(1) The general assembly finds that:
(a) In an effort to address the growing opioid addiction problem throughout
the nation, on July 22, 2016, President Obama signed into law the federal
Comprehensive Addiction and Recovery Act of 2016, also referred to as CARA;
(b) CARA authorizes qualified nurse practitioners and physician assistants in
community- and office-based practice settings to prescribe certain medications
used in the treatment of opioid addiction as a means of increasing access to
treatment for opioid-dependent patients;
(c) Opioid addiction has emerged as a significant public health concern in
Colorado, with over ten thousand deaths attributed to drug overdose since 2000
and the annual rate of drug overdose deaths doubling from 7.8 deaths per one
hundred thousand people in 2000 to 15.7 deaths per one hundred thousand people
in 2015, a rate significantly higher than the national rate;
(d) Southeast Colorado comprises six percent of the state's population and
accounts for eighteen percent of admissions for heroin treatment, the Pueblo
county jail sees over one thousand seven hundred opioid protocol prisoners each
year, and the Pueblo fire department used an opioid antagonist to halt an opioid-related drug overdose event one hundred forty times in 2015;
(e) In Routt county, drug overdose death rates have increased nearly six-fold
from 2014 to 2016, and over sixty-five percent of these deaths were related to
prescription opioids;
(f) Despite the prevalence of opioid addiction and opioid-related overdose
events in Pueblo and Routt counties, only three doctors in Pueblo county and one
doctor in Routt county are able to provide medication-assisted treatment to opioid-dependent patients in those counties;
(g) Medication-assisted treatment, which includes the use of medication and
behavioral therapies to treat individuals with opioid addictive disorders:
(I) Has proven to be clinically effective and to significantly reduce the need
for inpatient detoxification services for individuals with opioid addictive disorders;
(II) Provides a comprehensive, individually tailored program of treatment for
opioid-dependent patients;
(III) Is intended to achieve full recovery;
(IV) Can contribute to lowering a person's risk of contracting HIV or hepatitis
C by reducing the potential for relapse; and
(V) Has improved patient survival rates, increased retention in treatment,
decreased illicit opioid use and other criminal activity among individuals with
substance abuse disorders, increased patients' ability to attain and retain
employment, and improved birth outcomes among pregnant women who have
substance use disorders;
(h) In order to increase access to addiction treatment in areas of the state
where opioid addiction is prevalent, it is necessary to establish a pilot program to
award grants to:
(I) Organizations, practices, or pharmacies with nurse practitioners, physician
assistants, or pharmacists to enable them to obtain the training and ongoing
support required to prescribe medications, such as buprenorphine and all other
medications and therapies approved by the federal food and drug administration, to
treat opioid use disorders; and
(II) Community agencies to provide behavioral therapies, in conjunction with
medication treatment, to treat individuals with opioid use disorders; and
(i) Since the pilot program will provide access to treatment to individuals
with substance use disorders, the use of retail marijuana tax revenues to fund the
pilot program is authorized under section 39-28.8-501 (2)(b)(IV)(C).
(2) The general assembly further finds that:
(a) Since its creation, the pilot program has achieved numerous successes
toward program goals as follows:
(I) With regard to the program goal of increasing the number of advanced
practice providers able to prescribe medications to treat individuals with opioid use
disorders in Pueblo and Routt counties:
(A) Two medication-assisted treatment (MAT) programs in Pueblo county
were selected to receive funding and one MAT program was started in Routt
county;
(B) As of August 2018, four providers certified to prescribe MAT medications
were added to the two MAT programs in Pueblo county and six MAT medication-certified prescribers are available in the Routt county program; and
(C) Through July 1, 2018, fifty providers received education on opioid use
disorders and related issues in assessment and treatment; and
(II) With regard to the program goal of increasing access to MAT services in
Pueblo and Routt counties:
(A) Pueblo county increased MAT services from a total of ninety-nine clients
treated through its two MAT programs in 2017 to five hundred seventy-six clients
treated through the two programs through October 2018; and
(B) Routt county had very limited MAT services available in 2017 and,
through October of 2018, provided MAT services through its new MAT program to
fifty clients;
(b) Given the successes of the program in expanding access to MAT services
in Pueblo and Routt counties, the pilot program should be extended and made
available to additional areas of the state that are experiencing significant public
health concerns due to the prevalence of opioid addiction and overdose incidences
and inadequate numbers of providers;
(c) In the San Luis valley, which has approximately fifty thousand residents
and consists of the counties of Alamosa, Conejos, Costilla, Custer, Huerfano,
Mineral, Rio Grande, and Saguache, opioid overdoses have been increasing since
2010, with recent reports of more than ten overdoses per one hundred thousand in
population yearly in each of the counties in the valley;
(d) Huerfano county, which has about six thousand six hundred residents,
had six overdose deaths in 2016, a rate of 152.6 per one hundred thousand in
population, which was the highest overdose rate for any county in the state;
(e) Many other counties in the state are also experiencing high incidences of
overdose and lack available, qualified providers to meet the addiction treatment
needs in the county;
(f) Given the prevalence of opioid overdoses in the San Luis valley and other
areas of the state, it is necessary to extend the pilot program established pursuant
to this part 8 for an additional two years, expand its availability to critical-need
areas of the state, and increase its funding in order to increase access to addiction
treatment in these areas where opioid addiction and overdose incidences are at
significant levels.