SB 459 Passed the Assembly!

It has been an action oriented week at the legislature for SB 459! Thanks to PHASA allies continuing their hard work to educate our legislators and telling their compelling stories,  SB 459 passed the assembly with amendment. The next step is to get a majority vote through the assembly floor session which is slated to happen May 1, 2015 beginning at 11:30am. Then it is off to the Governor to get signed into Nevada Revised Statute (if it passes the assembly floor session)!

What can you do now?

Getting The Issue into the Media
Screen Shot 2015-04-30 at 5.56.31 PM

No compromise on naloxone for SB 459!

The Nevada State Medical Association (NSMA) has written a “friendly amendment” compromising the integrity of SB 459 to establish opioid overdose prevention policy for Nevada . PHASA will NOT compromise on standing orders and 3rd party prescriptions (section no. 7). There have also been some reservations from Assemblywoman/Dr. Titus. This is a CALL TO ACTION for those of you that support SB 459 as the bill stands.

  1. Write the Governor’s office and raise hell!  Accept no compromise on standing orders and 3rd party prescriptions for SB 459!
  1. Give thank you’s to the HHS committee members who spoke in support of this bill and reach out to those who have expressed apprehension.  We want to know who we appreciate so that they can persuade those who are hesitant on the committee.  We need phone calls and emails written by MONDAY, as big decisions will be made at the first part of the week to see what we can resolve by the deadline 4/10.
  1. Contact ANYONE you know who is a provider or pharmacist who would be affected by the NSMA objections to see if they will argue on our behalf in a letter or phone call.
  1. Don’t give up HOPE!!!  The HHS committee does NOT have to accept the NSMA recommendations.  We don’t have to accept a BAD bill and there are members of our legislature listening to us.  Members of PHASA have been contacted personally by the Governor’s office to say that we made a difference and helped convince them of this important piece of legislation.  We can work with the rest of the committees to do the same!

Here is the list of our current Health and Human Services Committee members.

Joe P. Hardy – Chair 702-293-7506 S
Ben Kieckhefer – Vice Chair 775-223-9618 S
Mark Lipparelli 775-684-1475 S
Joyce Woodhouse 702-896-1453 S
Debbie Smith 775-391-8031 S
James Oscarson – Chair 775-684-8805 A
Robin L. Titus – Vice Chair 775-684-8507 A
Jill Dickman 775-684-8563 A
David M. Gardner 775-684-8549 A
John Hambrick 775-684-8827 A
Brent A. Jones 775-684-8573 A
John Moore 775-684-8537 A
Glenn E. Trowbridge 775-684-8505 A
Nelson Araujo 775-684-8599 A
Teresa Benitez-Thompson 775-684-8845 A
Amber Joiner 775-684-8559 A
Ellen B. Spiegel 775-684-8577 A
Michael C. Sprinkle 775-684-8841 A
Tyrone Thompson 775-684-8569 A

It is absolutely essential that we make phone calls and emails to each of these legislators ASAP!

If you are able to write emails addressing each Committee Member individually this is the MOST effective way to persuade the individual legislators about the value of our message.

If you are unable to address each Committee Member individually then writing one letter and sending it to everyone is still better than tacit consent and our silence!

If you only write one or two personalized letters the people to target are the Doctors on the committee who likely have the most weight.

Joe P. Hardy – Chair 702-293-7506 S
Robin L. Titus – Vice Chair 775-684-8507 A

You can also email the Governor to tell him this bill will not stand as is here

We need to let our committee members know that this is NOT acceptable!

Please start revising your letters to let your legislators so they know that we are NOT willing to compromise on the 3rd party prescribing or standing order provisions! Sample documents are attached. Here is a template to get you started, just change the highlighted areas to personalize: Sample Letter to Legislators Template. Be sure to include the PHASA Positioning Statement!

We only have until 4/10 to get this out of the committee hearings with a bill all parties can agree upon, or the bill dies or becomes a BAD bill.

