SACRAMENTO— A bipartisan coalition of California State Assemblymembers announced a package of legislation today to combat the opioid crisis. The package of over a dozen bills will address the opioid epidemic by tightening prescription regulations, expanding access to alternative treatments, increasing prescriber training, and enhancing the tools available to health professionals and law enforcement.
In California, 1,925 people lost their lives from opioid overdoses in 2016. While the state as a whole has not been the hardest hit nationally, many rural California counties have some of the highest overdose rates in the country. For state and county overdose statistics, visit the California Opioid Overdose Surveillance Dashboard.
The bipartisan package consists of the following bills:
- AB 1751 (Low) links California’s prescription drug monitoring database with other states while ensuring that patient privacy is adequately protected.
- AB 1752 (Low) adds Schedule V drugs to the CURES database and changes the requirement for pharmacists to report dispensed prescriptions from seven days to the following business day, allowing for more “real-time” data updating in CURES.
- AB 1753 (Low) empowers the Department of Justice’s role in regulating vendors entrusted with manufacturing prescription pads by adding new controls, limiting the number of approved printers, and linking uniquely serialized pads with CURES.
“The opioid crisis has destroyed lives and devastated families. It is the deadliest drug crisis in U.S. history and it’s getting worse. In 2016 alone, our state lost 1,925 lives to the opioid epidemic,” said Assemblymember Evan Low (D-Silicon Valley). “While there is no silver bullet solution to the opioid crisis, there are concrete steps California can and must take to reduce the overprescribing and abuse of opioids that has claimed so many lives.”
- AB 2789 (Wood) requires that prescriptions be submitted electronically, with limited exceptions. The intent of the legislation is to reduce fraud, eliminate prescription errors and facilitate information in the state’s CURES database to be available to prescribers in a more timely fashion.
- AB 2760 (Wood) requires that, for certain categories of high-risk patients, prescriptions for opioids must also include a co-prescription for naloxone, a medication designed to rapidly reverse opioid overdose. High-risk patients include, for example, those taking a higher dose of an opioid, those who take a benzodiazepine and patients who have overdosed previously.
“Since joining the legislature three years ago, finding solutions to the opioid epidemic has been one of my top priorities, so I am very pleased to join a number of my colleagues as together, we tackle an issue that has shattered so many lives and families,” said Assemblymember Jim Wood (D-Healdsburg). “I’m a dentist by profession and understand that the best way to attack this crisis is on many fronts – prevention, treatment and carefully controlling the prescribing process.”
- AB 2384 (Arambula) will remove some of the largest barriers to Medication Assisted Therapy treatment, such as prior authorization requirements and limits on coverage for those who truly seek recovery, even when attempts in the past have failed. It will also mandate a limitation on initial prescriptions for Schedule II opioids when prescribed for acute pain, which will ensure that patients are able to receive appropriate and effective pain relief, but don’t find themselves with excess medication if they do not need to use the full duration of the prescription.
“As an emergency physician, I saw the impact that opioid abuse has on families and I believe we need to reduce the availability of prescription medications that may be misused or diverted,” said Dr. Joaquin Arambula (D-Fresno). “Last year, I was able to pass legislation to establish partial fill prescriptions in statute. This year’s legislation will place a 7 day mandatory limit on the initial filling of those prescription opioids that have the highest potential for abuse, helping to ensure that patients are able to continue an appropriate course of treatment if needed, and also have a choice not to fill the balance if it won’t be necessary. AB 2384 will also continue to advance California in the direction of recovery, as it removes barriers to some of the most effective and innovative treatment of substance abuse disorder in Medication Assisted Therapy. We are one of the states leading the country in multi-year reduction of overdose deaths from prescription opioids, and now we have a chance to lead in providing critical recovery services as well.”
- AB 2741 (Burke) sets a 5-day limit on all opioid prescriptions for minors, with exceptions for chronic pain management, hospice and palliative care patients, cancer patients and minors who are being treated for substance abuse disorders. The bill also requires prescribers, before prescribing the medication, to assess whether the minor is being treated for a substance abuse disorder, to discuss the potential risks associated with opioid use and obtain written consent from a minor’s parent or guardian.
