RI Senate Approves Bills To Stem Overdose Deaths

The RI State Senate voted Tuesday to approve several bills supported by its Health and Human Services Committee to address the recent increase in drug overdose deaths in the region.

“Addressing this epidemic will require approaching it from a number of sides, through drug abuse prevention and treatment efforts and broadening doctors’ ability to prescribe the safest treatments to their patients and to ensure that they are following their treatment plan,” said HHS Chairman Joshua Miller (D-Dist. 28, Cranston, Providence).

One of the bills the Senate approved today addresses health insurance coverage for people with opioid substance use disorder and chronic addiction. Sponsored by Sen. Paul V. Jabour (D-Dist. 5, Providence) the bill (2014-S 2801Aaa) would:

• Strengthens parity in coverage of mental health and substance use disorders, in clear language aligned with federal regulation, and require that both methadone treatment services and medications to treat opioid overdoses be included as covered health benefits.
  

• Provide patients with substance use disorders with information they need about critical services, when they need it most – when they are being discharged from a hospital. The legislation outlines a process that hospitals can use to make sure that patients with substance use disorders leave with real-time information in hand about community-based facilities and providers that have openings for them. As they leave, these patients would also have a follow-up appointment scheduled for them with licensed professionals who understand substance use disorders.
  

• Extend the safety net to other health care settings that patients with substance use disorders also consult – places like urgent care settings, freestanding clinics and emergency room diversion facilities. This legislation ensures that these settings also receive information about community and health care resources that can be consulted to support patients with substance use disorders.
  

Also approved today was legislation (2014-S 2523A) sponsored by Sen. Christopher Scott Ottiano (R-Dist. 11, Portsmouth, Bristol) to address prescription drug diversion. The bill amends Rhode Island’s electronic prescription drug monitoring program in two ways:

• It allows practitioners and pharmacists – the professionals who are in the best position to stop the flow of misused prescription drugs – to designate individuals who can access information from the database. By allowing these professionals to designate others in their office to access this information, prescribers and pharmacists will have about a clearer understanding of their patients’ use of controlled substances. This can help prevent misuse, prevent the misdirection of controlled substances, and alert prescribers and pharmacists about patients who are doctor shopping. Most importantly, it allows these healthcare professionals to help identify those patients who are most at risk of abusing controlled substances, and provide them with the support they need.
  

• It requires that all practitioners register with the prescription drug monitoring database maintained by the Department of Health, as a condition of their ability to prescribe controlled substances. This requirement would ensure that all prescribers know that this resource is available to them and are better able to integrate the database into their practice.
  

According to the Centers for Disease Control and Prevention (CDC), almost all prescription drugs involved in overdoses originally come from prescriptions. Very few come from pharmacy theft. However, once they are prescribed and dispensed, prescription drugs are frequently diverted to people using them without prescriptions.

• More than 3 out of 4 people who misuse prescription painkillers use drugs prescribed to someone else.
  

• Roughly 20 percent of prescribers prescribe 80 percent of all prescription painkillers.
  

• Six of the top 10 substances abused by 12th graders are pharmaceuticals
  

Forty-nine states, the District of Columbia, and one U.S. territory (Guam) have legislation authorizing the creation and operation of a prescription drug monitoring program to monitor controlled substances as defined by federal and state controlled substances law.

Additionally the Senate approved a bill (2014-S 2561) sponsored by Sen. Maryellen Goodwin (D-Dist. 1, Providence) which would require the Department of Health to promulgate rules and regulations regarding a system of electronic data transmissions of prescriptions for controlled substances.

The three bills approved today, all of which will now be forwarded to the House, are part of a portfolio the Health and Human Services Committee this year to address the growing problems of drug abuse and overdose. The package also includes:

• 2014-S 2534 – Sponsored by Chairman Miller, this bill would prevent health insurance policies that provide prescription coverage from requiring a beneficiary to use an opioid or another drug with a high risk of dependency before using a non-opioid or a drug with a low risk of dependency, if both could treat the same condition. The bill is meant to prevent prescription drug addiction.
  

• 2014-S 2524 – Sponsored by Sen. Walter S. Felag Jr. (D-Dist. 10, Warren, Bristol, Tiverton), this bill would allow physicians who prescribe electronically to request a notification about whether the prescription is filled, partially dispensed or not dispensed and returned to the pharmacy’s stock. This bill is aimed at helping doctors determine whether patients, particularly those with drug dependency, are in fact following their treatment plans.

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