One of Pennsylvania’s top drug watchdogs said Monday opioid use is showing signs of decline as other drugs appear more popular in hotspots across the state.

“The notion of the opioid crisis is starting to wane,” Jennifer Smith, secretary of the Department of Drug and Alcohol Programs, told the Senate Appropriations Committee. “We have seen an uptick in cocaine and meth particularly in Pittsburgh, Philadelphia, Cambria County, and Johnstown, [which] are the first areas to show new trends across the state.”

Westmoreland County District Attorney John Peck recently told TribLive detectives in Western Pa. “are seeing a resurgence of cocaine and methamphetamine as drug users increasingly shy away from heroin.” Why? A fear of fentanyl, the synthetic opioid linked to many of the state’s fatal overdoses.

Smith also said that her agency is seeing more drug use among “ethnically diverse populations,” particularly low-income Pennsylvanians and people of certain nationalities. For instance, Bhutanese immigrants are showing “tremendous need” for alcohol abuse treatment services.

Smith said her office is keeping a “very close watch” on the switch from opioid to cocaine and methamphetamine abuse.

She did not recommend that the state dial back its opioid treatment programs, though, and said Pennsylvania must maintain its opioid treatment capacity as it prepares to confront new types of drug addiction.

Smith also told senators that a growing number of Pennsylvanians are taking advantage of telemedicine services, especially for cognitive behavioral counseling and drug treatment services they may not be able to access locally.

Pennsylvanians who lack reliable transportation, or whose work schedules prevent them from attending in-person appointments, can receive counseling services over the phone or computer from licensed medical professionals, she said.

These services are particularly valuable to rural Pennsylvanians, she said, though demand for telemedicine is widespread across the state.

In addition to cognitive behavioral therapy, many patients turn to telemedicine for specialty services, evaluations, or other diagnostic services they cannot find close to home, Smith said.

This year, her office plans to partner with the Department of Human Services to mount an educational campaign to inform Medicaid patients that telemedicine appointments are often eligible for insurance reimbursements.

Many patients assume that telemedicine services are not covered by Medicaid or private insurance, Smith said.

She hopes that as the field grows in popularity among Medicaid patients, private insurance providers will start to offer reimbursement for remote medical care.

A bill introduced last session by Sen. Elder Vogel, R-Beaver, would have required insurance companies cover “medically necessary telemedicine” if the same care is provided in person. The legislation passed the Senate unanimously, but didn’t get a vote in the House.