“Our communities are saturated with an excess of opioid prescriptions; in some cities and towns of California, the amount of opioid prescriptions outnumbers the population,” said Assemblywoman Burke (D-Marina Del Rey). “Forty percent of all opioid overdose deaths involve a prescription and over 120,000 addicts are under the age of 21. This is an insidious crisis which compels us to take action. I’m proud to join my colleagues as we work towards bi-partisan, comprehensive solutions that will protect families from tragedies,” added Assemblywoman Burke.
- AB 2859 (Caballero) requires community pharmacies that dispense Schedule II, III, or IV controlled substances to display safe storage products within 50 feet of the counter. Pharmacies will also be required to make customers aware of the availability of safe storage products by displaying a sign near the products. Additionally, discretion will be given to the Board of Pharmacy to implement these requirements for ease of compliance.
“The wide prevalence of prescribed opioids has led to an issue that is often overlooked; dangerous opioids are now easily accessible to children and teens in thousands of homes in our state. This had led to an increase in accidental poisonings amongst toddlers, which has tripled since 1997, and early abuse among teens, who can easily access these highly addictive drugs from a regular medicine bottle. AB 2859 addresses this child safety problem by requiring pharmacies to carry safe storage products that keep medications locked and secured. This bill will increase the education of parents who are prescribed opioids about better storage practices to help safeguard children from accidental ingestion or curious experimentation, which can lead to early-onset abuse. AB 2859 is a small but important step to better protect children during this complex public health crisis,” said Assemblymember Anna Caballero (D-Salinas).
- AB 2086 (Gallagher) allows prescribers of controlled substances to request from the Department of Justice a list of patients for whom they are listed as being the prescriber. This will help combat the opioid epidemic by making it easier to identify fraudulent prescriptions.
“The opioid epidemic is a public health crisis that affects every community. Addressing it will take a multi-pronged approach that includes education, treatment, and prevention. It also includes keeping pills out of the hands of people who shouldn’t have them, and AB 2086 will do this by helping us identify fraudulent prescriptions,” said Assemblymember James Gallagher (R-Yuba City).
- AB 2487 (McCarty) adds opioid addiction training as a requirement to the physician licensing application and requires practicing physicians to fulfill the opioid addiction training requirement as part of their Continuing Medical Education (CME).
- AB 2486 (McCarty) establishes the Opioid Prevention and Rehabilitation Program Fund, a new source of funding that will allow us to treat opioid addiction by providing existing programs the adequate funding to meet demand.
“California’s opioid epidemic has cost state taxpayers millions and the lives of too many of our sons and daughters,” said Assemblymember Kevin McCarty (D-Sacramento). “We’re all in this together if we want to save American lives from opioid addiction. This includes drug makers, doctors, health providers and government. We must do more to help Californians struggling with opioid addiction find hope and sobriety.”
- AB 1963 (Waldron) In an effort to incentivize more medical providers to become certified prescribers of medication-assisted treatment (M.A.T.), this bill would increase the reimbursement rates for providers who prescribe these drug treatments.
“Despite the success of medication assisted treatments (M.A.T.) for opioid abuse, access to treatment is a desperate need - as less than 2% of California medical providers are certified to prescribe M.A.T. It's essential we go beyond the rhetoric to increase access by funding opioid abuse treatments in California,” said Assemblymember Marie Waldron (R-Escondido).
- AB 2783 (O’Donnell) will resolve discrepancies between California’s controlled substance schedules and the corresponding federal controlled substance schedules in a consistent manner that will clarify applicable law for prescribers, health practitioners, and others who rely on those schedules.
“I’m glad to see California taking the lead on a wide array of efforts to curb the opioid crisis,” said Bob Pack, patient safety advocate, whose children were struck and killed by a driver on prescription painkillers. “We must never lose sight of the families that have been devastated by these highly addictive drugs.”
Full bill language is available on http://leginfo.legislature.ca.gov/