HHS Takes Strong Steps to Address Opioid-Drug Related Overdose Death

hhslogoHHS takes strong steps to address opioid-drug related overdose, death and dependence
Evidence-based, bipartisan efforts focus on prescribing practices and treatment to reduce prescription opioid and heroin use disorders

U.S. Health and Human Services Secretary Sylvia M. Burwell today announced a targeted initiative aimed at reducing prescription opioid and heroin related overdose, death and dependence. Deaths from drug overdose have risen steadily over the past two decades and currently outnumber deaths from car accidents in the United States. The President’s FY 2016 budget includes critical investments to intensify efforts to reduce opioid misuse and abuse, including $133 million in new funding to address this critical issue.

The Secretary’s efforts focus on three priority areas that tackle the opioid crisis, significantly impacting those struggling with substance use disorders and helping save lives.

Providing training and educational resources, including updated prescriber guidelines, to assist health professionals in making informed prescribing decisions and address the over-prescribing of opioids.
Increasing use of naloxone, as well as continuing to support the development and distribution of the life-saving drug, to help reduce the number of deaths associated with prescription opioid and heroin overdose.
Expanding the use of Medication-Assisted Treatment (MAT), a comprehensive way to address the needs of individuals that combines the use of medication with counseling and behavioral therapies to treat substance use disorders.
Addressing the opioid crisis is a top priority for the department and the Secretary is committed to bipartisan solutions and evidence-informed interventions to turn the tide against opioid drug-related overdose and misuse. Read more…


Advocacy Materials for Senate Bill 459

Creating your lobby packet?  Let us help you! Here are some materials we put together to help educate your friends, neighbors, legislators, dog, grandma and house plant on the importance of Naloxone access and a Good Samaritan Law. Use at your leisure…

Important Documents for Naloxone Access and the Good Samaritan Law:

Senate Bill 459 – Being Heard 4/1/15

We support Governor Brian Sandoval’s fight to establish an opioid overdose prevention policy for Nevada (check out our positioning statement)!

Check out SB459, sponsored by the Committee on Health and Human Services on behalf of Governor Sandoval:

This bill is slated to be heard April 1, 2015 at 3:30pm. Get your testimony ready!

Meeting Information
  • 401 S. Carson Street
    Carson City, NV 89701
  • Room 2149
  • (775) 684-1441
  • Submit all documents, handouts and exhibits in support of your testimony must be submitted electronically in PDF format no later than 5p.m. the day before the meeting to the Committee on Health and Human Services Committee Manager at In addition, please bring 20 copies of your documents, handouts, and exhibits to the meeting for distribution to the public. If you are planning to provide a PowerPoint or other electronic presentation, you are responsible for notifying the Committee Manager prior to the meeting and bringing your own electronic copy for presentation.
Committee on Health and Human Services Members

Need advocacy materials? We have you covered! Click here

Positioning Statement SB 309: Establishing Opioid Overdose Prevention and 911 Good Samaritan Policies for Nevada

Drug overdose deaths are a major public health and safety issue in Nevada and the U.S. According to the Centers for Disease Control and Prevention (2012), Nevada is in the highest quartile of overdose death rates in the U.S. In 2013, there were 507 drug-related deaths in Nevada according to data from the National Vital Statistics Database. The rate of drug related deaths in Nevada doubled from 8.9 per 100,000 in 1999 to 17.5 per 100,000 in 2013.

In the U.S., deaths from overdose now exceed the annual rate of deaths caused by homicide and vehicle collisions. The majority of drug overdose deaths in the U.S. involve prescription or illicit opioids. In the U.S., the rate of prescription opioid related deaths quadrupled from 1999 to 2011.

This is a national epidemic that is being addressed at both the local and national level. At the federal level, President Obama has earmarked $133 million in his FY 2016 budget request to address the epidemic of heroin use, prescription drug abuse, and overdose deaths.

At the local level, the Public Health Alliance for Safety Access (PHASA, established 2011), an advocacy group for policy, system and environmental changes that promote the health and well being of all Nevadans, is working to support effective, public-health minded policies to reduce the burden of overdose deaths in Nevada. PHASA applauds the work of Governor Sandoval, Senator Kieckhefer, and Assemblyman Sprinkle in proposing BDRs 1199 (Sandoval) and 40-214 (Kieckhefer), which has coalesced to be Senate Bill (SB) 309, this will establish opioid overdose prevention and 911 Good Samaritan policies for Nevada. PHASA supports our legislators in their fight to end opioid overdose deaths in Nevada.

