Provides for the use of opioid antagonists.
Ayes (60): Addabbo, Avella, Ball, Bonacic, Boyle, Breslin, Carlucci, DeFrancisco, Diaz, Dilan, Farley, Felder, Flanagan, Gallivan, Gianaris, Gipson, Golden, Griffo, Grisanti, Hannon, Hassell-Thomps, Hoylman, Kennedy, Klein, Krueger, Lanza, Larkin, Latimer, LaValle, Libous, Little, Marcellino, Marchione, Martins, Maziarz, Montgomery, Nozzolio, O'Brien, O'Mara, Parker, Peralta, Perkins, Ranzenhofer, Ritchie, Rivera, Robach, Sampson, Sanders, Savino, Serrano, Seward, Skelos, Smith, Squadron, Stavisky, Stewart-Cousins, Tkaczyk, Valesky, Young, Zeldin
Excused (1): Espaillat
TITLE OF BILL: An act to amend the public health law, in relation to use of opioid antagonists
PURPOSE: Allows for the prescribing, dispensing and distribution of an opioid antagonist by a non-patient specific order.
SUMMARY OF PROVISIONS:
Section one amends Public Health Law § 3309 to authorize the Commissioner of Health to establish standards for the prescribing, dispensing, distribution, possession and administration of opioid antagonist under the Opioid Overdose Prevention Program. This section expands a health care professional's authority to prescribe, dispense or distribute, directly or indirectly, an opioid antagonist by authorizing such by non-patient-specific prescription. Additionally, this section provides that a pharmacist may dispense through a non-patient-specific prescription. A recipient of the opioid antagonist is authorized to posses, distribute and administer the opioid antagonist. The bill clarifies that any recipient acting reasonably and in good faith pursuant to this section shall not be liable. Lastly, this section requires the program to report annually.
Section two provides that the act shall take effect immediately.
JUSTIFICATION: New York State, like the nation, is in the midst of a severe prescription drug crisis. Prescriptions for opioids, particularly oxycodone and hydrocodone have skyrocketed. The Centers for Disease Control and Prevention reports that every 19 minutes, one person dies from an accidental overdose or suicide as a result of prescription drug abuse. In 2012, the legislature enacted the seminal I-STOP legislation to track controlled substance prescribing, prevent doctor shopping and weed out unscrupulous doctors. One unfortunate side effect of successfully restricting street access to these controlled substances, is that addicts are turning to other drugs, such as heroin. Heroin has now become the cheaper alternative to opioids. On Long Island it is estimated that heroin addiction has increased fourfold since 2011.
As detailed in the Senate Health Committee's white paper The Prescription Drug Crisis in New York: A Comprehensive Approach, there is a need to look at the complete spectrum of drug abuse in order to address this crisis. While the state has made great advances, much more is needed. One of the topics raised at the roundtables held by the Health Committee in 2011 and 2012, was access to Naloxone (Narcan). Naloxone, sometimes referred to as the drug-overdose antidote, counteracts the life threatening depression of the central nervous system and respiratory system caused by an opioid or heroin overdose. If timely administered, Naloxone can prevent overdose deaths. The Department of Health recommends administering Naloxone directly to an individual overdosing on an opioid after calling 911 and checking for breathing.
In 2005, the state authorized non-medical persons to administer Naloxone to an individual in order to prevent an opioid or heroin overdose from becoming fatal. In 2011, the state adopted good
samaritan protections for witnesses and victims of overdoses. By removing the threat of prosecution, this measure encourages witnesses of an overdose to call 911 before it becomes deadly.
Due to the increase of opioid abuse, expanded access to Naloxone has become a necessary priority to save lives. In Nassau County, EMTs administer Naloxone through their police department's ambulance services and in Suffolk County the state provided first responders with Naloxone. Expanding upon the success of existing programs, more lives could be saved if Naloxone was available to addicts, their families and other people likely to be in a position to assist a person at risk of an opioid related overdose. Currently, parents and family members of addicts are being turned away from Naloxone training programs or are attending the programs and not receiving Naloxone due to the shortage of prescribers participating in such programs. Under this legislation one prescriber would be able to issue a non-patient specific order to numerous programs, allowing for increased access. This legislation will also allow for expanded access through pharmacies. By increasing access, this legislation will equip individuals likely to discover an overdose victim with the ability to save their life.
