By Tammy Jo Musgraves
Injury prevention remains a key issue for state lawmakers due to its high toll on an individual’s health and state and individual finances.
Financially, at the beginning of 2019, the CDC estimated the total “economic burden” of prescription opioid misuse alone in the United States is $78.5 billion a year. In 2019, legislators considered at least 693 injury prevention bills in all 50 states.
NCSL tracks introduced legislation in the Injury Prevention Legislation Database, including topics such as adverse childhood experiences, teen dating violence, older adult falls, traumatic brain injury and prescription drug misuse prevention. Read on for trends in enacted legislation from 2019, as well as state examples.
Adverse Childhood Experiences (ACEs)
Adverse Childhood Experiences, potentially traumatic events that occur before the age of 18, have been linked to risky health behaviors, chronic health conditions, low life potential and early death.
State efforts to expand awareness and understanding of ACEs and to increase access to social services was a major trend in 2019 legislation—as of August, 36 states tackled 132 pieces of legislation pertaining to ACEs and 16 of those state enacted or adopted legislation.
- Georgia adopted HR 421 creating the House Study Committee on Infant and Toddler Social and Emotional Health. This committee will study the conditions, needs, issues, and problems concerned with the early intervention and prevention of mental health problems in children and adolescents in the state.
- Illinois adopted two bills this session. SR 99 urges policy decisions enacted by the legislature to acknowledge and take into account the principles of early childhood brain development and consider the concepts of toxic stress, early adversity and the role of early intervention and investment into early childhood years. SR 99 and HR 248 declare May 15, 2019, as Trauma-Informed Awareness Day.
- Montana enacted HB 604 which directs the Department of Public Health and Human Services to use funding from the Family First Prevention Services Act to create a strategic plan to develop and expand prevention services including, but not limited to, the Family First Prevention Services Act, ACEs, trauma and trauma-informed care.
Prescription Drug Misuse Prevention
The database contains several subcategories for prescription drug misuse tracking—from pain clinics and pain management, to prescribing guidelines and limits, to provider training, naloxone and other areas—that may include scope of practice or people also involved with the justice system. In 2019, NCSL tracked 293 pieces of legislation from 46 states. Much introduced legislation concerned training or partnering with first responders and law enforcement, increasing Good Samaritan Laws, and limiting the number of pills or morphine milligram equivalents prescribed to an individual.
In addition, legislation allowing schools to administer opioid antagonists and communities to adopt safe syringe programs (SSPs) gained more attention with at least 21 states introducing legislation.
- Arizona enacted HB 2075 related to electronic prescribing, expectations and deadlines for pharmacists while providing new rules for pharmacists relating to dispending of a prescription order of schedule II-controlled substances, which includes opioids.
- Illinois created the Needle and Hypodermic Syringe Access Program Act, allowing persons or entities that promote scientifically proven ways of mitigating health risks associated with drug use and other high-risk behaviors to establish and operate a needle and hypodermic syringe access program.
In 2019, NCSL tracked 32 bills across 17 states related to Prescription Drug Monitoring Programs (PDMP).
- Colorado enacted SB 228, allowing medical examiners access to the PDMP, increased training for prescribers on substance use disorders and opioid prescriptions and authorized the Department of Human Services to conduct substance use research for the purposes of treatment and prevention options.
- Indiana enacted HB 1295, limiting an opioid prescription for an animal to a seven-day supply, unless a listed exception applies and allows a veterinarian to obtain information about the owner of the animal from the PDMP prior to prescribing an opioid or benzodiazepine.
Traumatic Brain Injury
Legislators in 32 states introduced a total of 122 bills on traumatic brain injury. Much of the enacted legislation addressed awareness, traumatic brain injury for young athletes, veterans and expanding access to care under mental health and behavioral health state agencies.
- Louisiana adopted HCR 40, requesting the State Board of Elementary and Secondary Education to adopt policies requiring more rigorous student athlete health screenings so schools can be well prepared to preserve and protect the health of students.
- Texas enacted HB 833, creating a statewide alert system for missing military members who may suffer from mental illness, including post-traumatic stress disorder or traumatic brain injury.
Will trends from the 2019 session continue into the next legislative session? One thing’s for sure—NCSL will continue to track injury prevention issues and legislative trends through the 2019-2020 legislative session.
Tammy Jo Musgraves is a policy specialist in NCSL's Health Program.
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