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Will Brownsberger
State Senator
2d Suffolk and Middlesex District

Senate Passes Prescription Drug Legislation (12 Responses)

prescription drugs

Today the Senate passed a bill to strengthen the state’s response to prescription drug addiction.

This legislation builds on the tireless work of my predecessor, Steven Tolman, on this issue. Click here for former Senator Tolman’s Commission Report. The statistics are stunning — overdoses from prescription drugs now exceed both heroin overdoes and auto accidents as a cause of death. The problem touches every community in the state.

The center of the bill is an effort to strengthen the monitoring program that will help doctors identify patients involved in “doctor shopping.”
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BOSTON – With the abuse of prescription pain killers having reached epidemic levels in Massachusetts, the Senate on Thursday unanimously passed legislation for strict oversight of the drugs. The bill will reduce the excess supply of pills and require physician registration in the state’s Prescription Monitoring Program to prevent patients from “doctor shopping” for highly addictive medications such as OxyContin and Vicodin.

“When drugs like these are responsible for more accidental deaths in Massachusetts than motor vehicle accidents, you know we’ve got a problem,” Senate President Therese Murray (D-Plymouth) said. “I said at the beginning of this legislative session this would be a top priority. The abuse of these drugs has devastating effects on individuals and families of every socio-economic background. The costs are high, both to families and the economy, not to mention the significant impact on public safety. This bill will help save lives and keep us all safer.”

“This bill recognizes the quiet epidemic that has struck families all across this Commonwealth, and with practical, cost-effective measures steps up our fight against one of the main causes of the epidemic – prescription painkillers,” said Senator John F. Keenan (D-Quincy) lead sponsor of the bill.

A report released by the OxyContin and Heroin Commission in 2009 found that Massachusetts has one of the highest rates of opiate abuse in the nation, causing 3,265 deaths from 2002 to 2007 and 23,369 hospitalizations in 2006 alone.

The Drug Enforcement Agency reports that Vicodin is the second-most abused drug by high school seniors, behind marijuana, and opiate addiction is the leading cause of property crime. Meanwhile, taxpayers are spending hundreds-of-millions of dollars annually in costs associated with the epidemic – including hospital visits, court appearances, jail time and social services.

The bill increases prescription drug security by making enrollment in the state’s Prescription Monitoring Program mandatory. The top 30 percent of prescribers, who provide 90 percent of all controlled substances, are required to enroll immediately. All others would be phased-in over three years. Currently, participation in the program is voluntary, with only 1,700 out of 40,000 prescribers signed up.

To promote awareness, the Department of Public Health will be required to produce informational pamphlets explaining addiction risks, signs of dependency, where to go for treatment, and ways to safely store and discard drugs. The pamphlets will be distributed by pharmacies with each prescription filled.

Pharmacies, drug manufacturers and other relevant parties will also be required to alert local police when reporting missing controlled substances to the Drug Enforcement Administration. Under the bill, doctors and hospitals will be required to notify a parent or guardian of any minor treated for drug overdose. Information on substance abuse treatment options must also be provided, and a social worker will be available for counseling prior to hospital discharge.

The legislation also requires all prescriptions for controlled substances to be written on “secure” forms, using special watermarks, serial numbers or micro-printing to be determined by the Department of Public Health. The bill also forms a working group of practitioners to draft “best practices” for prescriptions that treat acute and chronic pain.

The bill also does the following:
• Bans the possession, distribution and manufacturing of synthetic over-the-counter recreational drugs known as “bath salts” which are smoked, inhaled or injected and linked to serious physical and mental problems;
• Prohibits pharmacists from filling certain narcotic prescriptions from doctors in non-contiguous states;
• Restricts MassHealth enrollees with a history of excessive use to one pharmacy;
• Provides limited immunity from drug possession charges for those who seek medical assistance for an overdose, but does not extend to drug trafficking cases;
• Allows sheriffs to enter into a study on the effectiveness of medication-assisted treatment for the successful transition of inmates back into society;
• Commissions a study on substance abuse among seniors; and
• Mandates professional training for court personnel and legal counsel on substance abuse services available for those facing criminal charges.

According to Centers for Disease Control, more people are overdosing on prescription pain killers (approximately 12,000 nationally in 2007) than on cocaine and heroin combined, with the number of people needing emergency treatment for overdoses having tripled in the last decade. Of the nearly 2 million emergency room visits nationally in 2009, almost half involved prescription drug abuse.

For an explanation of drug classifications, knows as schedules, under the U.S. Controlled Substances Act, please see this website: http://nationalsubstanceabuseindex.org/drugclass.htm.

The bill now goes to the House of Representatives for further action.

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  1. [...] We came very close to passing and may still pass legislation to control prescription drug abuse. [...]

  2. Another comment from a patient:

    I am 70yrs old and suffering from severe arthritis –it has been necessary to replace a hip and a shoulder as a result. It is an incredibly painful condition and complicated by bad back surgery. I have lost 4inches in height and there is a curve in my spine. This suffering is relieved by a combination of natural remedies, NSAIDs and Oxycontin and Oxycodone. With this combination I am able to continue working and manage my life. Your recent legislation regarding Opiates has made my life worse and put me in the category of those needing to be registered –ex felons, sex offenders etc. I am not a criminal.

