Working Together to Combat the Opioid Crisis

By: Dr. Rachel Levine, Pennsylvania Physician General

August 19, 2016

The prescription opioid and heroin crisis is the most significant public health crisis facing Pennsylvania. According to the Pennsylvania State Coroners Association 2015 Report on Overdose Death Statistics, 3,505 Pennsylvanians died as a result of drug poisoning. That is an astonishing 10 deaths a day. In Pennsylvania, more people die of drug overdose than car accidents.


This crisis affects urban areas, suburban areas and rural areas of our state. While younger white males continue to be the most at-risk demographic for opioid overdose, deaths from prescription painkillers among women have increased more than 400 percent since 1999.

How the Opioid Crisis Developed

The etiology of this crisis is the perfect storm of factors. In the 1990s and early 2000s, there was an increased focus by federal regulatory agencies on the diagnoses and treatment of pain by medical professionals. At the same time, there was the development of long-acting, powerful and, unfortunately, highly addictive opioid pain medications. These medications became widely prescribed.

In 2012, health care providers wrote 259 million prescriptions for painkillers, enough for every American adult to have a bottle of pills. Additionally, there was the influx of cheap and plentiful heroin from Central and South America. This confluence of factors have contributed to the crisis of substance use disorder and opioid overdose we currently face.

What We’re Doing to Combat the Opioid Crisis

Substance Use Disorder is a disease. It is not a moral failing. The disease is complex and complicated. The state’s response is interagency and multi faceted, including prevention, treatment and recovery. This includes training current and future medical providers. We are working with all of the medical school deans to improve student education. We have published seven evidence-based specialty-specific opioid prescribing guidelines. This includes guidelines for obstetrics and gynecology providers and the treatment of substance use disorder in pregnant patients.


We have also partnered with Pennsylvania Medical Society and other specialty organizations to produce continuing-education modules for medical professionals. All of the modules are free on the PA Medical Society website until the end of 2016. Starting this month, the Prescription Drug Monitoring Program will be available. This critical online tool will support clinicians in identifying patients who may be struggling from the disease of addiction and help connect them with treatment services.

To save lives and give individuals a chance to get into treatment, the state is focused on increasing access to naloxone, a life-saving medication that can reverse the fatal effects of opioid overdose. In April 2015, I signed a standing order prescription that allowed first responders, like municipal police and fire departments, access to the medication. Since then, law enforcement has saved at least 1,200 lives with naloxone. Then, in October 2015, I signed a standing order prescription for the public. This allowed any Pennsylvanian to walk into a participating pharmacy and secure naloxone for themselves or a family member under my standing order prescription.


Once reversed by naloxone, the patient must go to the emergency room and then be transferred to treatment. This process is called a warm handoff for treatment. The Wolf Administration is focused on increasing access to substance abuse treatment, with an emphasis on medication-assisted treatment. By October 1, 2016, 20 new Centers of Excellence will be available for Medicaid patients with substance use disorder.

This crisis is complex and requires all hands on deck. The public are important partners in our response. For more information about this crisis and the state’s response, visit


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