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 Public Health Law Sec. 3331(5)(b) and (c). 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) 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 defi- nition of acute pain.

Sections 2 through 4 of the bill amend section 3216, 3221, and 4303 of the Insurance Law respectively. These sections prohibit additional co-payments for prescriptions prescribed pursuant to Public Health Law Sec. 3331(5)(b). The limitation shall apply only to the amount of prescription drug constituting a thirty day supply, including the limit- ed 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 Roundta- bles 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. A persistent theme from these Roundtables was the concern regard- ing the volume of prescription pain medicine sitting unattended in medi- cine 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 than two million more prescriptions written than there are citizens in this state. This bill addresses two major recommendations from the Roundta- ble, (1) eliminating excess medication for the treatment of acute pain and (2) decreasing the volume of pills left in medicine cabinets. Treat- ing acute pain often involves patients recovering from surgical proce- dures, 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 cabi- nets, where it runs the risk of diversion. Approximately 70% of prescription painkiller abusers get their drugs from a family member or friend. 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, while also providing 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 co-payment 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.

Legislative history

2012: S.6745 Died in Rules.

Fiscal implications

None.

Effective date

On the sixtieth day after it shall have become law.