LEGISLATIVE HISTORY: New Bill
FISCAL IMPLICATIONS: None
EFFECTIVE DATE: Immediately
STATE OF NEW YORK ________________________________________________________________________ 6477--B Cal. No. 104 IN SENATE January 28, 2014 ___________Introduced by Sens. HANNON, BOYLE, BALL, CARLUCCI, ESPAILLAT, GRISANTI, HASSELL-THOMPSON, HOYLMAN, KENNEDY, KRUEGER, LANZA, MARCHIONE, MARTINS, MONTGOMERY, PARKER, RIVERA -- read twice and ordered printed, and when printed to be committed to the Committee on Health -- reported favorably from said committee, ordered to first and second report, ordered to a third reading, amended and ordered reprinted, retaining its place in the order of third reading -- again amended and ordered reprinted, retaining its place in the order of third reading AN ACT to amend the public health law, in relation to use of opioid antagonists THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 3309 of the public health law, as added by chapter 413 of the laws of 2005, is amended to read as follows: S 3309. Opioid overdose prevention. 1. The commissioner is authorized to establish standards for approval of any opioid overdose prevention program, AND OPIOID ANTAGONIST PRESCRIBING, DISPENSING, DISTRIBUTION, POSSESSION AND ADMINISTRATION PURSUANT TO THIS SECTION which may include, but not be limited to, standards for program directors, appro- priate clinical oversight, training, record keeping and reporting. 2. Notwithstanding any inconsistent provisions of section sixty-five hundred twelve of the education law or any other law, the purchase, acquisition, possession or use of an opioid antagonist pursuant to this section shall not constitute the unlawful practice of a profession or other violation under title eight of the education law or this article. 3. (A) AS USED IN THIS SECTION: (I) "OPIOID ANTAGONIST" MEANS A DRUG APPROVED BY THE FOOD AND DRUG ADMINISTRATION THAT, WHEN ADMINISTERED, NEGATES OR NEUTRALIZES IN WHOLE OR IN PART THE PHARMACOLOGICAL EFFECTS OF AN OPIOID IN THE BODY. "OPIOID ANTAGONIST" SHALL BE LIMITED TO NALOXONE AND OTHER MEDICATIONS APPROVED BY THE DEPARTMENT FOR SUCH PURPOSE. (II) "HEALTH CARE PROFESSIONAL" MEANS A PERSON LICENSED, REGISTERED OR AUTHORIZED PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW TO PRESCRIBE PRESCRIPTION DRUGS.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13628-05-4 S. 6477--B 2
(III) "PHARMACIST" MEANS A PERSON LICENSED OR AUTHORIZED TO PRACTICE PHARMACY PURSUANT TO ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION LAW. (IV) "OPIOID ANTAGONIST RECIPIENT" OR "RECIPIENT" MEANS A PERSON AT RISK OF EXPERIENCING AN OPIOID-RELATED OVERDOSE, OR A FAMILY MEMBER, FRIEND OR OTHER PERSON IN A POSITION TO ASSIST A PERSON EXPERIENCING OR AT RISK OF EXPERIENCING AN OPIOID-RELATED OVERDOSE, OR AN ORGANIZATION REGISTERED AS AN OPIOID OVERDOSE PREVENTION PROGRAM PURSUANT TO THIS SECTION. (B)(I) A HEALTH CARE PROFESSIONAL MAY PRESCRIBE BY A PATIENT-SPECIFIC OR NON-PATIENT-SPECIFIC PRESCRIPTION, DISPENSE OR DISTRIBUTE, DIRECTLY OR INDIRECTLY, AN OPIOID ANTAGONIST TO AN OPIOID ANTAGONIST RECIPIENT. (II) A PHARMACIST MAY DISPENSE AN OPIOID ANTAGONIST, THROUGH A PATIENT-SPECIFIC OR NON-PATIENT-SPECIFIC PRESCRIPTION PURSUANT TO THIS PARAGRAPH, TO AN OPIOID ANTAGONIST RECIPIENT. (III) AN OPIOID ANTAGONIST RECIPIENT MAY POSSESS AN OPIOID ANTAGONIST OBTAINED PURSUANT TO THIS PARAGRAPH, MAY DISTRIBUTE SUCH OPIOID ANTAG- ONIST TO A RECIPIENT, AND MAY ADMINISTER SUCH OPIOID ANTAGONIST TO A PERSON THE RECIPIENT REASONABLY BELIEVES IS EXPERIENCING AN OPIOID OVER- DOSE. (IV) THE PROVISIONS OF THIS PARAGRAPH SHALL NOT BE DEEMED TO REQUIRE A PRESCRIPTION FOR ANY OPIOID ANTAGONIST THAT DOES NOT OTHERWISE REQUIRE A PRESCRIPTION; NOR SHALL IT BE DEEMED TO LIMIT THE AUTHORITY OF A HEALTH CARE PROFESSIONAL TO PRESCRIBE, DISPENSE OR DISTRIBUTE, OR OF A PHARMA- CIST TO DISPENSE, AN OPIOID ANTAGONIST UNDER ANY OTHER PROVISION OF LAW. 4. Use of an opioid antagonist pursuant to this section shall be considered first aid or emergency treatment for the purpose of any stat- ute relating to liability.
[4.]A RECIPIENT OR OPIOID OVERDOSE PREVENTION PROGRAM UNDER THIS SECTION, ACTING REASONABLY AND IN GOOD FAITH IN COMPLIANCE WITH THIS SECTION, SHALL NOT BE SUBJECT TO CRIMINAL, CIVIL OR ADMINISTRATIVE LIABILITY SOLELY BY REASON OF SUCH ACTION. 5. The commissioner shall publish findings on statewide opioid over- dose data that reviews overdose death rates and other information to ascertain changes in the cause and rates of fatal opioid overdoses. The report may be part of existing state mortality reports issued by the department, and shall be submitted annually [for three years and as deemed necessary by the commissioner thereafter,]to the governor, the temporary president of the senate [and], the speaker of the assembly, AND THE CHAIRS OF THE SENATE AND ASSEMBLY HEALTH COMMITTEES. The report shall include, at a minimum, the following information: (a) information on opioid overdose deaths, including age, gender, ethnicity, and geographic location; (b) data on emergency room utilization for the treatment of opioid overdose; (c) data on utilization of pre-hospital services; (d) [suggested improvements in data collection.]DATA ON UTILIZATION OF OPIOID ANTAGONISTS; AND (E) ANY OTHER INFORMATION NECESSARY TO ASCERTAIN THE SUCCESS OF THE PROGRAM AND WAYS TO FURTHER REDUCE OVERDOSES. S 2. This act shall take effect immediately.