Public Health Committee
JOINT FAVORABLE REPORT
Bill No.: HB-5430
Title: AN ACT CONCERNING OPIOIDS.
Vote Date: 3/25/2022
Vote Action: Joint Favorable Substitute
PH Date: 3/14/2022
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
The Public Health Committee
REASONS FOR BILL:
This bill institutes several changes to the statutes to continue the fight against the opioid
epidemic. The bill adds chiropractic and spinal cord stimulation to the list of treatment options
that must be included in a patient's treatment plan when they are prescribed opioids for more
than 12 weeks. It also removes from the statutory definition of drug paraphernalia, drug
testing applications used by individuals before they take drugs to prevent an accidental
overdose. Additionally, the bill allows treatments like methadone, as well as behavioral health
services or substance use disorder treatment services, to be disbursed through mobile units.
Finally, the bill requires the Department of Mental Health and Addiction Services's (DMHAS)
use disorder plan to include policies to reduce the impact of behavior associated with drug
abuse.
RESPONSE FROM ADMINISTRATION/AGENCY:
Manisha Juthani, Commissioner, Department of Public Health (DPH):
DPH is supportive of efforts outlined in this bill, such as allowing the purchase and distribution
of fentanyl testing strips for harm reduction purposes and allowing methadone to be
administered remotely through a mobile narcotic treatment program that follows existing Drug
Enforcement Administration (DEA) regulations. The Department has concerns with Sec. 3 &
4, which remove the requirement for a pharmacist to receive appropriate training by a
program approved by the Department of Consumer Protection (DCP) prior to prescribing
naloxone. Proper training of individuals who may have the need to use naloxone is essential
to the effective use of this product.
While DPH agrees with the intent of Sec. 9, as data sharing is an important measure for
tracking and monitoring the opioid epidemic, the Department requests that this section be
removed. Interagency data sharing to address the opioid crisis is currently taking place, and
the Department has several Memoranda of Understanding with sister state agencies to track
data specifically related to the administration of associated grant funded initiatives.
Nancy Navarretta, Commissioner, Department of Mental Health & Addiction Services:
DMHAS fully supports Sec. 2 of this bill, which addresses harm reduction by legalizing the
drug testing applications by individuals who may use harmful drugs. This change will also
allow DMHAS to utilize federal dollars for fentanyl test-strip distribution. Sec. 3 & 4 are
concerning, as they remove an avenue for education related to the use of naloxone, which
could potentially put individuals at risk. Sec. 7 is unnecessary as the DMHAS Triannual
Report provides information on all levels of services available across the lifespan, and the
change would be duplicative. Sec. 9 establishes a parallel process to the already robust data
sharing occurring at the state level, spearheaded by the well-established, legislatively
mandated Alcohol and Drug Policy Council (ADPC).
Michelle Seagull, Commissioner, Department of Consumer Protection (DPH):
Sec. 2 & 8 of this bill will create additional harm reduction tools to help to combat the ongoing
opiate crisis. Sec. 3 & 4 are concerning as required training that will be removed. This training
is a one-time requirement of a pharmacists continuing education that ensures that patients
and loved ones receive instructions about how to administer this lifesaving medication, upon
dispensation. They also contend that Sec. 9 is duplicative and unnecessary.
NATURE AND SOURCES OF SUPPORT:
Dr. Mehul Dalal, Community Services Administrator, City of New Haven:
Mobile methadone treatment can help marginalized populations such as persons
experiencing homelessness, are homebound, have a disability, or lack transportation to
access these programs. That provision will be a step in the right direction to help reduce
treatment barriers for individuals most at-risk for overdose deaths. We discourage the
creation of any additional restriction beyond what is required by federal regulations and we
also encourage the DCP, coordinating with other state agencies, to provide a streamlined
pathway for practitioners to establish and implement mobile programs.
Joseph Podolski, Chief Medical Officer, Root Center for Advanced Recovery:
Sec. 6 of the bill allows DMHAS to grant exceptions to allow for takehome doses of up to
twentyeight days for stable patients and up to fourteen days for a less stable patient, even if
it exceeds relevant federal statutes. These changes provided much needed flexibility during
the pandemic. This provision has the potential to remove treatment barriers for some of our
patients.
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Ben Shaiken, Director of Government Relations, CT Community Nonprofit Alliance:
Sec. 6 of this bill will increase the availability of take-home methadone for people recovering
for opioid addiction. More broadly, however, Connecticut does not have the luxury of time to
address the opioid crisis in Connecticut. For behavioral health services, legislative
commitment to increase funding is needed now more than ever, as opioid overdose deaths
have skyrocketed during the pandemic. There is no way to address the gaps in the mental
health system without addressing the chronic underfunding of the existing services provided
by nonprofits.
Brendan Saloner, Associate Professor, Johns Hopkins School of Public Health:
Sec. 9 of this bill creates a foundation for a data-driven public health response to the opioid
overdose crisis. Specifically, linked administrative data systems will allow the state to identify
opportunities for intervention, monitor evolving trends in a rapidly changing landscape, and
evaluate the impact of statewide policy strategies such as expanded provision of medication
treatment for opioid use disorder or broadened access to harm reduction services.
Sumitha Raman, Chief Resident, Yale Internal Medicine-Primary Care Program:
Sec. 9 of this bill directs state agencies including DMHAS, DCP, and others to share data
relevant to the opioid epidemic such that a shared database can be created to identify the
needs of patients who are directly impacted by opioids. Although the state agencies have
established a variety of services to combat the opioid epidemic, the states ability to further its
response to the burgeoning epidemic is hindered by the lack of shared data among agencies.
This bill furthers a data-driven approach to the issue.
Connecticut Chiropractic Association:
Far too many patients who suffer from chronic or excruciating pain become addicted to
narcotics as they attempt to deal with this problem. Fortunately, patients can successfully
treat their pain issues without the use of drugs. A drug-free approach is a chiropractic
treatment for our patients, and we do it very successfully. This bill would be one more step in
the recognition of the treatment provided by a chriropractor.
Additional Testimony in Support
Kellie Choquettem, For Cameron
Joseph Firine, For Cameron
Dawn Hemstock, For Cameron
Rick DelValle, President, New Beginning Recovery
Jennifer Muggeo, Deputy Director-LLHD, New London County CARES
Dr. Tanner Bommersbach
Dr. Katherine Kennedy
Dr. Daniel Kerekes
Benjamin Howell, MD, Yale University
Claire Gibson, MD
Zina Huxley-Reicher, MD
Emma Lo, MD
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 Darve Robinson, MD
Andrew Segoshi, MD
Stuart Steinman, MD FACEP
Karron Cohoon, PMHNP-BC
Jeff Holland, New Canaan
Francesca Maviglia, New Haven
NATURE AND SOURCES OF OPPOSITION:
No sources of opposition were provided for this bill.
Reported by: Dallas Emerle Date: 4/6/2022
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Statutes affected:
Raised Bill: 20-14s, 20-633c, 20-633d
PH Joint Favorable Substitute: 20-14s
File No. 416: 20-14s
File No. 582: 20-14s
Public Act No. 22-108: 20-14s