Comment; I like that CA is working to help reduce opioid prescribing and putting more restrictions on doctors (ugh!), but they’re forgetting that most opioid overdoses ARE NOT FROM PHYSICIANS! Street drugs outstripped prescribed drugs long ago! Making MAT more accessible makes sense, paying practitioners more to deal with these difficult patients makes sense, putting more restrictions on us doesn’t!
Wednesday, January 16, 2019 | Sacramento, CA | Permalink
About 2,000 Californians die from opioid overdose annually, according to the California Department of Public Health. This week in Chico, one person died and 12 were taken to the hospital after a suspected overdose on a powerful opiate called fentanyl.
The California Legislature looked at more than 20 bills last year designed to address the ongoing opioid crisis, passing 14. The laws cover a few approaches to bringing opioid death numbers down, including stemming over-prescribing practices, improving medication assisted treatment and saving people in the throes of overdose with an antidote called naloxone.
Here’s a roundup of what former Gov. Jerry Brown signed to tackle the problem.
Curbing Painkiller Prescriptions
In an effort to reduce fraud, AB 2789 will require doctors to write electronic prescriptions starting in 2022. Supporters argue this will make it easier for doctors to record prescriptions in the state’s CURES opioid database. Some physician groups say that the electronic system is too costly for doctors with small practices.
AB 1753 authorizes the Department of Justice to reduce the number of printer vendors making prescription pads and requires pads be marked with a serialized number starting this year. It’s part of a wider effort to standardize and label all prescription pads, which could help law enforcement track down lost, stolen and counterfeit prescription pads.
There’s currently a mismatch between California’s controlled substance schedules and the federal government’s. AB 2783 aims to fix it by reclassifying some drugs as Schedule II controlled substances.
SB 1109 aims to better educate doctors about opioid addiction risk. Physicians and surgeons are already required to take continuing education courses on pain management. Starting in 2019, the course must also address the risks of addiction associated with the use of Schedule II drugs. The law makes a similar change to mandatory courses for dentists, nurses, osteopathic physicians and physician assistants.
Also on the topic of education, AB 2487 authorizes physicians and surgeons to complete a one-time continuing education course on opiate-dependent patient treatment and management, instead of the mandatory continuing education course on pain management.
Expanding Treatment
Starting July 2020, AB 349 requires the Department of Health Care Services to adopt new regulations and update reimbursement rates for the Drug Medi-Cal Treatment Program
Naloxone Access
AB 2256 is designed to make it easier for pharmacists to give naloxone, an overdose antidote, to law enforcement officers who have completed special training. An individual pharmacist can already give the drug to a law enforcement officer, but wholesalers cannot. If law enforcement agencies want to acquire large amounts of naloxone, they must go through a local health department. Police departments and other agencies argue this process makes it unnecessarily difficult to get the life-saving drug. The U.S. Surgeon General said earlier this year that all people at risk for overdose, and community members who interact with them, should know how to use naloxone and keep it within reach at all times.
Patients at high-risk of overdose should have wider access to naloxone in doctor’s offices this year under AB 2760. The law requires doctors prescribing opioids to also offer patients for the overdose antidote, and educate patients and their loved ones on how to use it.
Strengthening the Opioid Database
Right now, patients can get an opioid prescription in California and then go get another in Nevada without anyone knowing they’ve double-dipped. AB 1751 authorizes the Department of Justice to share opioid prescriptions entered into California’s CURES database across state lines. The department must adopt regulations for interstate data sharing by July 2020.
AB 2086 allows doctors to review how many patients they are listed as the prescriber for in CURES. This could help doctors identify fraudulent prescriptions.
Regulating Rehab
The Department of Health Care Services will be required to adopt the American Society of Addiction Medicine treatment criteria, or a similar standard, as the minimum standard of care for licensed adult alcohol and drug abuse recovery facilities when SB 823 takes full effect in January 2023. The law’s author, Democratic Sen. Jerry Hill, said in a statement that the law will help crack down on facilities that currently use “widely divergent methods of treatment” and often lack evidence-based standards of care.
And SB 992 tightens licensing criteria for these facilities and requires them to disclose more information to the department.
Safely Storing and Dumping Drugs
As it stands, counties run their own drug take-back programs and pay to safely dispose of opioids and other prescription medications. SB 212 will now require drug-makers to take on that burden by building collection sites and paying for disposal. CalRecycle must adopt regulations to enforce the law by January 2021.
And AB 2859 could help people keep opioids away from children by requiring community pharmacies that dispense opioids to display safe storage products on the premises.
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