patty murray

After the formal conversations ended, Sen. Patty Murray and Dr. Luke Rosen continue to talk about the suboxone clinic he runs at PeaceHealth St. John Medical Center’s Broadway Campus during her visit to learn about local opioid treatment methods.

Bill Wagner, The Daily News

Editor’s note: The Daily News will take a closer look at the opioid crisis and how it is affecting childbirth in a special report this Sunday.

U.S. Sen. Patty Murray was confronted with a staggering statistic on a tour of PeaceHealth St. John Medical Center on Tuesday: Nearly 50 percent of women who give birth in Longview are substance abusers.

The ranking Democrat on the Senate Health and Education Committee was in town to meet with local health care providers to learn more about the opioid crisis, which is disproportionately afflicting rural America.

Murray said the St. John statistic was one of the most shocking facts she has heard so far after completing dozens of hospital tours throughout the state.

“That is a stunning number and should be a wakeup call that this is not somebody else’s problem. It’s all of ours,” she said.

The figure was shared with Murray by St. John Medical Director Eleen Kirman and Director of Nursing Debbie Luttman.

Kirman and Luttman said the data point emerged after the hospital hired Dr. Natalie Booker in August of last year, who conducted a review and instituted a more rigorous approach to gathering data.

Booker, who previously worked at Kaiser Permanente, is the director of St. John’s birthing unit and emergency department.

Booker has helped restructure St. John’s birthing unit to care for addicted mothers and their babies in Longview instead of transferring them to PeaceHealth Southwest.

Murray also met with Dr. Luke Rosen, who runs St. John’s suboxone clinic at its Broadway campus. Rosen, who’s certified in addiction medicine and behavioral health, is one of just two doctors in Cowlitz County who can legally prescribe suboxone to patients struggling with opioid addiction.

Suboxone blocks the effects of opioid medications and is used to treat individuals suffering from opioid addiction by reducing withdrawal symptoms and cravings.

Of the 78 patients Rosen is currently treating, 11 are pregnant.

“If we really want to solve this, we’ve got to be talking to people who are (treating) it every single day,” Murray said.

Murray had a hand in securing $1 billion in federal funding for states to fight opioid abuse through legislation signed into law last December. But she wanted to know what else the government could do to help local communities.

Rosen offered a number of recommendations Murray could seek to incorporate into federal legislation.

For starters, the government could streamline the prior authorization process to make it easier for opioid-addicted patients to fill prescriptions for suboxone, he said. Prior authorization is a process used by some health insurers to determine if they will cover a prescription medication.

“I’ve had pregnant patients who have had to wait days in order to get this medicine because they were jumping through hoops with their insurance companies,” he said.

Rosen said the government could also make the prior authorization process harder for patients filling traditional opioid painkillers such as oxycontin, hydrocodone, codeine and morphine.

“My other colleagues might hate me for this, but we need to flip it around,” he said.

Rosen also floated the idea of creating a special program for international medical students in order to boost the number of medical professionals who are able to prescribe medications such as suboxone. The suggestion is driven by the shortage of domestic medical school graduates willing to work in rural communities.

The U.S. Drug Enforcement Agency recently changed its guidelines to allow mid-level nurse practitioners and physician assistants to prescribe suboxone, “but there’s no guarantee that all of those folks will,” he said.

Giving green cards to international graduates who help in the fight against the opioid crisis could be one way to expand access to life-saving medications, he said.

Rosen said decriminalizing drug possession would also help.

“We need to treat this more like a disease and less like a crime,” he said.

Murray said she was drawn to Cowlitz County because she wanted to see how rural communities are coping with the crisis.

“I know they don’t have a lot of resources like some of our higher population areas like Seattle,” she said. “I wanted to see firsthand what Longview was doing and what some of the challenges were.”

“We need to treat this more like a disease and less like a crime.” Dr. Luke Rosen,
St. John Medical Center
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