Editor’s note: This story has been updated.

Legislators are eyeing new mandates on providers of healthcare, as laid out in five bills forwarded to the General Assembly on Monday.

The Opioid and Other Substance Use Disorders Study Committee formed in 2017 to review substance-use disorders, medication-assisted treatment and gaps in the system of care.

Bill 1 would limit co-payments that acupuncturists and physical or occupational therapists could charge, as well as requiring insurance carriers to cover acupuncture and physical therapy visits in their plans. The provisions are aimed at allowing alternative approaches to pain management other than opioids.

“We heard from more than one doctor about how they would like to provide options like physical therapy or occupational therapy before they turned to opiates,” said Rep. Bri Buentello, D-Pueblo. “Insurance companies are ostensibly saying, ‘no, you need to give them the painkillers right away.'”

The bill also makes permanent the requirement of opioid prescribers to limit new patients to a seven-day supply and to check with the state’s prescription drug monitoring program before refilling a prescription. Pharmacies upload prescriptions for some categories of medications to the program for providers to check before assigning drugs to patients.

Elsewhere in the package of legislation, insurance companies would be required to cover treatment for substance-use disorders.

“The bottom line is that these very dangerous, addictive drugs were more or less handed out like Tic Tacs for the better part of a decade,” Buentello added.

Legislators also addressed opioid addiction within the criminal justice system, requiring jails and the Department of Corrections to provide treatment to those with an addiction, and to continue their treatment throughout their incarceration.

Drug treatment has been a tool to cut recidivism rates. A 1999 study of a California prison found that 27% of inmates who received treatment re-offended – compared to 75% who did not receive treatment. A multi-state study from that same year mirrored those results.

For the general population of Colorado, Bill 2 would extend legal protections to people who deliver expired opioid-countering drugs like naloxone, as well as requiring insurance to pay for such drugs if administered in a hospital.

Finally, legislators would direct millions of dollars into a range of programs. Individual placement and support programs would receive $2 million per year. Housing assistance would increase five-fold, to $5 million. A tweak to the definition of child abuse would include any instance of a baby being born affected by alcohol or other substance, unless prescribed. 

“There is not one silver bullet to address the opioid epidemic; it’s a complex, enormous problem,” said Sen. Brittany Pettersen, D-Lakewood, said in a statement. “While today we passed the most impactful package we’ve seen yet, I know that our work isn’t done, and we are committed to continuing the work to address this crisis.”

Deaths due to opioids, either by prescription or heroin, numbered 9.8 per 100,000 Coloradans in 2017. That is nearly a 400% increase from 1999. Methamphetamine deaths were a distant second, and all drug deaths combined placed Colorado slightly below the national average of 21.7 overdose deaths per 100,000 people.