opioid – Missouri House of Representatives Newsroom

Bill to legalize limited medical marijuana in Missouri heard in House committee

Again this year the Missouri House has heard testimony on whether the state should legalize marijuana for limited medicinal use.

Representative Jim Neely (photo; Tim Bommel, Missouri House Communications)

Cameron doctor and state representative Jim Neely (R) has proposed allowing the use of marijuana to treat terminal conditions. Neely said his House Bill 1554 would expand on legislation that became law in 2014 that allows the use of a cannabis extract, cannabidiol (CBD) oil, to treat intractable epilepsy. It would also expand on Missouri’s “right to try” law that allows doctors and patients to use drugs that haven’t completed the approval process of the federal Food and Drug Administration.

The House Committee on General Laws heard from people who said marijuana did help or could have helped their loved ones. Jane Suozzi said her daughter Kim was diagnosed with brain cancer shortly before she graduated with two degrees from Truman State University in 2011.

After studying and pursuing multiple experimental treatments Kim turned to marijuana shortly after her diagnosis.

“Kim viewed marijuana the same as all the other experimental options she pursued. She didn’t enjoy it but it gave her some additional hope and sometimes relieved her nausea,” Jane Suozzi testified. “I appreciate Doctor Neely’s efforts to afford people like Kim potentially life-extending access to experimental treatments including medical cannabis.”

The committee also heard from a number of veterans and organizations that represent them. Kyle Kisner served in the Missouri National Guard for seven years and spent tours in Iraq and Afghanistan. He said for years he was treated with opioids for pain and benzodiazepines for depression, during which time he said his personality was altered and he twice attempted suicide.

“Cannabis allows me to focus. It’s allowed me to consistently hold some kind of employment for the past few years, and for the past year-and-a-half I’ve gone back to school and I’m currently finishing up two bachelor’s degrees at Lindenwood University; something I couldn’t do when I was nodding out on three to four hours a day taking some kind of opioid or something for anxiety,” said Kisner. “There’s thousands of veterans out there that are taking that. You guys asked if this is medicine. I say, ‘Yes, absolutely, without a doubt this is medicine.’”

The Missouri Prosecutor’s Association spoke against the proposal. Its lobbyist, Woody Cozad, said for Missouri to pass legislation legalizing marijuana at any level would fly in the face of federal statute.

“Nullification was decided by the Civil War. Whether this legislature has previously attempted to nullify federal gun law or anything else doesn’t alter the fact that under our system of government, the system for which all of these veterans including myself fought, the states don’t nullify federal laws,” said Cozad, “and it just creates a confusion that at least our members can have a lot of difficulty dealing with.”

Legislators noted that Missouri already has laws that conflict with federal laws, and questioned whether prosecuting people like those who testified for the bill – veterans and those with serious medical conditions – would be a priority for any prosecutors.

Kansas City Democrat Jon Carpenter told Cozad several states have already legalized marijuana to some extent, in spite of federal law, “and I don’t see the mass confusion happening, so I’m not sure why we would anticipate having a different experience if we were to go down this path in Missouri.”

Neely said his bill, as it is written, is about improving quality of life for patients.

“I remember, I may have been an intern, a doctor telling me that his goal as he was near the end of his life as a physician, what he did in life was to provide some comfort to people, and I guess that resonated with me,” said Neely. “I think that’s what I’m after is that I’ve seen people struggle. Narcotics aren’t effective, pain control, anxiety, depression, a variety of other issues that the marijuana may be beneficial.”

The committee has not voted on Neely’s bill. Last year he filed the same language in House Bill 437 and it was voted out of two committees but was not debated in the full House.

House asked to back needle exchanges to stem potential disease outbreaks

Members of a House Committee have been told a bill to exempt needle exchange programs from drug paraphernalia laws could help combat a potential outbreak in intravenous diseases like HIV and Hepatitis C.

Representative Holly Rehder (photo; Tim Bommel, Missouri House Communications)

Representative Holly Rehder (R-Sikeston) told the Special Committee on Urban Issues that abusers who take advantage of needle exchange programs are five times more likely to enter treatment programs.

The committee also heard that the Centers for Disease Control have identified 10 counties in Missouri where conditions could lead to an outbreak like that in Scott County, Indiana. In that county of more than 24,000 people, 227 became infected with HIV in 2015 and 2016 due largely to sharing needles used to abuse intravenous drugs.

“This bill is to, honestly, sanction existing programs that we have running in the state,” Rehder told the committee about her bill, House Bill 1620 . “Right now we have syringe access, or needle exchange which it is also called, running in the St. Louis area and the Kansas City area. These have been ongoing for some time but the problem is that they’re running in a somewhat grey area because Missouri’s law has a paraphernalia charge that could be charged. The local jurisdictions have not pressed that because they see the good in these programs.”

