I first met Todd Pillion at the 2016 Ninth District Republican Convention. It was a long convention. We were sitting through the thirtieth speech of the day and I heard him let out a sigh. I could tell right away he was not the biggest fan of inside baseball politics. Different than most elected officials I’ve met, he isn’t doing this for the fame, notoriety, or the financial gain. In that aspect, he’s financially successful as owner of multiple businesses and a thriving pediatric dentistry practice.
A few months later, Pillion invited Senator Jill Vogel and me to visit his district in Abingdon. Gone was the frustrated elected official of that Ninth District convention. He spoke with such pride of his district and drove us to almost every nook and cranny, showing us the best of his region of the state. For somebody who is so successful, he still claims to just be “an old farm boy from Lee County.”
That farm boy from Lee County has decided to tackle an issue hitting his district, the devastating opioid crisis. He outlined some of the issues facing his district last year in an op-ed for the Roanoke Times. [1]
In Southwest Virginia, I represent three of the five counties with the highest fatal overdose rate in the commonwealth. During the past several months, we have seen in the media and heard at multiple forums the horrifying statistics and stories surrounding the nation’s opioid epidemic. For many families across Virginia, these tragic stories hit too close to home.
While public awareness to this crisis has been growing, progress has been frustratingly slow. It is time to realize that Band-Aids are not a fix for a wound this large. We have to amputate the prescription supply chain before we lose an employable generation to addiction.
Access to opioids is the central link in the supply chain. The United States accounts for 5 percent of the global population, but consumes 80 percent of the global opioid supply. The National Institute on Drug Abuse reported that significant increases in prescriptions and overall greater acceptability of their use have contributed to the crisis. Data from the Centers for Disease Control (CDC), show that approximately 20 percent of visits to physician offices result in an opioid prescription. Both supply and demand are alarmingly high and warrant a closer examination of the commonwealth’s prescribing practices.
On the other side of the opioid epidemic, we find concerns over the abuse of medication-assisted treatments. Bupenorphines such as Suboxone and Subutex are the common medications used in this treatment. Whereas Suboxone contains naloxone as an active ingredient that makes it more difficult to abuse, Subutex fills and activates receptors in the brain that can mimic a “high” and become addictive.
Because there is little accountability and oversight, users and pill mill doctors are taking advantage of this opportunity to create a market for themselves. As a result, there is a serious difference in the street value — approximately $60 for Subutex and $25 for Suboxone in parts of Southwest Virginia.
Part of having a skilled and qualified workforce means being able to pass a routine drug test. To strengthen Virginia’s economy and attract new opportunities, we have to show that we have a sustainable labor market. In turn, we want Virginians to have access to good-paying jobs that allow for healthy and productive lives.”
Most opioid addictions begin with a prescription, which then leads to an addiction. According to the Department of Behavioral Health in Virginia [2], 801 people in Virginia died of opioid overdoses in 2015. Pillion’s office noted that the State Health Department is still tabulating the results from last year, but the number could easily be over 1,000.
For Pillion, that’s too many. Therefore, he has proposed multiple pieces of legislation on the opioid crisis. As of last Friday, they have all passed their respective committees and have been moved to the House floor. Here’s a summary of all the bills that Pillion has submitted provided by his office:
HB 2161: Requires the Secretary of Health and Human Resources to convene a workgroup that shall include representatives of the Departments of Behavioral Health and Developmental Services, Health, and Health Professions as well as representatives of the State Council of Higher Education for Virginia and each of the Commonwealth’s medical, dental, and health professional schools. The work group will develop educational standards and curricula for training health care providers, including physicians, dentists, optometrists, pharmacists, physician assistants, and nurses, in the safe and appropriate use of opioids to treat pain while minimizing the risk of addiction and substance abuse.
HB 2162: Directs the Secretary of Health and Human Resources to convene a work group to study barriers to treatment of substance-exposed infants in the Commonwealth. The workgroup will review current policies and practices as well as identify barriers to treatment and make recommendations for the elimination of barriers to treatment of substance-exposed infants in the Commonwealth. According to the DSS Division of Family Services, the number of children exposed to drugs in utero increased 21 percent to 1,334 in fiscal year.
HB 2163: Provides that, for the treatment of substance use disorder, prescriptions for products containing buprenorphine without naloxone shall be issued only for a patient who is pregnant. Commonly referred to as Subutex, this is a substance that is used in medication-assisted treatment. Although it has a higher potential for abuse, it is intended for pregnant women provided the absence of naloxone is deemed safer for a fetus in the womb.
HB 2164: Adds any material, compound, mixture, or preparation containing any quantity of gabapentin, including any of its salts, to the list of drugs of concern. This makes gabapentin reportable to the Prescription Drug Monitoring Program to better track frequent misuse when combined with other opioids.
HB 2165: Requires a prescription for any controlled substance containing an opiate to be issued as an electronic prescription and prohibits a pharmacist from dispensing a controlled substance that contains an opiate unless the prescription is issued as an electronic prescription, beginning July 1, 2020. The bill requires the Secretary of Health and Human Resources to convene a work group to review actions necessary for the implementation of the bill’s provisions and report on the work group’s progress by November 1, 2017 and a final report by November 1, 2018. The work group will also consider hardships to meet the July 1, 2020 deadline and whether extension and/or exemption processes are necessary.
HB 2166: Lists possession of certain controlled substances (buprenorphine, cocaine, codeine, fentanyl, heroin, hydrocodone, hydromorphone, methadone, methamphetamine; methylphenidate, morphine, and oxycodone) as separate offenses under the existing crime of possession of controlled substances for the purpose of having the Virginia Criminal Sentencing Commission promulgate separate Virginia crime codes for such offenses. The bill does not alter the existing penalty for possession of these substances.
HB 2167: Directs the Boards of Dentistry and Medicine to adopt regulations for the prescribing of opioids and products containing buprenorphine. Draft regulations include dosage limits on opioids and buprenorphine, referrals for substance abuse counseling when appropriate, and the implementation of a treatment plan in cases involving chronic pain/long-term treatment. These regulations are commensurate with recently adopted CDC guidelines.
Delegate Pillion also added this statement:
“We have all seen the tragic headlines that highlight the devastating impact that opioid addiction has had – and continues to have – on families and communities throughout the Commonwealth and the Nation,” said Delegate Pillion. “This is an issue that I see not only as a legislator, but as a prescriber myself. Furthermore, we have to act to ensure that medication-assisted treatment of an opioid addiction is as effective and responsible as possible. We cannot condone a system that allows one addiction to be traded for another. I believe that with a shared focus on prevention, treatment, and appropriate oversight, we can begin to move forward with measures that will save lives.”
On Monday, Pillion addressed the bills on the House floor. Here’s a video of his speech:
[youtube https://www.youtube.com/watch?v=3B5qCSM0Y9k&w=560&h=315]
It is apparent that Pillion is extremely committed to, if not fixing the problem of opioid addiction and overprescription, at least making postive changes on the issue. I applaud his attempts to make Southwest Virginia a safer place to live.
The people who make a difference are those who care more about the problems in their districts than the political situations of their state. You will never see Pillion go on a Twitter rampage against an opponent, you will never see him in the Washington Post complaining to Laura Vozzella about the Democratic caucus, and he certainly doesn’t speak on the House floor every chance he gets.
However, it’s sometimes the “Quiet Giant” legislators of the General Assembly who get more done for the Commonwealth than any of the legislators who focus on their twitter account all day. Delegate Pillion is one of those “Quiet Giant” legislators who quietly get the job done for his district. I’m proud of his leadership, and more importantly, I’m proud to call him a friend.