new committee to help oversee the state’s prescription drug database.  The committee would be able to establish which doctors have extraordinary opiate prescription patterns, and determine if referrals to licensing authorities or law enforcement authorities are necessary. 

In March, Denn said the state is aware there are some individuals and practices that are prescribing at a much higher rate than others. While the Office of Controlled Substances can do reporting currently, the new legislation allows them to be more effective and efficient when targeting prescribers, he said.

Carney said he believes the state is taking strides to tackle drug addiction through these bills.

“I think they’re important on two levels—one is the cooperation that went behind it, the advocates, the family members who have lost loved ones, who have worked with members of the General Assembly and the Attorney General, and I think they’re going to be tools,” he said. “They’re not going to be the be all and end all, but they’re going to be important tools, they will help people who need help get the help they need.”

Carney said he’s unsure if efforts in Washington to repeal and replace the Affordable Care Act, known as Obamacare, will affect the legislation signed Tuesday—but believes most individuals will benefit from the bills in Delaware.

“The discussion around the Affordable Care Act only involves about 10 percent of the population. Most people get insurance in a different manner, those other 90 percent will continue to get the support their insurance provides,” he said. “But I think the point of these bills is it doesn’t always provide enough, and it doesn’t provide it in a way that makes the treatment effective, so at the end of the day that’s what this is all about, getting effective treatment to people who are addicted to save their lives.”

The bills passed almost unanimously in May in the General Assembly, with some members absent during voting. Some of the bill’s sponsors, including Senators Margaret Rose Henry, Stephanie Hansen and Anthony Delcollo, and Representative Helene Keeley, attended the Tuesday press conference.

Sen. Stephanie Hansen, D-Middletown, who in February was elected into office after Bethany Hall Long, D-Delaware, became Lt. Governor, is the primary sponsor for the first bill, which is her first since taking office.

“These are just first steps, and we have a long way to go. The good news is rarely have so many in positions of authority been on the same page and ready to take action. Now we need to balance action with thoughtfulness, planning with doing,” she said.

“Many of us have lost friends and family members, and unfortunately, until we have a firm hold on a workable comprehensive plan to address addiction well beyond initial treatment we will continue to lose sons, daughters, spouses and grandparents. But do not lose hope, because we are on the path, we’re working together, and I guarantee you, we are relentless.”

Delaware is the first state to introduce laws that allow the Department of Justice to secure medical advice for those who are denied coverage and to create a committee to oversee a prescription database, Denn said.

“These new laws set us on the right path and they will save lives, but they aren’t going to fix those problems overnight,” he said. “Part of the reason they’re not going to be an overnight fix is that we now have to make them work. These things are new and powerful tools and we need to make sure we use them effectively.”

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