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Preventing Prescription Drug Abuse: Laws and Legislation. Hollie Hendrikson, MSc. Hollie.Hendrikson@ncsl.org 303-856-1525 Policy Specialist, Health Program National Conference of State Legislatures. Prescription Drug Overdose and Abuse: A Growing Problem.

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Preventing Prescription Drug Abuse: Laws and Legislation

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Preventing Prescription Drug Abuse: Laws and Legislation

Hollie Hendrikson, MSc.

Hollie.Hendrikson@ncsl.org

303-856-1525

Policy Specialist, Health Program

National Conference of State Legislatures


Prescription Drug Overdose and Abuse: A Growing Problem

Source: National Center for Health Statistics, Drug Poisoning Deaths in the United States Databrief, 2011.


Prescription Drug Abuse: Overdose Death Rates and Amount Sold

Drug overdose death rates per 100,000 people (2008)

Amount of prescription painkillers sold per 10,000 people (2010)

Source: National Center for Injury Prevention and Control, 2011.


Impact of Opioid Use on Health Care

For every 1 overdose death there are:

Source: National Center for Injury Prevention and Control, 2011.


Where are the nonmedical users getting their drugs?

Bought from friend or relative

Took from friend or relative w/o asking

70% obtained from friend or relative

Bought from drug dealer

Other source

Free from friend or relative

From one doctor

Source: SAMHSA, 2009 National Survey on Drug Use and Health (September 2010).


Common Legislative Issues

  • Prescription Drug Monitoring Programs (PDMP)

  • “Doctor Shopping”

  • Tamper-resistant prescription forms

  • Pain management clinic oversight

  • Immunity or “Good Samaritan” laws


Prescription Drug Monitoring Programs (PDMP)

  • Established to help prescribers, pharmacies, law enforcement agencies, etc., track who is writing, filling and receiving prescribed controlled substances.

  • In Oklahoma:

    • PDMP is housed in the Bureau of Narcotics (CA, NJ, PA, TX).

    • Prescriptions are required to be reported to PDMP.

    • Data collected daily.

    • Data accessible to: prescribers, pharmacists, pharmacies, law enforcement, licensing boards, the Attorney General and medical examiners.


States with Prescription Drug Monitoring Programs

Source: National Center for Injury Prevention and Control, 2011.


2012 Prescription Drug Monitoring Program Legislation

Idaho House Bill 439:

Allows licensed practitioners in other states to access data and information within the PDMP. Enacted, 2012.

New Hampshire Senate Bill 215:

Establishes a PDMP. Enacted, 2012.

Utah House Bill 257:

Provides a procedure for an emergency room employee to look up information in the PDMP. Enacted, 2012.

Louisiana Senate Bill 112:

Authorizes the sharing of PDMP information with PDMP located in other states. Enacted, 2012.


Doctor Shopping Laws

  • “Doctor Shopping” typically refers to a patient obtaining controlled substances from multiple providers without the prescribers’ knowledge of the other prescriptions.

  • Uniform Narcotic Drug Act of 1932

    • Almost all states have adopted a general fraud statute that prohibit obtaining drugs by: fraud, deceit, misrepresentation, subterfuge or concealment of material fact.


Doctor Shopping Laws, cont.

  • Specific doctor shopping laws:

    • Prohibit patients from withholding prior prescription information from any health care provider.

  • Example:

    • South Dakota: any person who knowingly obtains a controlled substance from a medical practitioner and who knowingly withholds information from that medical practitioner that (s)he has obtained a controlled substance of similar therapeutic use in a concurrent time period from another medical practitioner.


States with Doctor Shopping Laws

Source: National Center for Injury Prevention and Control, 2011.


Tamper-Resistant Form Laws

  • Requiring special tamper-resistant prescription forms for controlled substances.

  • As of 2008, all prescriptions covered by the Medicaid program are required to use special tamper-resistant prescription forms.

  • In Oklahoma:

    • Tamper-resistant prescription forms are required for all prescriptions.

    • All written prescriptions must conform with federal tamper-resistant prescription form regulations.


States with Tamper-Resistant Form Laws

Source: National Center for Injury Prevention and Control, 2011.


2012 Tamper-Resistant Legislation

Tennessee Senate Bill 3003:

Requires the board of pharmacy to publish a list of opioid drugs incorporating tamper-resistant technology. Enacted, 2012.


Pain Management Clinic Laws

  • Pain management clinics or “pill mills” are facilities that employ a physician who is primarily engaged in the treatment of pain by prescribing or dispensing controlled substance medications.

  • Pain clinic laws typically require oversight of clinic or describes specific regulations (patient registration, physician licensure, ownership requirements, payment methods, etc.).


States with Pain Management Clinic Laws

Source: National Center for Injury Prevention and Control, 2011.


2012 Pain Management Clinic Legislation

Tennessee House Bill 1040:

Establishes certain requirements for pain management clinics including allowed payment methods, limits on clinic ownership, and prescription limits. Enacted, 2012.


Immunity from Prosecution Laws

  • Provides a degree of immunity to an individual seeking help for themselves or for another person experiencing an overdose.

  • Examples:

    • A person experiencing an overdose and needing medical attention will not be prosecuted for possession resulting from evidence gained from the call for help (New Mexico and Washington).

      • Protection from prosecution will not extend to other criminal charges (Washington).


States with Immunity or “Good Samaritan” Laws

Source: National Center for Injury Prevention and Control, 2011.


Hollie Hendrikson, MSc.

Hollie.Hendrikson@ncsl.org

303-856-1525

http://www.ncsl.org/issues-research/health/prevention-of-prescription-drug-overdose-and-abuse.aspx


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