    The online report of the need for legislation lists high rate of usage in Massachusetts. Perhaps some of that high rate is from returning Veterans with horrific and painful disabilities. There is comment about teenagers getting medications prescribed to parents who are irresponsible about care of medication and parenting in general. That´s a parenting issue, not a medical one. There is mention of doctor shopping. Where? There is a shortage of Primary Care Physicians in this state. Because of a Cancer misdiagnosis I am not able to change my PCP because practices are closed. This new legislation will make it impossible for me to find another PCP – what doctor, already overwhelmed with paperwork/ administrative demands, would take on a new patient with pain management paperwork? These requirements are a real interference in medical practice.

    I don´t believe that anybody in the Senate is M:D:, yet you are making medical decisions about my care when you restrict what my Doctor may prescribe.

    I don´t believe that you are taking into account the difficulty and hardship that this legislation is causing people who because of physical difficulties, need this medication to have some relief .

    I question whether it will address the issues of your concern.

    There are already difficult restrictions on using these drugs:

    I have to physically retrieve the prescription from my Doctor´s office – it cannot be mailed because of security concerns, nor can it be faxed. This is an hour and half of time spent getting to the office every month. It can´t be filled in advance. My prescription needed to be refilled over Christmas – I was not able to visit my brother who lives out of state for this Holiday because of the travel time conflict.

    I really think you need to reconsider the validity of this legislation and the interference in Doctor / patient relationship and confidentiality.

  3. A constituent sent me an email recounting a story showing why we need to make sure that the regulations that emerge under this legislation are reasonable and practical — many people need pain medication. She didn’t feel comfortable posting under own name, but I’ve quoted from her email here:

    I read this with interest as my dad was recently diagnosed with stage IV pancreatic cancer and one of the real burdens I’ve encountered in caring for him are all the restrictions around narcotics. These generally involve limits to the amount of drug that can be dispensed in a given time period. Over the New Year’s weekend, I spent hours trying to get past a cap on his Oxycontin which he was running out of. His oncologist even called our local CVS twice and spoke with the pharmacist. All to no avail; we ended up without the drugs we needed — a situation which would have been unbearable for him, except that he ended up being hospitalized on New Year’s Day and was given the medications in the hospital. He is now home again and I just ran into the same issue with the Fentonyl patches he was switched to: he only has enough for one more dose (he receives it every 72 hours), but the pharmacy couldn’t fill his prescription until the 4th due to the caps on the amount of narcotic he can be dispensed in a given time period. Do you know what it’s like to, in addition to all the other tasks of a caregiver of a seriously ill patient, to have to spend hours on the phone, make multiple trips to the pharmacy (one to drop off the prescription, a second to another CVS because the first didn’t have the drug on hand, a third because the 2nd pharmacy wouldn’t fill the prescription anyway because the drug couldn’t be dispenses till the 4th, a fourth to the original pharmacy to provide the prescription so they could special order the drug and a 5th–I hope!–so I can actually have the prescription filled on Tuesday…) and have to involve physicians and other healthcare providers off hours and on the weekends because without the narcotics my father will be in unbearable pain? Please, please find a way to make it EASIER, not harder, for patients and their caregivers to get the narcotics they need.

  4. MarkKaepplein says:

    Will, with 2x drug overdose deaths as traffic deaths and more deaths from dirty hands in hospitals than traffic deaths, reason implies that law enforcement should stop wasting resources writing speeding tickets and buying laser speed guns? They would save more lives by monitoring hand washing in hospitals, checking scripts, and getting reports from the DEA and other LE. Likewise, intersection and bus cameras seem like a huge waste of money, especially when they don’t catch bicyclists who are the ones most often running red lights.

    I’ve had a number of sport/exercise related knee injuries and laws inducing doctor paranoia have been the biggest problem I’ve experienced, not addiction despite having taken 300 Percocets, often with alcohol for enhancement, over a few months recovering from my last open surgery. For an earlier arthroscopic surgery when much younger, my parents were given only 3 Percocets on day surgery discharge with instructions on the bottle to take 1 every 4 hours and NEVER EVER with alcohol. My mother, thus would not give me any, and I couldn’t go get it. So, I was in excruciating pain after the local anesthetic in my knee wore off and swelling continued (they didn’t ice my knee in the recovery room while waiting for my nausea to stop). After a sleepless night, my father was finally able to spend hours getting and filling for me another script – in person because the law doesn’t allow calling in vital scripts like these. On hindsight, him being given my schedule 1 script by a pharmacist must have broken some laws.

    I’ve never smoked cigarettes, but understand nicotine is far more addictive than opiates where under 10% of the population may be susceptible to addiction. I see that this bill only makes the problem worse, not better. Also, because the DEA communicates poorly with other government law enforcement, the solution is putting more burden on the private sector to bridge the communication gaps? With the ever more obscene prices of medications at pharmacies, legislators want to make them even more expensive?

    The bill could be written for the 21st century and encourage secure electronic prescription delivery from the doctor’s computer to the pharmacy, with all the various government agencies getting carbon copied (by the pharmacy upon receipt). A doctor I have uses this amazing new technology on his desktop computer, and there might even be an iPad or iPhone app for that! Isn’t this better than hand delivered pieces of (secure) paper?

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