Governor Wolf Announces Naloxone Standing Order to Combat Heroin Epidemic (+ FAQs)
October 28, 2015
On January 10, 2018, Governor Tom Wolf declared the opioid epidemic a statewide disaster. Under this declaration, emergency service providers are now able to leave naloxone behind after a 911 visit. Centralized Coordinating Entities (CCE) can contact the Pennsylvania Commission on Crime and Delinquency (PCCD) to obtain naloxone for first responders under their jurisdiction. For more information, visit PCCD’s website.
Updated with the paragraph above: February 15, 2018, 12:00 PM
Updated with FAQs: October 29, 2015, 3:59 PM
Posted: October 28, 2015, 1:20 PM
Harrisburg, PA – Governor Tom Wolf today continued his “Government That Works” Tour and announced a significant step forward in his administration’s fight against the heroin epidemic in Pennsylvania. Governor Wolf stood with Physician General Dr. Rachel Levine at the Pennsylvania Medical Society as Dr. Levine signed a statewide standing order for naloxone*, a medication that can reverse an overdose that is caused by an opioid drug. The governor was also joined by Secretary Ted Dallas, Secretary Gary Tennis, Secretary Karen Murphy, and Chairman Josh Shapiro.
“This standing order is the next step in my administration’s fight against the addiction and overdose epidemic in our state,” said Governor Wolf. “We must do all that we can to support those Pennsylvania families suffering from the effects of addiction. I am proud to take this action with my cabinet members today.”
Through the signing of this standing order, Dr. Levine has signed a prescription for naloxone to all Pennsylvanians. For more information about naloxone and how to administer it, please visit the Department of Drug and Alcohol Program’s page on overdose reversal.
“Making it possible for all Pennsylvania residents to access the life-saving drug naloxone is a huge victory in our battle against drug overdose deaths in the commonwealth,” said Physician General Dr. Rachel Levine. “I am proud to sign this standing order and continue the efforts of the Wolf Administration to protect the most vulnerable Pennsylvanians. This forward-thinking initiative gives people the tools they need to keep their communities and families intact.”
The rise in heroin addiction and prescription drug abuse has quickly led to a public health crisis in Pennsylvania, where 1 in 4 families suffer from the effects of substance abuse addiction. Heroin and opioid overdose are now the leading cause of accidental death in Pennsylvania, killing more individuals than those involved in fatal motor vehicle accidents. In 2014, 2,400 Pennsylvanians died from drug overdoses.
“Addiction can happen to anyone from any walk of life, and heroin is now the second leading cause of years of life lost,” said Department of Human Services Secretary Ted Dallas. “I am not going to accept that. We must fight to ensure our children, our loved ones, and our neighbors have access to these critical life-saving programs.”
“Too many Pennsylvania families are being affected by this crisis,” said Department of Drug and Alcohol Programs Secretary Gary Tennis. “In addition to finding solutions like these to save lives, we are also working hard to raise awareness and break down stigmas about substance abuse disorders. My department will continue to work tirelessly to provide the best possible recovery and treatment options, to ensure that we do not see high rates of overdose recurrences.”
“It is our goal at the Department of Health is to ensure that life-saving resources such as naloxone are available to every Pennsylvanian,” said Department of Health Secretary Dr. Karen Murphy. “Educating Pennsylvanians on how to use naloxone in case of an emergency is essential to curbing the devastating number of opioid-related overdose deaths that we have seen in the commonwealth over the past several years.”
“The opioid epidemic is a serious public health issue and is it also an issue of public safety,” said Pennsylvania Commission on Crime and Delinquency Chairman Josh Shapiro. “PCCD is working to ensure that the healthcare and law enforcement communities are working collaboratively to bring all our resources to this fight.”
Since his inauguration, Governor Wolf has worked with his administration to provide real solutions not only to save lives but also to help addicted individuals and their families get the treatment they need to live long, productive lives. Such actions taken by the Wolf Administration include the development of the ABC-MAP prescription drug monitoring program, the creation of the interagency Heroin Task Force, the support for the use of naloxone at schools across the Commonwealth, and stocking all Pennsylvania State Police cars with the naloxone drug. Since equipping State Police cars with naloxone, over 300 lives have been saved with this drug.
Governor Wolf’s 2015-16 budget proposes $7.5 million in funds to provide more naloxone to police and to provide more and better treatment options for Pennsylvanians.
“My administration, law enforcement agencies, those in the health care field, those in county services offices, and many others work hard every day to fight back against heroin epidemic,” concluded Governor Wolf. “My greatest hope is that today’s action will continue to aid these statewide efforts to overcome the addiction and overdose crisis in Pennsylvania.”
What is naloxone?
Naloxone is a medication that can temporarily reverse an overdose that is caused by an opioid drug (prescription pain medication or heroin). When given during an overdose, naloxone blocks the effects of opioids on the brain and restores breathing within two to eight minutes. Naloxone has been used safely by medical professionals for more than 40 years and has only one function: to reverse the effects of opioids on the brain and respiratory system in order to prevent death. Naloxone has no potential for abuse- a person can’t get high or become addicted to it – and it is safe to use. (Naloxone does not work to reverse overdose from other types of substances).
How do I get naloxone?
