July 09, 2018
Area(s) of Interest: Advocacy Drug Prescribing/Dispensing
On June 22, the U.S. House of Representatives passed HR 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act. It includes more than 55 opioid-related bills intended to help combat the nation’s opioid crisis by advancing treatment and recovery initiatives, improving prevention, protecting our communities and bolstering our efforts to fight deadly illicit synthetic drugs. HR 6 also includes several Medicaid, Medicare and public health reforms to help combat the opioid crisis.
The California Medical Association (CMA) aggressively advocated for more funding for prevention, treatment and alternative therapies and worked alongside the American Medical Association (AMA) to avoid legislation that interferes with the practice of medicine, such as mandating dosage and duration limits. CMA also secured an amendment (HR 58010) that prevents federal preemption of state laws that mandate physicians consult state prescription drug monitoring programs prior to prescribing.
Unfortunately, HR 6 does include a mandate to e-prescribe controlled substances, despite opposition from CMA and AMA. Less than 25 percent of physicians currently e-prescribe controlled substances because of the antiquated DEA system. CMA and AMA will continue to urge Congress to require the DEA to update its program and reduce the costly burdens of e-prescribing controlled substances before mandating that physicians use it.
The House also passed HR 6082, the Overdose Prevention and Patient Safety Act, expanding the circumstances under which medical records relating to substance use disorders can be securely disclosed to health care providers.
The issue of opioid-related misuse, abuse and overdose remains a major policy issue at the federal, state and regional levels. CMA will continue to advocate to increase access and availability of medication-assisted treatment, opioid use disorder treatment programs, and non-opioid therapies, including mental health services and fight proposals that interfere with the practice of medicine and create barriers to care.
Demonstrated Opioid Success in California and Across the Nation
Like the nation as a whole, California is faced with a serious health care dilemma: how to prescribe controlled substances safely and effectively to relieve pain, while simultaneously reducing the risk of prescription medication misuse, addiction and overdose.
California has been leading the way in efforts to reduce prescription drug abuse and drug diversion.
From 2013-2017, there has been a 22 percent decline in opioid prescriptions, which shows that physicians and other health professionals are increasingly judicious when prescribing opioids. California’s rate declined by more than 24 percent, with an 8.6 percent drop 2016 to 2017.
From 2013-2016, California had the second lowest per capita rate of filled opioid prescriptions, and that rate dropped even more in 2017 – California now has the lowest per capita opioid prescribing rate in the country.
California has one of the lower overdose death rates in the country. Unlike other states, California has seen its prescription opioid overdose rate decrease over the last two years.
Safe Prescribing Resources
CMA supports a well-balanced approach to opioid prescribing and treatment that considers the unique needs of individual patients. CMA’s safe prescribing resource page includes the most current information and resources on prescribing controlled substances safely and effectively to relieve pain, while simultaneously reducing the risk of prescription medication misuse, addiction and overdose. There you will find:
Resources on prescribing controlled substances safely and effectively to relieve pain, while simultaneously reducing the risk of prescription medication misuse, addiction and overdose
CMA’s white papers on prescribing opioids
Links to relevant documents in CMA’s health law library
Continuing medical education courses and webinars
Current information on the state's prescription drug monitoring database