A $2 million grant the Nebraska Department of Health and Human Services received from the federal government is intended to help the state take the next steps in its response to the nation’s opioid drug abuse crisis.
The grant, which comes from the federal Substance Abuse and Mental Health Services Administration, can be renewed in 2018 for the same amount. The grant is part of the $1 billion included in the 21st Century Cures Act to address the crisis. States and territories were awarded funds based on rates of overdose deaths and unmet need for opioid addiction treatment.
“The opioid epidemic is taking hold across the country, but we have an opportunity to be proactive, focus on prevention and treatment and raise awareness now to help stop opioid abuse from reaching crisis levels here,” Gov. Pete Ricketts said in a statement.
Nebraska so far has not seen as big a problem with opioid abuse as many states, officials have said. However, opioid overdoses killed 54 people in Nebraska in 2015, and the rate of drug overdose deaths increased more than 20 percent over the past decade.
State officials haven’t publicly drawn conclusions about why Nebraska appears to have steered clear of the worst of the crisis.
But a new report from the Blue Cross and Blue Shield Association indicates that prescription opioid use in Nebraska is much lower than in other parts of the country — especially the South. Blue Cross plans in the southern U.S. have a 78 percent higher prescription opioid use than among those covered by Blue Cross Blue Shield of Nebraska. The study is based on medical claims from across the country.
“Nebraska does have a lesser prescribing rate for these opioids than other states do, so that is part of the reason we don’t have such a problem,” said Dr. Deborah Esser, the Nebraska insurer’s chief medical officer. “Our doctors are really careful about the number of prescriptions they write and the number of long-acting opioids they write.”
The long-acting versions of the drugs, she said, are the ones that tend to lead to addiction.
Nebraska does, however, have a problem with alcohol. “That seems to be the drug of choice in Nebraska,” Esser said.
In an effort to ensure that opioids don’t become a bigger problem, state officials held an opioid summit in October to begin forming a strategy.
In January officials launched a monitoring program to track prescriptions for narcotics written and filled in the state and make it more difficult for people to doctor- and pharmacy-shop to feed their addictions. All prescriptions will be reported to the system as of Jan. 1.
Officials followed in February with a public information campaign aimed at educating people about the dangers of prescription painkillers and how they can reduce those risks.
The grant will be targeted toward increasing access to treatment and to preventing opioid-related deaths by improving health care providers’ capacity to serve people with opioid disorders. A training program will provide general practitioners and others access to experts on opioid treatment.
“This grant provides critical funding to provide targeted training on the complexities of opioid use and to invest in evidence-based prevention and treatment interventions,” Sheri Dawson, director of the division of behavioral health, said in a statement.
Overdose prevention initiatives also include increasing awareness about expanded access to naloxone, a drug that blocks or reverses the effects of opioid medications. A 2015 law made it easier for families and friends of drug users to get naloxone. It also authorized emergency responders and law enforcement to give it to people experiencing an overdose.
Among other efforts, the state health agency will work with pharmacists, physicians and emergency responders to provide education about the legislation, a spokeswoman said.
The agency already is working with the Nebraska State Patrol to help provide naloxone to its drug investigators, evidence technicians and crime lab staff.
Lt. Jason Scott, a patrol investigator, said naloxone has been issued to investigators who are most likely to come into contact with fentanyl. The synthetic opioid can be deadly to those exposed to even minute amounts.
The federal Drug Enforcement Administration warned last year about the risks fentanyl can pose to human and canine officers. As the patrol gets funding, Scott said, it will issue naloxone to other officers. State officials said some fire and rescue services and ambulance services in the state already are carrying and administering the drug.
Omaha police soon will have 300 units of naloxone spray, said Officer Gregory O’Neil, a spokesman. Officers will carry it primarily for their own protection. However, the department will explore using it with patients as it rolls out training. The Omaha Fire Department already carries it for use on patients, he said.
The drug also is becoming more available to the public. Hy-Vee Supermarkets and CHI Health announced last week that they were partnering to make the drug available without a prescription at Hy-Vee pharmacies in Nebraska under a physician-signed protocol CHI provided to Hy-Vee. It soon will be available at all CHI Health pharmacies.
Hy-Vee pharmacists also will ensure that patients and their family members know how to recognize signs of an opioid overdose and how to administer the medication.
Nebraska is the fifth state in Hy-Vee’s eight-state region, including Iowa, where the grocery chain is making the medication available without a prescription. CVS Health has made similar arrangements in Iowa and 40 other states, not including Nebraska.