Two opioid bills work their way through Washington’s legislature

A bill that would allow registered nurses and licensed practical nurses to administer opioid overdose reversal medication like naloxone in emergency rooms had a public hearing on Feb. 15. The bill, HB 1761, was sponsored by Reps. Joe Schmick and Jessica Bateman. While it’s largely a technical fix, it could have significant implications in emergency room care for overdoses. Currently, only practitioners capable of issuing prescriptions, are allowed to provide naloxone in emergency rooms. Another piece of fentanyl testing legislation previously reported on by State of Reform marks two opioid bills we’re tracking.

 

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Naloxone is a controlled substance, and normally would require a prescription to purchase. But Washington has been under a standing order for pharmacists to provide naloxone to anyone who asks. However, since many emergency departments do not have a pharmacy, the nurses aren’t explicitly allowed to administer the lifesaving drug under current law.

“It just amazes me that we have to pass a bill to allow nurses to dispense this in an emergency room,” Sen. Judy Warnick said during the public hearing. 

Naloxone is already included in medical kits for first responders. 

Katie Kolan, with the Washington State Hospital Association, testified in support of the measure. The bill, along with SB 5195 which passed the legislature last year, have greatly expanded the ability for health care professionals to treat opioid overdoses. 

Paula Meyer, executive director of the Department of Health’s Nursing Care Quality Assurance Committee also testified in support. 

Regarding the other piece of opioid-related legislation, SB 5509 was approved by the Senate on Feb. 8. The bill, sponsored by Sens. Jim Honeyford and Mark Mullet, would exempt fentanyl testing equipment from the definition of drug paraphernalia. 

The bill cleared the Senate with no opposition votes, and is working its way through the House. While fentanyl test strips have long been used by advocacy groups and have even been provided by the Department of Health as part of a now-defunct pilot program, they may still be technically considered drug paraphernalia. 

Fentanyl deaths have been skyrocketing in Washington State, and have only increased during the pandemic. A paper from University of Washington doctors Caleb Banta-Green and Jason Williams published in December shows that between 2010 and 2020, 8,362 people died from opioid-involved overdoses. 

It found that by 2019, fentanyl surpassed other categories of opioids in overdose deaths for those under the age of 30. Much of the fentanyl in the drug supply is likely illicitly manufactured. In addition, most fentanyl in the state is in tablet form, and made to look like legal prescription opioid pills, like oxycodone pills. 

Fentanyl deaths appear to be occurring primarily among three groups, the report states: young adults inexperienced with opioids, young adults with rapid onset opioid use disorder, and older adults with ongoing opioid use disorder who are often switching from heroin.