Family members and friends can access this medication by obtaining a prescription from their family doctor or by using the standing order (a prescription written for the general public, rather than specifically for an individual) issued by Rachel Levine, M.D., PA Physician General. The standing order is kept on file at many pharmacies, or may be downloaded here.
If you cannot access Scribd, you can also download the standing order here from the Department of Health’s website.
Naloxone prescriptions can be filled at most pharmacies. Although the medication may not be available for same day pick up, it can often be ordered and available within a day or two.
What types of naloxone are available?
Two of the most common ways that naloxone is administered are intranasal (nasal spray) and the auto-injector. Please note, not all pharmacies stock both forms and insurance coverage may vary depending on the type of medication being purchased and each individual insurance plan. Check your insurance prescription formulary or call your benefits manager to determine if the medication is covered by your particular plan or if your purchase of the medication will be an out-of-pocket cost.
- Intranasal currently has two pieces that are easily assembled: a prefilled medication tube and an atomization device which is sold separately. The nasal piece may not be stocked at your local pharmacy; however, they may assist in ordering it. Additionally, the nasal atomization device can be ordered from a number of medical supply companies without a prescription.
- The Auto-injector comes in a manufactured dosage form (similar to an epi-pen) and has a recorded message to talk you through giving the medication.
How do I administer naloxone?
In addition to talking to your healthcare provider or the pharmacist about how to use naloxone, individuals giving this medication to someone should take the online training ahead of time. Training is available at one of the Department of Health approved training sites: Get Naloxone Now or PA Virtual Training Network. These easy to understand, brief trainings explain how to recognize the signs and symptoms of an opioid overdose, what to do in the event of an overdose, and instruct on how to give naloxone. While it is not necessary to obtain a training certificate in order to purchase naloxone, learning these important details will help you respond properly in the event of an overdose and also meet the immunity requirements of PA Act 139.
Could I get in trouble for giving someone naloxone (statutory immunity)?
Good Samaritan: Through the ‘Good Samaritan’ provision of Act 139, friends, loved ones and bystanders are encouraged to call 911 for emergency medical services in the event an overdose is witnessed and to stay with the individual until help arrives. The provision offers certain criminal and civil protections to the caller so that they cannot get in trouble for being present, witnessing and reporting an overdose.
Administering Naloxone: Physicians are permitted to write third party prescriptions for naloxone and you are immune from liability for giving naloxone if you believed the person was suffering from an opioid overdose (heroin or prescription pain medication) and you called for medical help/911 after giving the medication.
Does insurance cover naloxone?
Insurance companies vary in how they cover naloxone and other drugs used to treat an opioid overdose. Prior to having a naloxone prescription filled with a pharmacy, consumers are encouraged to check with their insurance carriers to find out whether naloxone is a covered benefit under their policy, and, if so, what form of naloxone is covered, and any cost-sharing amounts that may apply under their policy.
Will Fee-for-Service and the managed care organizations (MCOs) pay for naloxone dispensed under the standing order for Medical Assistance recipients?
Will Medical Assistance require a prescription in order for the pharmacist to fill the naloxone for a Medical Assistance recipient?
Yes, per 55 Pa Code, Chapter 1121 – Pharmaceutical Services – §1121.52, pharmacists can treat the standing order as a verbal order for Medical Assistance recipients.
Can a person other than the eligible Medical Assistance recipient (friend or family member) obtain the naloxone at the pharmacy on the recipient’s behalf? Will the Medical Assistance Program make payment?
PA Medical Assistance will make payment for naloxone for the eligible Medical Assistance recipient.
Is prior authorization required by Medical Assistance for any of the naloxone products or supplies?
The Evzio Auto-Injector is covered by Medical Assistance, but requires prior authorization. Generic naloxone is covered without the need for prior authorization.
Where can a pharmacy access Medical Assistance billing procedures for naloxone and the nasal actuator?
The Fee-for-Service Program will post information related to billing for naloxone on the DHS Pharmacy Services website. Pharmacies will need to contact each MCO individually to obtain information about their billing procedures.
Will copays apply for the naloxone products and nasal actuator?
No, the Medical Assistance copay will not apply.
Is there a limit to the number of times that a Medical Assistance recipient can get naloxone?
No, there is no limit to the number of fills that can be obtained.
How can someone with an addiction to prescription pain medicines, heroin or other drugs get help?
Treatment for drug abuse and addiction is available! You can find out more by calling the County Drug and Alcohol Office where you live. For more information or to get the contact information for your local office visit the Department of Drug and Alcohol Programs website or call 717-783-8200.
While it may be uncomfortable to talk to someone about their substance abuse problem, research shows that it is more likely for an individual to seek help for their problem within 30 days following an overdose if someone talks to them right after the overdose event about going to treatment.
Are there any other standing orders in Pennsylvania?
Yes. There have been three well publicized standing orders that we are aware of to date that impact Pennsylvania which include: 1) CVS who has developed one for their pharmacies nationwide; 2) Montgomery County; and 3) Allegheny County.
The standing order being signed today does not affect these standing orders. Instead the Physician General’s standing order expands upon them to ensure statewide access.
*If you cannot access Scribd, you can also download the standing order here from the Department of Health’s website.
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