As of 2014, 28 states across the U.S. have passed laws to expand access to naloxone, the life-saving medication that can be used by bystanders to reverse the potentially fatal effects of an opioid overdose. As of 2010, more than 50,000 people in the US have been trained to use naloxone, and have used naloxone more than 10,000 times to respond to overdoses in their communities. In addition, 22 states have passed 911 Good Samaritan laws, which encourage witnesses to call for emergency medical help in the event of a drug overdose.

In accordance with other states and organizing bodies that seek to pass effective, public health-minded reform to reduce drug overdose deaths, PHASA recommends that the following provisions be included in Nevada’s drug overdose prevention legislation:

Naloxone Access Provisions

Authorization for health care professionals with existing prescribing authority to prescribe and dispense naloxone, directly or by standing order, to people at risk of experiencing an opioid-related overdose, or to a family member, friend, or other person in a position to assist.
Protection from criminal, civil, or professional liability for health care professionals who prescribe or dispense naloxone
Assurance that the possession of naloxone is lawful
Protection from civil and criminal liability for any individual who possesses naloxone and/or acts in good faith to administer naloxone to an overdose victim
Authorization for basic EMTs to administer naloxone
Guidance for the inclusion of naloxone on the Medicaid Preferred Drug List
Authorization for persons or organizations acting under a standing order issued by a health care professional to store and dispense naloxone
Collection of data on drug overdose numbers, rates, trends, patterns, and risk factors in Nevada
Provisions of grants from existing resources to support drug overdose prevention and naloxone access

911 Good Samaritan Provisions

Protection from arrest, charge, prosecution, conviction, or forfeiture resulting from commission of drug-related crimes, violation of a restraining order, or violation of probation or parole, if the evidence for the arrest, charge, prosecution, conviction, seizure or penalty was gained as a result of seeking medical assistance for a person experiencing a drug or alcohol overdose or other medical emergency.

We further suggest that the following provisions be avoided in Nevada’s law, due to their potential to weaken the effectiveness of the law:

Any mandates regarding the quantity, duration, timing, location, context, or other details of providing training and education on overdose prevention and naloxone.
Why should this not be included? Due to the diversity in educational needs of individuals at risk, their friends and family members, and the variety of circumstances related to each clinical encounter, mandating universal training requirements will limit the ability of health care professionals and public health departments to exercise due care when educating their patients and will create barriers to providing and accessing effective prevention resources. Training and education should be conducted based on the professional judgment of the health care professionals and program staff.

The identification of a single entity (e.g., a health department, community based organization, or clinical entity) that is entirely responsible for the implementation of overdose prevention activities.
Why should this not be included? Due to the diversity of need throughout Nevada and unique circumstances of communities in different areas of the state, identifying a single “home” for overdose prevention would unduly burden a single entity with a large programmatic mandate and would create barriers to accessing effective prevention resources. Decisions about how and where to provide overdose prevention services should be left to the community stakeholders and the entities providing the services.

Any mandate regarding the specific formulation or route of administration for naloxone
Why should this not be included? The changing nature of the pharmaceutical industry means that there is constant flux in the availability and pricing of different formulations of naloxone (i.e., higher concentration used to administer intranasally vs. lower concentration used for intramuscular administration). Creating a mandate for the use of a single formulation or route of administration would unduly burden consumers, providers, and programs, while potentially limiting access if the mandated formulation became unavailable.