Chad Sabora is a former prosecutor who became a heroin user, and is now an activist in fighting heroin addiction. He runs one of the needle exchange programs operating in Missouri, which he said won’t stop an outbreak but is a “crucial piece of the puzzle.”

“80-percent of the people that use my syringe access program I put into treatment within three months, because as Holly stated it’s early engagement,” said Sabora. “They walk into my office seeking clean needles and nothing else, and what they get is something different. They get conversation, they get compassion, they get treatment resources that they did not know exist, and once they find out that all these options are available for them most of them reach out for help, and I never would have told them about those options if they didn’t walk into my office just to get that clean needle that day.”

The committee heard needle exchange programs could also save the state money. Rehder told the committee the cost to treat HIV patients on Medicaid is expected to increase this year because of changes to the Medicaid program.

Sabora told the committee that a rule change by the Department of Social Services means that anyone with Medicaid can receive treatment for Hepatitis C.

“Before that passed, when it was only the very limited few that got Medicaid treatment, the state still spent upwards of $80-million in 2014. We can reduce these infections, we can reduce future cost of treatment, and lower the cost to the state,” said Sabora.

Rehder has led legislative efforts in recent years to pass a statewide drug monitoring program to help fight opioid abuse, and has shared how opioid addiction struck her family; her daughter became addicted to opioid painkillers after being treated for a cut she suffered at work. Rehder said she sees this as another tool to fight opioid addiction.

“We’ve got to be sure that we move emotion to the side and actually look at the numbers, look at the statistics – what’s working?” said Rehder. “When people first hear about needle exchange one of the first things they say is that’s enabling a user, but you have to look past that. You have to look beyond the stigma of addiction and you have to see, ok but what helps? What works? What gets better outcomes?”

Rehder said if her bill passes to remove the “gray area,” she believes needle exchange programs will spread to other parts of the state including the counties flagged by the CDC.

“There are some federal dollars that we’re passing up right now because we don’t have in statute that these are clear of any gray area, so once we get this passed these individual health departments or individual needle exchanges can reach out to get some of that help in some of these more underserved areas,” said Rehder.

The committee voted unanimously to pass HB 1620. It next goes to the House Committee on Rules.

Sponsor of bills to help overdose victims looks for next challenge in drug abuse fight

The sponsor of Missouri’s new law providing some immunity for those seeking help for overdose victims says he’s achieved all he set out to do, and is looking for other ways to help substance abusers.

Representative Steve Lynch (photo; Tim Bommel, Missouri House Communications)

Senate Bill 501 contained language offered by Representative Steve Lynch (R-Waynesville). It provides immunity to anyone seeking medical help for themselves or anyone else who is overdosing, from crimes including possessing small amounts of drugs; probation, parole, or restraining order violations; and underage drinking.

Lynch said that combined with other laws allowing first responders, friends, and loved ones of abusers to have and administer naloxone – a drug that counteracts opioid overdoses – could save lives. Lawmakers considering the bill heard that often a person will die of an overdose or from drinking too much because others don’t call for help out of fear they will be prosecuted for crimes or face other consequences.

“In North Carolina where they did their bills the same year it was just a couple years later that there were more drug rescues than there were overdose deaths,” said Lynch. “We are certainly hoping that will be the case for us.”

Lynch also sponsored the language that in 2014 and 2016 became the laws related to naloxone.

He began working on these issues after learning that the son of one of his childhood friends died of a heroin overdose.

“What inspired me was he was taking his sadness and turning it into something positive, and he became an advocate that other parents wouldn’t have to go through what he did,” said Lynch, who said as he’s worked on these issues he’s seen many other parents who do the same. “To turn all their energies around and to try and get laws changed, to raise awareness … It inspired me to get into an area that I don’t really know much about.”

Having sponsored now a series of laws aimed at saving the lives of overdose victims, Lynch is now wondering what the next such issue to tackle might be. He’s meeting with the advocacy groups he’s worked with before in looking for the next steps that could be taken.

“Most of those areas are going to be in the treatment side and in the prevention side, and certainly those are so important,” said Lynch. “Saving their lives is such a narrow part but important part of it, but if we can get people not to use it or if we can get people off of heroin or the opioid addiction … I’m really looking forward to making some progress on some treatment laws.”

Meanwhile, Lynch says there must be an awareness campaign so that people with drug problems know about the laws that have been passed in recent years and can take advantage of them.

“I’ve already talked to some of the people that I’ve been dealing with on these bills for years, particularly in the metropolitan areas, to run some big awareness [campaigns] that you can call because if they don’t know, they’re still not going to call,” said Lynch. “Unfortunately it’s not just the metro areas that are having problems – it’s everywhere.”

