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                                                       Current News

New Law - When an opioid is prescribed under certain defined circumstances, it must be accompanied by a prescription for an opioid antagonist.

Governor Hochul has signed into law, as Chapter 803 of the Laws of 2021, a bill – A.336-A (Braunstein) / S.2966-A (Harckham) – requiring that when an opioid is prescribed under certain defined circumstances, it must be accompanied by a prescription for an opioid antagonist.  The bill does not take effect for 180 days from December 29, 2021.  It will have some impact for dentists, although much more for physicians.  Copies of the bill and the Sponsor Memorandum explaining the bill are below.  

STATE OF NEW YORK

        ________________________________________________________________________  336--A

2021-2022 Regular Sessions

 

IN ASSEMBLY

 

                              January 6, 2021

                                       ___________

 

        Introduced  by  M.  of A. BRAUNSTEIN, DINOWITZ, OTIS, CYMBROWITZ, AUBRY,

          L. ROSENTHAL, FERNANDEZ, STERN, HEVESI, HUNTER, JOYNER, PERRY,  RAMOS,

          STECK, BARRON, McDONALD -- Multi-Sponsored by -- M. of A. McDONOUGH --

          read  once  and  referred  to  the Committee on Health -- reported and

          referred to the Committee on Ways and Means --  committee  discharged,

          bill  amended,  ordered  reprinted  as amended and recommitted to said

          committee

 

        AN ACT to amend the public health law, in  relation  to  prescribing  an

          opioid  antagonist  with  a  patient's  first opioid prescription in a

          given year

 

          The People of the State of New York, represented in Senate and  Assem-

        bly, do enact as follows:

 

  1      Section  1. Section 3309 of the public health law is amended by adding

  2    a new subdivision 7 to read as follows:

  3      7. With the first prescription to a particular patient of an opioid of

  4    each year for use in a setting other than a general hospital or  nursing

  5    home  under article twenty-eight of this chapter or facility under arti-

  6    cle thirty-one of the mental hygiene law,  or  when  a  practitioner  is

  7    prescribing  a  controlled  substance  to  a  patient  under the care of

  8    hospice as defined by section four thousand two  of  this  chapter,  the

  9    prescriber  shall prescribe an opioid antagonist when any of the follow-

10    ing risk factors are present: (a) a history of substance  use  disorder;

11    (b) high dose or cumulative prescriptions that result in ninety morphine

12    milligram  equivalents  or higher per day; (c) concurrent use of opioids

13    and benzodiazepine or nonbenzodiazepine sedative hypnotics.

14      § 2. This act shall take effect on the one hundred eightieth day after

15    it shall have become a law. Effective immediately, the addition,  amend-

16    ment and/or repeal of any rule or regulation necessary for the implemen-

17    tation  of  this act on its effective date are authorized to be made and

18    completed by the commissioner of health  on  or  before  such  effective

19    date.

 

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets

                              [ ] is old law to be omitted.

                                                                   LBD03417-04-1

BILL NUMBER: A336a

 SPONSOR: Braunstein

 TITLE OF BILL:

An act to amend the public health law, in relation to prescribing an

opioid antagonist with a patient's first opioid prescription in a given

year

 PURPOSE OR GENERAL IDEA OF BILL:

To prescribe an opioid antagonist, a drug used to counter the effects of

opioid overdose, with a patient's first opioid prescription each year.

 

 SUMMARY OF SPECIFIC PROVISIONS:

Section 1. Adds a new subdivision 7 to

Section 3309 of the public health law, which provides that the first

opioid prescription to a particular patient each year, in a setting

other than a general hospital, nursing home, or hospice care, shall be

accompanied with a prescription for an opioid antagonist if any of the

following risk factors are present: a history of substance use disorder;

high doses or cumulative prescriptions that result in ninety morphine

milligram equivalents or higher per day; concurrent use of opioids and

benzodiazepine or nonbenzodiazepine sedative hypnotics.

 

 Section 2. Contains the effective date.

 JUSTIFICATION:

Drug poisoning is the leading cause of death from injuries in the United

States. In New York State and New York City, between 1999 and 2008 the

leading cause of accidental death was overdose, ahead of accidental

falls and motor vehicle accidents. The vast majority of these overdose

deaths occurred inside the home.

According to studies by the Centers for Disease Control and Prevention,

drug poisoning deaths involving opioid analgesics, also known as

prescription pain relievers, such as codeine and oxycodone, have more

than tripled nationally since 1999, and between 2000 and 2011, the rate

of drug poisoning deaths involving opioid analgesics in NYC increased by

267%. In 2012, prescription opioid analgesics were involved in 28% of

overdose deaths in NYC. Between 2015 and 2016 the opioid overdose death

rate in New York State increased by 40%.  Additionally, eighty percent

of heroin users have reported that they used opioid analgesics before

switching to heroin. As of March 2018, more than 115 people in the

United States die every day from overdosing on opioids, according to the

CDC.

 

 The CDC has stated that higher dosages of opioids are associated with

higher risks of overdosing. Furthermore, higher dosages have not been

shown to reduce pain over the long term.

 

 Opioid antagonists, such as naloxone, are drugs that reverse the effects

of opioids, and are effective in preventing overdose deaths.  The avail-

ability of an opioid antagonist is crucial in ensuring that overdose

deaths do not occur. However, an opioid antagonist can only be effective

as an antidote if it is readily accessible when an overdose is happen-

ing. Additionally, opioid antagonists are non-habit forming and non-tox-

ic. On April 5th, 2018, the United States Surgeon General issued the

first national advisory in over a decade, urging all Americans to carry

naloxone.

 

 Currently, opioid antagonists can only be used if they are prescribed.

A recent NYC Department of Mental Health and Hygiene study supported a

co-prescribing mandate to increase the availability of opioid antag-

onists. This legislation, by increasing access to opioid antagonists,

may be able to save the lives of those at risk for opioid analgesic

overdoses.

 

 PRIOR LEGISLATIVE HISTORY:

 

 2013-2014: A.9365 - Referred to Health.

2015-2016: A.661 - Referred to Health.

2017-2018: A.1531-A - Referred to Health.

2019-2020: A.5603-B - Referred to Ways and Means.

 

 FISCAL IMPLICATIONS:

 

 None.

 

 EFFECTIVE DATE:

This act shall take effect on the one hundred eightieth day after it

shall have become a law. Effective immediately, the addition, amendment

and/or repeal of any rule or regulation necessary for the implementation

of this act on its effective date are authorized to be made and

completed by the commissioner of health on or before such effective

date.

 

 "Do more than belong: participate.
                              Do more than care: help.
                                           Do more than believe: practice." 

                                                                        - William Arthur Ward                                                                                                                  American author, editor, pastor and teacher

                                                                                              

  

                                                                                              

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