By Kate Blackman and Amber Widgery
The attention to opioid misuse prevention in state legislatures parallels the continued rate of overdoses.
In 2016, state lawmakers considered more than 500 pieces of legislation related to opioid misuse prevention, and 2017 is on pace to top that.
As we near the end of summer, most legislatures have adjourned their sessions for the year and lawmakers may be reflecting on their recent progress. Across all 50 states, 604 bills were introduced by mid-August. Of those, 150 bills were enacted or adopted.
The legislative trends—according to NCSL’s tracking of six categories of opioid misuse prevention legislation—are outlined below. Some states tackled multiple issues in one or more bills, so overlap exists between the categories.
Prescription Drug Monitoring Programs (PDMP). Legislation related to prescription drug monitoring programs continues to be an active issue in 2017, with 161 bills introduced and 56 enacted to date. As almost all states operate PDMPs—state electronic databases that track prescriptions of controlled substances—this legislation focuses on changes to these programs. These changes are similar to those seen in 2016, such as provisions related to provider registration and use (e.g., mandatory check and reporting requirements), and authorization for various entities to access information from the PDMP.
Naloxone (Rescue Drugs). States have steadily been increasing access to the overdose reversal drug naloxone. In total this year at least 137 bills addressed naloxone access—42 of which have been enacted. States with an existing law passed legislation to expand access even further, such as through standing orders or allowing certain categories of people to carry and administer it. The remaining three states that had yet to address the issue—Kansas, Montana and Wyoming—also passed legislation. States also continued to address Good Samaritan, or immunity, provisions for those who call 911 to seek medical assistance in the event of an overdose. Montana, Nebraska and South Dakota each enacted a new law bringing the total number of states with an immunity provision to 40.
Prescribing Guidelines or Limits. Limits or guidelines for opioid prescriptions debuted in 2016 and have quickly caught on. Lawmakers considered 81 bills so far in 2017, and 23 states now have laws related to opioid prescription limits or guidelines. These provisions typically set the number of days’ supply for an initial opioid prescription, with various exceptions (e.g., chronic pain, cancer treatment, palliative care). A handful of these laws direct other entities, such as the department of health, to set limits.
Training or Education. Thirty-eight bills covered training or education for providers, and 12 have been enacted. Legislators primarily passed provisions requiring continuing education or medical education for health care providers related to prescribing opioids. A few states also included recognizing substance use disorders in educational requirements.
Pain Clinics. Laws related to pain clinics—facilities that specialize in treating chronic pain—have seen less attention recently. This year, 30 bills have been introduced, with four enacted. This legislation looks at topics like registration and licensure of pain clinics, and also broadly includes chronic pain management.
Other. In addition to the categories above, NCSL captured nearly 250 bills in the “other” category. Around 50 have been enacted or adopted. This legislation spans a wide range of issues, such as: non-opioid directives for patients, taxes on opioids, abuse-deterrent formulations of opioids, and drug “take-back” programs or days to collect unused pills.
Keep track of introduced and enacted legislation with NCSL’s interactive Injury Prevention Legislation Database. The database has cataloged more than 1,300 bills related to six categories of opioid misuse prevention legislation since 2015.
Kate Blackman covers opioid misuse prevention and other public health issues for NCSL’s Health program. Amber Widgery specializes in justice involved mental health and drug crime policies for NCSL’s Criminal Justice program.
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