Lawmakers look to monitor opioids, expand treatment

Montana's top prosecutor says he wants the 2019 Legislature to combat addiction to prescription opioids and expand on a policy of treatment rather than incarceration for drug offenders.

Republican Attorney General Tim Fox said his office would suggest legislation requiring photo ID cards when picking up prescription painkillers, making the state's prescription drug registry mandatory and putting a five-day limit on prescriptions for opioids.

"Opioid prescriptions are not monitored very well and people can get addicted very easily," Fox said. "People are dying, people are inundating our justice system and we've gotten to a point where we absolutely have to work together to find solutions."

According to a report released by Montana's Department of Justice, visits to Montana emergency rooms due to drug use increased nearly 60 percent from 2010 to 2015. In 2015, doctors issued over 700,000 prescriptions for opioid painkillers to Montanans.

By making use of the state's prescription drug registry mandatory for doctors and pharmacists, Fox said patients could be tracked on their opioid painkiller use and prevented from developing an addiction.

Expanded treatment

Fox's office said another legislative priority for the attorney general would be to expand specialty courts in the state, specifically those for drug treatment.

"Right now, the emphasis is on treatment courts, diverting people from incarceration and into treatment," said John Barnes, a spokesman for the Department of Justice. Bills passed in 2017 centered on this philosophy as well, with mandatory minimum sentences removed for possession of marijuana along with jail time for a first-time possession charge.

Currently, drug offenders make up most of Montana's prison population, according to the Department of Corrections.

Established in 1996, drug courts offer rehabilitation services for offenders in order to prevent them from entering the prison system. A 2017 report from Montana's legislature showed a decrease in recidivism among those who completed treatment through a drug court.

"One of the problems is they typically rely on grants and a hodgepodge of funding," Fox said. "So, we're looking at a more permanent funding source."

Having received a biennial federal grant for such courts, the cost now falls to the state. According to Bethany McLaughlin, Montana's court administrator, the typical two-year cost of a specialty court is $135,000.

"It's a small chunk when compared to the overall state budget," she said.

One possible source, according to Fox, would be a tax on opioid prescription distributors. When asked if passing such a tax would affect the cost of prescription drugs, Fox's spokesman said he did not see any impact on premiums.

Medical marijuana

As it did in 2017, drug and alcohol legislation will play a prominent role this session, with over 128 bill drafts submitted as of early December. Those ideas range from providing safe haven for pregnant women seeking drug treatment to revising the state's DUI laws and changing policies regarding psychologists' prescription authority. Additionally, legislators may revisit policies regarding marijuana use.

Currently, lawmakers have requested eight bill drafts regarding marijuana, medical and otherwise.

According to the Montana Department of Revenue, cardholders spent nearly $45 million on marijuana in the past year. A bill passed in 2017 ensured that $1.7 million of that was collected in state taxes.

"One of the things that we're looking at is giving the Department of Revenue better oversight on tracking medical marijuana sales," said Rep. Daniel Zolnikov, R-Billings.

Proposals for legislation also include one giving medical marijuana cardholders the option to choose their own provider.

"We want marijuana to hark back to standard business practices," said Rep. Mary Caferro, a Helena Democrat. "Just like going to a dentist, we want those with marijuana cards to be able to select their provider," she said.

This story was written for the University of Montana's Community News Service, which features coverage by students at UM's School of Journalism. Editors with questions about this story may contact reporter Paul Hamby (paul.hamby@umontana.edu) or supervisor Dennis Swibold (dennis.swibold@umontana.edu).