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Conmonweatra oF PenwavivAnia Orrice oF THe Govennon October 3, 2016 De. Robert Calif Commissioner United States Food and Drug Administration 10903 New Hampshire Avenue Silver Spring, MD 20993 Dear Commissioner Calift am writing today in support of the Food and Drug Administration expanding access to and development of opioids with abuse-deterrent formulations. Pennsylvania, and indeed the nation, is experiencing an unprecedented opioid abuse and heroin use epidemic, When I became Governor, Imade ita top priority of my administration to fight the epidemic by focusing our effrts across the whole spectrum of issues ~ education, prevention, weatment, and eriminal justice reform. ‘Through participating in dozens of roundtable discussions across the commonwealth, meeting with numerous cabinet secretaries, and bringing together community leaders, elected officials, medical professionals, and individuals suffering ftom substance use disorder themselves, we have been able to construct better policies in response to the crisis. A consistent message from these discussions is that while prescription opioids are an essential component of modem ‘medicine, over-prescription isa key contributor tothe epidemic. Inresponse, the Pennsylvania Department of Health (DOH) and the Pennsylvania Medical Society have collaborated to create modules to help educate our medical professionals ~ both ‘present and future on how to best approach opioid prescription. These modules wil play a crucial role in reevaluating prescription guidelines to ensure that patients receive the citical pain ‘medication that they need in « safe, sustainable manner. The Pennsylvania Department of Drug, snd Alcohol Programs (DDAP) and DOH have worked together to develop aid impleneat wast hhandoff procedures in emergency rooms across the commonwealth 10 ensure patients with substance use disorder, when identified, are steered appropriately into the aftercare they Aesperately need. In addition, beginning in October, the Pennsylvania Department of Human Services is opening 45 Centers of Excellence across the commonwvealth to coordinate physical and bbchavioral health care and improve access to medication asisted treatment for more than 11,000 individuals suffering from opioid-specfic substance use disorder. Still, I know mote can be done, Dr. Robert Califf October 3,2016 Page Two | support and encourage your efforts to remove unnecessary restrictions on access to and

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