NEW JERSEY STATE LEGISLATIVE UPDATE, July 2016

NEW JERSEY STATE LEGISLATIVE UPDATE
By LAURIE CLARK – NJAOPS LEGISLATIVE COUNSEL
JULY, 2016

NEW COMPREHENSIVE LEGISLATIVE PACKAGE INTRODUCED TO ADDRESS OPIOID & HEROIN ADDICTION ISSUES
MANDATORY CME AND MANDATORY E PRESCRIBING FEATURED

The legislative package has been introduced in both Houses of the Legislature and consists of the following bills:  

7 DAY OPIOID PRESCRIBING LIMIT PASSES NEW JERSEY SENATE
Legislation restricting initial prescriptions for opioid drugs to a seven day supply cleared the full Senate on June 30 by a vote of 24-13.   The bill, S2035, sponsored by Senator Shirley K. Turner (D-14) provides that a healthcare professional may not issue an initial prescription for an opioid drug in a quantity exceeding a seven-day supply. The restriction on initial prescriptions for opioid drugs will not apply to prescriptions issued to patients receiving hospice care. Additionally, subsequent prescriptions for the drug may be issued in any quantity that complies with applicable State and federal laws, provided that the prescription is not deemed to be an initial prescription, the practitioner determines the prescription is necessary and appropriate to the patient's treatment needs, and the practitioner determines that issuance of the subsequent prescription does not present an undue risk of abuse, addiction, or diversion.
          
If enacted, New Jersey would join several other states that have similar legislation limiting opioid prescription including Connecticut, New York, and Massachusetts.  According to published reports there were 781 heroin-related overdose deaths in New Jersey in 2014, which is more than double since 2010. The New Jersey Division of Mental Health and Addiction reported that 28,332 entered drug treatment in 2014, with an addiction to heroin or other opiate and that's nearly half of the 64,766 people that sought drug treatment that year. According to the Centers for Disease Control and Prevention, nationally, overdose deaths involving prescription opioids have quadrupled since 1999, and so have sales of these prescription drugs. From 1999 to 2014, more than 165,000 people have died in the U.S. from overdoses related to prescription opioids. New Jersey's overdose rate is more than triple the national rate reported by the Centers for Disease Control.

The bill will apply to prescriptions for opioid drugs for which the patient has never been issued a prescription, or if the patient was previously prescribed the drug or its pharmaceutical equivalent, the current prescription is being issued more than one year after the date the patient last used or was administered the drug or its equivalent. In determining whether a prescription is an "initial prescription," the practitioner would be required to consult with the patient and review the patient's medical record and prescription monitoring information.
             
The bill now awaits hearing in the Assembly Health and Human Services Committee along with its Assembly counterpart, A-4035 sponsored by Assemblywoman Annette Quijano (D-20).

INVOLUNTARY COMMITMENT FOR SUBSTANCE USE AND ADDICTION ISSUES    
A3981 (Lagana D-38)/S2455 (Codey D-27) would establish a process that would allow an individual to petition the courts for the involuntary commitment of another individual for treatment for substance use disorder.

Specifically, the bill would provide for a "petitioner" who is the spouse, civil union partner, relative, friend, or guardian of an individual to submit to the court a petition for the involuntary commitment of the individual to treatment for a substance use disorder. The petition must be accompanied by a guarantee obligating the spouse, civil union partner, relative, friend, or guardian of the individual to pay all costs for treatment of the individual that is ordered by the court.

MANDATORY ELECTRONIC PRESCRIBING OF ALL SUBSTANCES:

A3882 (Lagana D-38/S2420 (Vitale D-19) requires that every prescription for a controlled dangerous substance, prescription legend drug, or other prescription item be transmitted electronically using an electronic health records system. This requirement would take effect one year after the date of enactment.
EXPANSION OF THE PMP TO INCLUDE NALOXONE AND ADDITIONAL OPIOID ANTIDOTES

A3982 (Lagana D-38)/S2428 (Gordon D-38) would add naloxone hydrochloride, and other opioid antidotes, to the list of prescription drugs that are to be monitored as part of the state's Prescription Monitoring Program. While the PMP focuses on monitoring the dispensation of controlled dangerous substances in the state, and although opioid antidotes are not considered to be controlled dangerous substances, the sponsor noted that information related to the dispensation of opioid antidotes is nonetheless relevant to determinations regarding the prescription and dispensation of controlled dangerous substances.

The bill, called "John Wagner's Law", is named after the son of former Assemblywoman Connie Wagner who lost his battle with opioid addiction. Lagana holds the seat vacated by Wagner.  Assemblyman Lagana said the bill came about after hearing from local law enforcement and addiction specialists that they needed naloxone deployment data to help with their prevention efforts.

ONE CREDIT MANDATORY CME ON OPIOID ADDICTION - ABUSE ISSUES
A3930 (Lagana D-38)/S2419 ( Vitale D-19)  would require certain health care professionals to meet continuing education requirements on topics related to prescription opioid drugs as a condition of renewal of a professional license, certification or registration. Under the bill, health care professionals with the authority to prescribe opioid medications, including physicians, physician assistants, and dentists would be required to complete one continuing education credit on topics that include responsible prescribing practices, alternatives to opioids for managing and treating pain, and the risks and signs of opioid abuse, addiction and diversion. Health care professionals without prescribing authority would be required to complete one continuing education credit on alternatives, risks and signs of abuse.

The credits required under this bill would be part of a professional's regular continuing education credits and would not increase the total number of continuing education credits required.
 
The last two measures are resolutions:

CDC OPIOID GUIDELINES
    AR 157 (Lagana D-38) /SR 60(Gordon D-38)   respectfully urges the State Board of Medical Examiners to adopt the CDC Guideline for Prescribing Opioids for Chronic Pain, United States 2016 to improve patient safety and educate patients about the risks and benefits of opioid use as a pain management treatment.

ABUSE OF PRESCRIPTION OPIOIDS BY STUDENTS
AR 156 (Lagana D-38) /SR 59 (Gordon D-38) urges school districts and nonpublic schools to adopt a policy, as suggested by the New Jersey State Interscholastic Athletic Association Medical Advisory Committee, to address the abuse of prescription opioids by students. The policy would include: notification to the school nurse by the student's parent or guardian if an opioid medication has been prescribed; and drug monitoring if the student demonstrates any signs of symptoms that raise the possibility of opioid abuse during or beyond the duration of the prescription. The resolution would be distributed by the state Board of Education to all public and nonpublic schools.
In terms of current status, all of the bills are in committee awaiting hearing. S2035 has already passed one house and is awaiting hearing in the Assembly Health and Senior Services Committee.  The remainder must go through the full process in both Houses.  Additional bills may be added to the package as the process continues.