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Legislature Sends Prescription Drug Monitoring Bill to Governor

August 9, 2012

The Legislature today enacted final legislation that will reduce the number of people abusing or selling prescription pain killers, while also increasing opportunities for those battling addiction to receive treatment, Senator Karen Spilka (D-Ashland) 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.

“This legislation takes important steps to address prescription drug abuse, a problem we are seeing across the Commonwealth – from our cities to our most rural areas,” said Spilka. “With these new protections and restrictions, we look to help our residents struggling in the grips of addiction from continuing down this dangerous path while also preventing these powerful and highly addictive drugs from getting in the hands of our children.”

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.

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