NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8637B
SPONSOR: Dinowitz 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 § 3390 to authorize the Commission-
er 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 clari-
fies 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 oxyco-
done 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, counter-
acts 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 over-
dosing 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 prose-
cution, 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 admin-
ister 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 numer-
ous 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
________________________________________________________________________
8637--B
IN ASSEMBLY
January 29, 2014
___________
Introduced by M. of A. DINOWITZ, GOTTFRIED, CYMBROWITZ, CLARK, QUART,
GALEF, ROSENTHAL, ORTIZ, SALADINO, MONTESANO, GUNTHER, P. LOPEZ --
Multi-Sponsored by -- M. of A. BRAUNSTEIN, COOK, GIGLIO, HEVESI, McDO-
NALD, PAULIN, PERRY, RIVERA, ROSA, SEPULVEDA -- read once and referred
to the Committee on Health -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee --
again reported from said committee with amendments, ordered reprinted
as amended and recommitted to said committee
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:
1 Section 1. Section 3309 of the public health law, as added by chapter
2 413 of the laws of 2005, is amended to read as follows:
3 § 3309. Opioid overdose prevention. 1. The commissioner is authorized
4 to establish standards for approval of any opioid overdose prevention
5 program, and opioid antagonist prescribing, dispensing, distribution,
6 possession and administration pursuant to this section which may
7 include, but not be limited to, standards for program directors, appro-
8 priate clinical oversight, training, record keeping and reporting.
9 2. Notwithstanding any inconsistent provisions of section sixty-five
10 hundred twelve of the education law or any other law, the purchase,
11 acquisition, possession or use of an opioid antagonist pursuant to this
12 section shall not constitute the unlawful practice of a profession or
13 other violation under title eight of the education law or this article.
14 3. (a) As used in this section:
15 (i) "Opioid antagonist" means a drug approved by the Food and Drug
16 Administration that, when administered, negates or neutralizes in whole
17 or in part the pharmacological effects of an opioid in the body. "Opioid
18 antagonist" shall be limited to naloxone and other medications approved
19 by the department for such purpose.
20 (ii) "Health care professional" means a person licensed, registered or
21 authorized pursuant to title eight of the education law to prescribe
22 prescription drugs.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13628-04-4
A. 8637--B 2
1 (iii) "Pharmacist" means a person licensed or authorized to practice
2 pharmacy pursuant to article one hundred thirty-seven of the education
3 law.
4 (iv) "Opioid antagonist recipient" or "recipient" means a person at
5 risk of experiencing an opioid-related overdose, or a family member,
6 friend or other person in a position to assist a person experiencing or
7 at risk of experiencing an opioid-related overdose, or an organization
8 registered as an opioid overdose prevention program pursuant to this
9 section.
10 (b)(i) A health care professional may prescribe by a patient-specific
11 or non-patient-specific prescription, dispense or distribute, directly
12 or indirectly, an opioid antagonist to an opioid antagonist recipient.
13 (ii) A pharmacist may dispense an opioid antagonist, through a
14 patient-specific or non-patient-specific prescription pursuant to this
15 paragraph, to an opioid antagonist recipient.
16 (iii) An opioid antagonist recipient may possess an opioid antagonist
17 obtained pursuant to this paragraph, may distribute such opioid antag-
18 onist to a recipient, and may administer such opioid antagonist to a
19 person the recipient reasonably believes is experiencing an opioid over-
20 dose.
21 (iv) The provisions of this paragraph shall not be deemed to require a
22 prescription for any opioid antagonist that does not otherwise require a
23 prescription; nor shall it be deemed to limit the authority of a health
24 care professional to prescribe, dispense or distribute, or of a pharma-
25 cist to dispense, an opioid antagonist under any other provision of law.
26 4. Use of an opioid antagonist pursuant to this section shall be
27 considered first aid or emergency treatment for the purpose of any stat-
28 ute relating to liability.
29 [4.] A recipient or opioid overdose prevention program under this
30 section, acting reasonably and in good faith in compliance with this
31 section, shall not be subject to criminal, civil or administrative
32 liability solely by reason of such action.
33 5. The commissioner shall publish findings on statewide opioid over-
34 dose data that reviews overdose death rates and other information to
35 ascertain changes in the cause and rates of fatal opioid overdoses. The
36 report may be part of existing state mortality reports issued by the
37 department, and shall be submitted annually [for three years and as
38 deemed necessary by the commissioner thereafter,] to the governor, the
39 temporary president of the senate [and], the speaker of the assembly,
40 and the chairs of the senate and assembly health committees. The report
41 shall include, at a minimum, the following information:
42 (a) information on opioid overdose deaths, including age, gender,
43 ethnicity, and geographic location;
44 (b) data on emergency room utilization for the treatment of opioid
45 overdose;
46 (c) data on utilization of pre-hospital services;
47 (d) [suggested improvements in data collection.] data on utilization
48 of opioid antagonists; and
49 (e) any other information necessary to ascertain the success of the
50 program and ways to further reduce overdoses.
51 § 2. This act shall take effect immediately.