PDF of Positioning Statement

Adapted from the Naloxone Overdose Prevention Education Working Group: 
Naloxone Legislation Drafting Guide

Huffington Post: Heroin-Linked Deaths Surge 39 Percent, CDC Finds

Drugs are prepared to shoot intravenously by a user addicted to heroin on Feb. 6, 2014, in St. Johnsbury Vermont. Vermont Gov. Peter Shumlin recently devoted his entire State of the State speech to the scourge of heroin. Heroin and other opiates have begun to devastate many communities in the Northeast and Midwest leading to a surge in fatal overdoses in a number of states. As prescription painkillers, such as the synthetic opiate OxyContin, become increa | Spencer Platt via Getty Images

Drugs are prepared to shoot intravenously by a user addicted to heroin on Feb. 6, 2014, in St. Johnsbury Vermont. Vermont Gov. Peter Shumlin recently devoted his entire State of the State speech to the scourge of heroin. Heroin and other opiates have begun to devastate many communities in the Northeast and Midwest leading to a surge in fatal overdoses in a number of states. As prescription painkillers, such as the synthetic opiate OxyContin, become increa | Spencer Platt via Getty Images

Overdose deaths linked to heroin jumped 39 percent in 2013 from the year before, according to data released Monday by the Centers for Disease Control and Prevention.

The CDC said 8,257 people died of heroin-related deaths in 2013, compared with 5,925 deaths in 2012. The number of overdose deaths overall increased to 43,982 from 41,340.

Many more Americans die from prescription opioids. But the rise in fatal heroin overdoses came as users of prescription painkillers switched to the cheaper, illicit street drug. The heroin deaths contributed to an overall 6 percent jump in drug overdose deaths in 2013 from 2012. Read more…

NPR Story: Teaching Friends and Family to Reduce a Drug Overdose

Tina Wolf demonstrates the use of naloxone to community members in Lindenhurst, N.Y., during an overdose prevention training. Georgia Dolan-Reilly (left) of the Suffolk County Prevention Resource Center helped with the training. Kevin Hagen for NPR

Tina Wolf demonstrates the use of naloxone to community members in Lindenhurst, N.Y., during an overdose prevention training. Georgia Dolan-Reilly (left) of the Suffolk County Prevention Resource Center helped with the training.
Kevin Hagen for NPR

When Priscilla Graham-Farmer went to get her hair done in Newark, N.J., recently, she noticed the elevator in the building was broken, so she took the stairs. And that’s when Graham-Farmer saw him: a young guy sprawled out, not breathing.

“He was literally turning blue,” she says. “And everybody was walking over him.”

But Graham-Farmer stopped. And looked closer. She saw that he had a needle and some cotton balls. The guy had clearly overdosed.

“I’m screaming in the hallway,” Graham-Farmer remembers. “Nobody’s answering.” Click here for the rest of the story…

History of PHASA

PHASA LogoThe Public Health Alliance for Syringe Access (PHASA) was formed in 2011 as an ad hoc policy committee to the Nevada State AIDS Task Force to bring forth policy change regarding Nevada Revised Statute (NRS) 458.480, which prohibited the distribution of hypodermic devices beyond medical purposes. This law served as a barrier to reduce the spread of HIV, hepatitis and other blood-borne illnesses by inhibiting syringe service programs and the distribution of hypodermic devices to people who inject drugs. Syringe Service programs are considered evidence based practice to reduce the spread of disease among people who inject drugs and have also provided linkages into continued care.

In 2012, PHASA evolved to become an ad hoc policy of the Northern Nevada Outreach Team (NNOT) with the same mission in mind. Taking lessons from the 2011 Nevada legislative session, PHASA conducted a statewide needs assessment for syringe access to obtain localized data, mobilized the community for support and testimony, and educated all of Nevada on the benefits of syringe service programs. In 2013, SB 410 passed (sponsored by Senator David Parks) and Governor Brian Sandoval signed legislation into law. In 2014, the first syringe service program in Nevada opened called Change Point in Reno, Nevada.

BusinessCardLogoPHASA has since evolved to the Public Health Alliance for Safety Access to tackle further policy, systems and environmental changes that will establish sound law regarding health and wellness for all Nevadans. In the 2015 legislative session, PHASA will be tackling the regulation of naloxone distribution which provides as a barrier to reduce opioid overdose deaths in Nevada. Additionally, PHASA will be supporting legislative reform to institute a Good Samaritan Law in Nevada which will protect people from persecution if they assist an individual who may be fatally sick from a drug overdose.