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Preventing Prescription Drug Abuse:
Laws and LegislationHollie Hendrikson, MSc.
303-856-1525
Policy Specialist, Health Program
National Conference of State Legislatures
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Motor vehicle traffic, poisoning, and drug poisoning death rates, 1980-2009
Motor Vehicle Traffic
Poisoning
Drug Poisoning
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
Source: National Center for Injury Prevention and Control, 2011.
Abuse treatment admissions
ED visits for misuse or abuse
People who abuse or are dependent
Nonmedical users
10
32
130
825
For every 1 overdose death there are:
Other source
Bought from drug dealer
From one doctor
Free from friend or relative
Bought from friend or relative
Took from friend or relative w/o asking70%
obtained from friend or relative
Where are the nonmedical users getting their drugs?
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
• 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.
Prescription Drug Monitoring Programs (PDMP)
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.
Louisiana Senate Bill 112: Authorizes the sharing of PDMP information with PDMP located in other states. 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.
• “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
• 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.
Doctor Shopping Laws, cont.
States with Doctor Shopping Laws
Source: National Center for Injury Prevention and Control, 2011.
• 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.
Tamper-Resistant Form Laws
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 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.).
Pain Management Clinic Laws
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.
• 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).
Immunity from Prosecution Laws
States with Immunity or “Good Samaritan” Laws
Source: National Center for Injury Prevention and Control, 2011.
Hollie Hendrikson, MSc.
303-856-1525
http://www.ncsl.org/issues-research/health/prevention-of-prescription-drug-overdose-and-
abuse.aspx
