Legislature Sends Prescription Drug Monitoring Bill to Governor

The Legislature today enacted final legislation that, officials say, will reduce the number of people abusing or selling prescription pain killers, while also increasing opportunities for those battling addiction to receive treatment, Senate President Therese Murray, D-Plymouth, announced.

The bill requires doctors, dentists and other practitioners to conduct drug history screens for new patients, creates a professional working group to recommend new prescribing standards for painkillers, and requires all prescriptions for painkillers, such as OxyContin, Percocet and Vicodin, to be written on tamper-resistant pads.

“You know we’ve got a problem when drugs like these are responsible for more accidental deaths in Massachusetts than motor vehicle accidents,” Murray said. “This was one of our top priorities and I’m glad that we got this bill done. The abuse of these drugs has devastating effects on individuals and families of every socio-economic background. The costs are high, both to families and the economy, not to mention the significant impact on public safety. This bill will help save lives and keep us all safer.”

“This bill recognizes the role everyone has to play in battling this epidemic, from doctors and pharmacists to parents and patients,” said the bill’s lead sponsor, Senator John F. Keenan (D-Quincy), co-chairman of the Joint Committee on Mental Health and Substance Abuse. “It consists of practical, common-sense strategies that will have a real, positive impact.”
 
Under the bill, prescribers would automatically be enrolled in the state’s Prescription Monitoring Program (PMP) when they renew their controlled substance prescribing license. They will then be required to use the PMP to review a new patient’s drug history to ensure that patient is not doctor shopping for painkillers. Small exemptions will be granted for emergency treatments, or if the PMP system is inoperable. Currently, participation in the program is voluntary, with only 1,700 out of 40,000 prescribers signed up. The bill also allows licensed professional staff in the practitioner’s office to conduct the screens, thereby not taking time away from patient visits.

To promote awareness, the Department of Public Health will be required to produce informational pamphlets explaining addiction risks, signs of dependency, where to go for treatment, and ways to safely store and discard drugs. The pamphlets will be distributed by pharmacies with each prescription filled.

Pharmacies, drug distributors and other relevant parties will also be required to alert local or state police when reporting missing controlled substances to the Drug Enforcement Administration. Under the bill, doctors and hospitals will be required to notify a parent or guardian of any minor treated for drug overdose. Information on substance abuse treatment options must also be provided, and a social worker will be available for counseling prior to hospital discharge.

The legislation also requires all prescriptions for controlled substances to be written on “secure” forms, using special watermarks, serial numbers or micro-printing to be determined by the Department of Public Health. This requirement is already in place for Medicare and Medicaid recipients.

In addition, the bill forms a working group of practitioners, nurses, and pain advocates to draft “best practices” for the use of prescription painkillers in the treatment of acute and chronic pain. The commission of the Department of Public Health can then turn those recommendations into regulations.

The bill also does the following:
• Bans the possession, distribution and manufacturing of synthetic over-the-counter recreational drugs known as “bath salts” which are smoked, inhaled or injected and linked to serious physical and mental problems;
• Restricts pharmacists from filling out-of-state prescriptions for narcotics unless the prescriptions were written by practitioners in the five contiguous states, plus Maine;
• Requires professional training for pharmacists on using the PMP as part of their relicensure process;
• Restricts MassHealth enrollees with a history of excessive use to one pharmacy;
• Allows sheriffs to enter into a study on the effectiveness of medication-assisted treatment for the successful transition of inmates back into society;
• Commissions a study on substance abuse among seniors; and
• Mandates professional training for court personnel and legal counsel on substance abuse services available for those facing criminal charges.

A report released by the OxyContin and Heroin Commission in 2009 found that Massachusetts has one of the highest rates of opiate abuse in the nation, causing 3,265 deaths from 2002 to 2007 and 23,369 hospitalizations in 2006 alone.

The Drug Enforcement Agency reports that Vicodin is the second-most abused drug by high school seniors, behind marijuana, and opiate addiction is the leading cause of property crime. Meanwhile, taxpayers are spending hundreds-of-millions of dollars annually in costs associated with the epidemic – including hospital visits, court appearances, jail time and social services.

According to Centers for Disease Control, more people are overdosing on prescription pain killers (approximately 12,000 nationally in 2007) than on cocaine and heroin combined, with the number of people needing emergency treatment for overdoses having tripled in the last decade. Of the nearly 2 million emergency room visits nationally in 2009, almost half involved prescription drug abuse.

For an explanation of drug classifications, knows as schedules, under the U.S. Controlled Substances Act, please see this website: http://nationalsubstanceabuseindex.org/drugclass.htm.

The bill will now go to the Governor for his signature.

--from Senate President Therese Murray's office

Will this bill help people with drug problems? Do the requirements of the bill make it more difficult for doctors to do their jobs? What do you think of the bath salts provision? Share your thoughts in the comments box.