The immunity law is often called the “Good Samaritan” law, or “Bailey and Cody’s Law,” for two overdose victims whose parents believe having it in place might have saved their children’s lives.

House backer of prescription drug monitoring wants a special session to get program passed

The legislative session has ended without passage of a statewide prescription drug monitoring program (PDMP), but the top advocate for that issue hopes the legislature will be called back early to try again.

Representative Holly Rehder (R-Sikeston) has been pushing for a statewide PDMP for several years. Missouri is the only state that does not have one, though several of its counties are participating in a program based in St. Louis County.

She kept fighting until the final hours of the session on Friday for passage of a bill to create a program. Now she hopes Governor Eric Greitens (R) will call a special session of the legislature to focus on the issue.

“I think if there’s any hope of us getting a statewide [PDMP] passed it’s going to have to be a special [session] sooner than later, and I’m going to have to have help from [legislative] leadership,” said Rehder.

Backers of PDMPs say they help fight prescription drug abuse, particularly opioids. PDMPs collect and monitor drug prescription and dispensing data to look for, among other things,

“doctor shopping;” the visiting of multiple doctors in an attempt to get as much as possible of drugs that are commonly abused.

Rehder came away from a conference between selected House and Senate members with a version of the program that would purge patient data after two years; would include reporting on all schedules II through IV drugs; and a mandate that all physicians would have to report to the system. She said she simply ran out of time Friday to educate fellow lawmakers on the measure to get it passed.

She said in order to get a statewide PDMP passed time is now of the essence, because with no program having been approved by the legislature, more counties will be looking to join St. Louis County’s system.

“We’ve kind of reached a tipping point with these counties,” said Rehder. “We can never get that type of a robust program out of both [chambers of the legislature], yet I need counties’ representatives’ votes to get it out of the House, and so … if we don’t get this out in something like a special session right away, the more counties that get added, just the more reps that are going to have to be against it.”

Rehder believes if the legislature is called back for a special session it will be able to come to agreement on a monitoring program, and she thinks it will look much like the bill that came out of the conference committee in the final days of the session.

Rehder said if a county-by-county PDMP is the only option, she’ll support that, but she still thinks it is important that a state-run PDMP be created.

“We shouldn’t be penalizing people’s safety because of their zip code,” said Rehder, saying anyone could drive until they are in a county that isn’t participating in a program.

She noted proposals for a state program would also prohibit authorities from using prescription data to prevent individuals from owning guns – a provision the St. Louis County program doesn’t have.

In order for a bill to pass the House, Rehder would likely need to regain the support of urban Democrats whose districts are covered by the St. Louis County program. Many voted against the final proposal to come before the House, viewing the program it would create as less robust than the county’s.

House passes bill to shield those seeking help for overdose victims

The state House has approved a bill that supporters hope will prevent overdose deaths.

House Bill 294 would give immunity from charges for minor possession of drugs or paraphernalia or being under the influence to a person who calls for emergency medical attention for someone who is overdosing on drugs or alcohol, and would give immunity to the person in need of medical attention.

The bill’s sponsor, Representative Steve Lynch (R-Waynesville), called the bill an effort at “harm reduction,” and refers to it as “Bailey and Cody’s law,” for two overdose victims whose parents believe that having such a law in place might have saved their children’s lives.

“I fight hard on this issue because I believe that every life is valuable, and that some, because of bad decisions, or bad circumstances, or bad home life, or running with the wrong group, make one wrong decision sometimes and because heroin or opioids are so powerful, it takes all those dreams that they had and all those goals, and it becomes the next fix that becomes their focus,” said Lynch.

Lynch’s legislation won bipartisan praise and support. Velda Village Hills Democrat Clem Smith said in the neighborhood he grew up in, he saw people who had overdosed and their bodies were left, sometimes for days, in places like alleys and empty lots by people afraid of being prosecuted if they called for help.

“I’m glad that your bill will allow that somebody could get some help. Sometimes it’s those minutes that make a difference,” said Smith.

Lynch said this “Good Samaritan” bill has been shown in other states and local areas to save lives, particularly when working in conjunction with bills that allow first responders or friends and loved ones to have and administer naloxone – a drug that counteracts overdoses to opioids, including heroin. Missouri in 2014 and 2016 enacted such laws, both also sponsored by Lynch.

Lake St. Louis Republican Justin Hill, a former police officer, was one of 21 “no” votes against HB 294. He said by giving immunity to callers and those overdosing, the bill takes away an opportunity to get those individuals into treatment programs.

“There’s all kinds of problems with this, and here’s another bill that purports to help people with a drug problem that makes it worse,” said Hill.

The bill passed with 134 votes and goes to the Senate for consideration.

Earlier story: Proposed ‘Good Samaritan Law’ aims to save the lives of some who would overdose