Omaha Sen. Sara Howard always tells a personal story of the experience that led her and her mother before her to introduce legislation to try to lessen opioid drug addiction and death.
Monday, she retold what led her sister Carrie to become addicted to the powerful painkiller oxycontin. It was spinal-fusion surgery for which doctors sent her home with a large bottle of the drug, she said. Carrie had a number of recoveries and relapses, but the last time she looked to be on the most positive recovery from the addiction, a dentist gave her more of the drug, and she never recovered again.
After five months, that relapse killed her. By doctor shopping, she was able to get prescriptions for 4,500 pills a month — nearly 150 pills a day — before she died of an overdose, Howard said.
Sen. Gwen Howard introduced the first bill to create the prescription-monitoring program to prevent doctor shopping from succeeding, and Sara Howard has been adding to and improving the program since.
The bill (LB556) discussed Monday would clarify patient identification to help with matching by prescribers and pharmacists, add to the record the number of refills prescribed, add security and data-sharing provisions, allow for sharing of data with other states and for interface with electronic health records.
The measure is Howard's priority bill.
Sen. Bruce Bostelman of Brainard said he'd like to see limits put on "far too many" opioids prescribed to cancer and hospice patients. He said his brother, as he fought cancer, was given far more than was needed.
Howard said the Legislature has been a leader and force in the country in addressing opioid overdoses. But there is more to do.
Last year, senators put a cap on prescribing to minors of no more than a week's worth of opioid medication. Other states have put caps on adult prescriptions.
What's coming is that prescribers will be required to check the Prescription Drug Monitoring Program information before prescribing, which will be tied to federal funding, she said. And sometime in the near future, senators will have to consider putting oversight of drug monitoring in an advisory committee, rather than leaving it with the Legislature, Howard said.
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Sen. Robert Hilkemann of Omaha said it's important to begin coordinating drug prescriptions, diseases and illnesses, if the cost of medications and treatments are ever going to be controlled.
The prescription drug-monitoring program is funded through a federal grant, which ends Aug. 31. A new competitive grant is available beginning Sept. 1, according to the bill's fiscal note. It is likely the federal funding will be available to cover the costs of the bill, which are mostly for software and computer program modifications.
In fiscal year 2019-20, the estimated cost for that work is $1.07 million in federal funds. In 2020-21, the cost for ongoing software maintenance and fees would be $125,000.
Howard closed discussion on the bill saying people in the Legislature have been a part of her family, through her mother, since before her sister died.
"While ... we get very rancorous with each other and we fight with each other, just know that at the end of the day we are absolutely a family," she said.
Former Gov. Dave Heineman and every member of the Legislature showed up at Carrie's funeral in 2009, she said. Senators and lobbyists came to her mother's house with boxes of food. Sen. Deb Fischer, a member of the Legislature at the time, took Howard's mother to lunch every time the anniversary of Carrie's death rolled around.
"It's sort of OK to fight with your brothers and sisters, but when we walk out of here we are a family, and we support each other, and this legislation, I hope, reminds us of that as we go into our long days and our hard days," she said.
"I appreciate the little lovefest we had this morning, because I think maybe we needed it on a Monday morning."
The bill advanced on a 44-0 vote.