Provides that the initial prescription or dispensing of a controlled substance for acute pain shall be limited to a 3 - 10 day supply

Summary of provisions

Section 1 of the bill adds subsections (b) and (c) to Subdivision 5 of section 3331 of the public health law. Subsection (b) permits authorized practitioners, within the scope of their professional opinion or discretion, to dispense between three and ten days of any schedule II or III controlled substance to a patient suffering from acute pain. Subsection (c), which provides a definition of acute pain. The term encompasses accidental and intentional pain lasting only a short or finite period of time. The subsection expressly excludes chronic pain, cancer pain, or palliative care practices from the definition of acute pain.

Sections 2 through 4 of the bill amend section 3216, 3221, and 4303 of the insurance law respectively. The limitation shall apply only to the amount of prescription drug constituting a thirty day supply, including the limited supply provided pursuant to Subdivision 5 of section 3331 of the public health law.

Section 5 of the bill provides for an effective date.

Justification

Prescription drug abuse is a growing crisis in both New York State and the country at large. In this state, there has been armed violence, deaths by overdose and suicide, and increasing rates of addiction. To address this crisis, the Senate Standing Committee on Health held two Roundtables on the topic in August 2011 and February 2012. The Roundtables included panelists from all aspects of this debate, including law enforcement, doctors, addiction specialists, government agencies, and family members who have lost loved ones to prescription painkiller abuse. One overwhelming comment from these Roundtables concerned the volume of prescription pain medicine sitting unattended in medicine cabinets throughout the state.

In 2010, there were 22.5 million prescriptions issued for prescription painkillers-not including refills-in New York State. That is more two million more prescriptions written than there are citizens in this state. This bill resolves two major recommendations from the Roundtable, (a) eliminating excess medication for the treatment of acute pain and (b) decreasing the volume of pills left in medicine cabinets. Treating acute pain often involves patients recovering from

surgical procedures, short-term trauma, or dental procedures. By definition, acute pain is also finite pain-with the exception of certain situations involving terminal cancer pain. However, it is not uncommon for a doctor to prescribe 30 pills for pain following a dental procedure. Most patients will use 2-3 pills and the excess sits in their medicine cabinets, where it runs the risk of diversion. Recent news tells the story of teenagers taking whatever pills are available in the home medicine cabinet and taking or selling them on the street. Prescription painkillers are a wonderful tool, and allow us to treat pain as never before in human history, but they are also highly addictive.

This bill ameliorates the excess volume of pills on the street, but it also provides better continuity of care. Acute pain can be a powerful diagnostic tool for medical professionals. It is common for this form of pain to follow various timelines. If pain worsens or lasts for a longer time, it can be an important signal that something else is happening. Providing excess medication helps patients dampen their current pain, but it also prevents them from seeking additional medical help that they might need. This bill limits the amount of medication, so that patients feeling additional pain will seek medical intervention earlier. The bill also ensures patients will only pay a single copayment for the first 30 days of medication, even if the medication comes in the form of several prescriptions over the course of those 30 days.

Prior legislative history

New bill

Fiscal implications

None.

Effective date

On the sixtieth day after it shall have become law.