With four days left in the current legislative session, backers of a bill that would enable more people to administer a life-saving drug to someone overdosing from heroin and other opiates are hoping the measure will become law.
Sen. James Thomas “Jabo” Waggoner (R-Vestavia Hills) and Rep. Allen Treadaway (R-Warrior) said the proposed law’s prospects got a boost last week when representatives of physicians and plaintiffs’ lawyers worked out their differences on some language in the bill.
Waggoner said he planned to introduce a substitute for the bill, one reflecting the agreed-upon language change, after the Senate convenes on Tuesday, June 2. The House has already passed a version of the bill sponsored by Treadaway, and would have to vote on the Waggoner version once that measure passes the Senate.
“It looks like it’s probably non-controversial,” Waggoner said Monday.
“I’m very cautiously optimistic,” Treadaway said last week.
Once the Legislature passes the bill, it will go to Gov. Robert Bentley for his signature.
According to its current House and Senate versions, the bill would authorize a physician or dentist, “acting in good faith and exercising reasonable care,” to “directly or by standing order prescribe an opiod antagonist” to someone “at risk of experiencing an opiate-related overdose” or to “a family member, friend or other individual, including law enforcement, in a position to assist an individual at risk of experiencing an opiate-related overdose.”
The “opiod antagonist” mentioned in the bill is naloxone hydrochloride, a synthetic drug commonly known as narcan that can reverse the effects of an overdose of heroin or another opiate. At present, trained paramedics give naloxone to someone overdosing on heroin, hydrocodone or other opioid painkillers.
The bill’s supporters say that in many areas of Alabama law enforcement officers are often the first to arrive at an overdose scene and that they could save lives by giving naloxone by injection or by nasal spray to overdose victims. The bill would require the Alabama Department of Public Health to approve a program to show law enforcement officers how to properly administer naloxone.
Support for the measure has come from relatives of heroin users, Birmingham Treatment Alternatives for Safer Communities and the Jefferson County Board of Health. Dr. Mark Wilson, Jefferson County health officer, has lobbied in Montgomery on behalf of the bill.
Support for the legislation has grown because of the growing number of deaths caused by heroin or other opiates in Alabama. In Jefferson County alone, heroin was the primary cause of 137 deaths in 2014, more than double the 58 recorded in 2013 and in 2012. So far this year, the number of heroin-linked deaths is 45, a number that suggests the year’s total may be lower than that of 2014. But Jefferson County Chief Deputy Coroner Bill Yates said another narcotic known as fentanyl is making its lethal presence felt, and has caused 32 deaths so far this year.
“It takes a whole lot less to overdose on fentanyl than it does on heroin,” Yates said.
Wilson said naloxone can also reverse a fentanyl overdose.
The naloxone bill passed easily in the House, but it hit a snag in the Senate over a section which would grant immunity “from any civil or criminal liability” to a physician or dentist who prescribes naloxone, an individual who administers it when someone is overdosing or a pharmacist who dispenses the naloxone. That immunity would not apply if the individuals had engaged in “unreasonable, wanton, willful or intentional conduct.”
The immunity wording troubled the Alabama Association for Justice, formerly the Alabama Trial Lawyers Association, which represents plaintiffs’ attorneys across the state. But the Medical Association of the State of Alabama was keen on keeping immunity for physicians, dentists and pharmacists.
“That was a huge stumbling block,” said Niko Corley, a lobbyist for the medical association.
Despite their differences, Wilson said, both groups prodded by Treadaway and Waggoner, “recognized the importance of getting some legislation passed that has the potential to save lives, and agreed to work on a ‘third way.’” Ultimately, he said, they came to an agreement.
Representatives from both groups met in Waggoner’s office last Wednesday, and Wilson and Treadaway were present. Mike Ermert, a partner with the Birmingham firm of Hare, Wynn, Newell and Newton and current president of the Alabama Association for Justice, was at the meeting, but declined to comment on the specifics of the bill.
“We prefer not to discuss legislation that is still pending, and we certainly have appreciated the chance to work both with Rep. Treadaway, Sen. Waggoner and all others that are interested in this bill, and we hope that it can move forward,” Ermert said.
“We’re so close to the finish line,” Treadaway said.