Panel seeks more control of Suboxone
By Neal P. Goswami
VERMONT PRESS BUREAU | February 12,2014
MONTPELIER — Lawmakers are looking at ways to stem the black market flow of a drug that is prescribed to help addicts kick opiate habits.
Sen. Richard Sears, D-Bennington, chairman of the Senate Judiciary Committee, said the state is spending $8.4 million a year through the Medicaid program to provide Suboxone, or buprenorphine, to Vermonters addicted to opiates.
The cost accounts for about 5.9 percent of the total annual medication costs for the state.
But the drug is finding its way into the illicit drug trade in Vermont — and into the state’s prisons.
“Whether it’s true or isn’t true, there’s certainly an impression with people that drugs are readily available in our corrections facilities,” Sears said Tuesday during a committee hearing on the issue.
Aaron French, deputy commissioner for health services and managed care in the Department of Vermont Health Access, said state health officials are eager to find ways to prevent the overprescribing and diversion of Suboxone.
For example, he said the state is now requiring patients who receive the drug to have a set pharmacy. Any deviation from that pharmacy requires prior authorization. The state is also limiting the amount that can be prescribed in a 14-day period.
A skeptical Sears said more measures are needed. “Somehow, our practices aren’t effective,” he said.
French acknowledged that more could be done.
“We could certainly put in tighter controls. Not off the top of my head would I suggest any,” he said.
The Judiciary Committee is looking to add language to a bill addressing opiate addiction in Vermont that will help curb the diversion of Suboxone.
Included in the language will be a list of approved doctors who can prescribe the treatment drug. They would be required to enter prescription information into the state’s prescription drug database, and the provider list would be maintained by the Department of Health.
Doctors treating more than 10 opiate addicts would be required under the bill to provide a full range of treatments including counseling. Doctors would also have to monitor urine tests and check prescription packaging to ensure proper use.
Finally, the committee is seeking language directing the manufacturer, Reckitt Benckiser Pharmaceuticals, to improve its packaging of Suboxone to make it more tamper-proof. Andrew Maclean, a lobbyist representing the company, said it would be willing to work with the state on the problem.
Meanwhile, the Department of Corrections and the Vermont State Employees Association are working on improving procedures to prevent the drug from entering Vermont prisons illegally.
“I think we’re working toward an agreement. We all have the same goal, we’re on the same page. We want to reduce as much as possible the flow of drugs into prison,” said Dave Bellini, chairman of the VSEA’s Corrections bargaining unit.
The union presented a range of ideas Tuesday to improve security at prisons, including random searches of temporary workers and visitors entering the secure portions of correctional facilities. The union also wants pre-employment drug screening and background checks.
According to Bellini, a criminal records check is currently done, but no further background screening is conducted for employment.
Additionally, Bellini said prisoners who test positive for drugs while in prison should lose their right to in-person visits.
Corrections Commissioner Andrew Pallito said he supported the VSEA proposals but that searches would have to extend to everyone entering the facility, including union staff. He said the department has three active investigations underway into contraband entering prisons, though he didn’t indicate if the investigations involve state employees or temporary workers.
In the end the VSEA security proposals weren’t included in the language the Judiciary Committee is developing. Instead they will be added to a bill before the Government Operations Committee.
Sen. Joe Benning, R-Caledonia, said cutting off visits for inmates isn’t likely to end the influx of drugs in Vermont prisons.
“The solutions that I’m listening to don’t tell me that’s going to happen,” he said.