Heroin OD drug bill progresses at Capitol

Examples of opiates
Hennepin County Sheriff Rich Stanek brought examples of the different forms of opiates to show the Senate Committee on Health, Human Services and Housing members during a hearing on Monday, March 10, 2014. Here, a deputy holds the display.
Jon Collins / MPR News

As U.S. Attorney General Eric Holder urged law enforcement to start carrying a drug that reverses opiate overdoses, a state Senate committee pushed forward a bill Monday evening that would allow that to happen in Minnesota.

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The proposal would make Minnesota the 18th state to allow emergency responders or other trained volunteers to carry and administer the anti-overdose drug Narcan, also known generically as naloxone.

The bill is sponsored by Sen. Chris Eaton of Brooklyn Center, whose daughter Ariel Eaton-Willson died of a heroin overdose in 2007, said a lot of states across the country are looking to Narcan for relief as use of opiates becomes more widespread.

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"For some reason it became OK with middle-class suburban kids to try it as a recreational thing," Eaton said. "Unfortunately for them heroin is pretty unforgiving, it's very addictive and every time you do it you have a chance of overdosing."

The Senate bill got its first hearing in the Committee on Health, Human Services and Housing on Monday evening. Committee members unanimously voted to send it on to the Judiciary Committee, where it's expected to appear Friday.

Opiates, including prescription drugs like oxycodone and street drugs like heroin, can shut down a user's respiratory system. Narcan can revive an overdose victim until they can receive more thorough medical care, according to Hennepin County Medical Center addiction medicine specialist Dr. Charles Reznikoff.

"Narcan buys 45 minutes to an hour where it blocks the heroin's activity and wakes them up, that gives them time to then seek emergency room help or seek help otherwise," Reznikoff told the committee. "And it may hopefully be a wakeup call, hopefully that's their rock bottom, and then they realize there's something valuable in life."

Reznikoff said two types of opiate users are at risk for overdose: younger people who are recreationally using heroin and older people who have been prescribed opiates for pain management.

"This isn't a tool just for addicts -- it's going to save addicts' lives and it's going to give them a chance to get into recovery," Reznikoff said. "This is also a tool for those in pain, and for family members of those in pain, so that they can be more safe in their medications."

Narcan can currently only legally be prescribed from a doctor directly to a patient or administered by medical professionals like emergency room doctors or paramedics. Narcan doesn't get people high and won't have any effect on people who don't have opiates in their systems.

Under Eaton's bill, emergency responders, police and the staff of health or social service organizations would all be legally able to carry and administer Narcan. Advocates say the language in the bill would also entitle them to train lay people, even family members of those prescribed opiates, in how to administer the anti-overdose drug.

Corrine Rockstad of St. Paul attended Monday's hearing in order to give voice to her 28-year-old daughter Elizabeth, who died of a prescription opiate overdose in April. She had been prescribed Oxycodone for a chronic pain condition just a few months before.

"When you're on pain medication you often fall asleep, and that's what she did, and she didn't wake up," said Corrine Rockstad, who found her daughter after the overdose. "If she would have been prescribed naloxone or Narcan right along with her Oxycodone, I could have saved her life -- I would have paid millions of dollars for it."

The move to expand access to Narcan comes during what public health officials are calling an opiate epidemic. In Minnesota in particular, law enforcement officials say the heroin is especially cheap and pure.

Hennepin County Sheriff Rich Stanek has been a longtime backer of making Narcan more widely available. Fifty-six people died just of heroin overdoses in Hennepin County last year. Stanek said his department and others across the state have been ramping up enforcement and education efforts, but that more needs to be done.

"We must address the issue of preventable deaths due to heroin overdose," Stanek told the committee members. Narcan "gives law enforcement the opportunity to save lives."

The portion of Eaton's bill that allows more widespread use of Narcan is uncontroversial and has earned the backing of organizations as diverse as the Minnesota Sheriffs' Association, the Minnesota Medical Association, the Minnesota Board of Pharmacy and the Minnesota Department of Health.

Another component of the bill, called Good Samaritan Overdose Medical Assistance, is running into opposition in its current form from some law enforcement agencies and state county attorneys. It would give limited immunity from prosecution for drug or paraphernalia possession to someone who called 911 to report an overdose.

Stanek, speaking for the Minnesota Sheriffs' Association, said sheriffs have some concerns about the Good Samaritan provision, but that they're working with the bill's authors to get them ironed out by Friday's hearing in the Senate Judiciary Committee.

John Kingrey, executive director of the Minnesota County Attorneys Association, said members are concerned that the bill would take away prosecutors' discretion about how to charge cases.

"The main concern is that here you have an individual who has provided a drug to somebody who is now experiencing an overdose," Kingrey said. "We need to follow that trail up the chain there to find out where those drugs are coming from, and we think this would interfere with that."

Kingrey said his association does support a provision that reporting an overdose could be considered as a "mitigating factor" in a criminal prosecution. But he said they'd strongly oppose offering blanket immunity and may ask Gov. Mark Dayton to veto the legislation if it makes it to his desk.

The bill's authors have included some language that would limit immunity in cases where evidence of wrongdoing is obtained by an independent source not related to the person seeking medical help for the overdose victim.

Eaton said her daughter was with a friend when she overdosed. After she fell out, the man tried to dispose of the drugs and paraphernalia rather than seeking out help.

"There was no reason for him not to call for help if he didn't have to worry about arrest," Eaton said. "I think if he'd known he was safe that way, he would have called for help, they'd known one another for a long time, and she might be here today."

The immunity portion of the legislation is called "Steve's Law" in honor of Steve Rummler, who died of an opiate overdose in 2011. His fiance, Lexi Reed Holtum, who helped put together the bill through the Steve Rummler Hope Foundation, said the Good Samaritan provisions aren't a get out of jail free card.

"It's about good public health and safety," Holtum said. "What we'll see happen is that people will actually stay with people and call for help when they're in a situation where someone is dying."

The Good Samaritan portion of the bill is backed by the Minnesota Medical Association and the Minnesota Department of Health. It will be discussed Friday in the Senate Judiciary Committee. A House version of the bill has been referred to the Judiciary Housing and Finance Committee.