What's happening
This bill requires that every patient's first high-dose opioid prescription each year be accompanied by a prescription for an opioid overdose antidote like naloxone.
Why it matters
Targets patients at elevated risk of overdose. by ensuring those prescribed high-dose opioids (≥50 morphine milligram equivalents) automatically receive access to an opioid overdose reversal medication, which could reduce fatal overdose incidents.
Shifts part of the opioid crisis response to prescribers and pharmacies. , making overdose prevention a routine part of pain management and potentially increasing both awareness and conversations between patients and providers about opioid risks.
May lower stigma and logistical barriers. for patients and families in obtaining naloxone or similar antidotes, as the co-prescribing requirement makes having this life-saving medication standard practice rather than an exception.
Could impact prescribing behavior. by prompting clinicians to reconsider high-dose opioid prescriptions, knowing that such a prescription now also triggers an automatic naloxone prescription and potential patient education about overdose risk.
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Who cares
Headline styles
Prescribe Naloxone With Opioids
Plain English, a few words. Used as the page title.
Sponsors
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History
- Referred to health
- Referred to health
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4095
2019-2020 Regular Sessions
IN SENATE
February 28, 2019
Introduced by Sen. RANZENHOFER -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the public health law, in relation to prescribing an opioid antagonist with a patient's first opioid analgesic prescription in a given year
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Section 3302 of the public health law is amended by adding two new subdivisions 44 and 45 to read as follows:
44. "Opioid analgesics" means the medicines buprenophine, butorphanol, codeine, hydrocodone, hydromorphone, levorphanol, meperidine, methadone, morphine, nalbuphine, oxycodone, oxymorphone, pentazocine, propoxyphene as well as their brand names, isomers and combinations.
45. "Opioid antagonist" means an FDA-approved drug that, when administered, negates or neutralizes in whole or in part the pharmacological effects of an opioid in the body. The opioid antagonist is limited to naloxone or other medications approved by the department for this purpose.
§ 2. Section 3309 of the public health law is amended by adding a new subdivision 7 to read as follows:
7. Every initial opioid analgesic prescription per year, which is equal to or greater than fifty morphine milligram equivalents, shall be accompanied with a prescription for an opioid antagonist.
§ 3. This act shall take effect on the ninetieth day after it shall have become a law. Effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized to be made and completed by the commissioner of health on or before such effective date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01771-01-9
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the public health law, in relation to prescribing an opioid antagonist with a patient's first opioid analgesic prescription in a given year
Purpose or general idea of bill
To prescribe an opioid antagonist, a drug used to counter the effects of opioid overdose, with a patient's first opioid analgesic prescription, which is equal to or greater than 50 morphine milligram equivalents, in a given year.
Summary of specific provisions
Section 1. Adds a new subdivision 42 to Section 3302 of the Public Health Law. Subdivision 42 defines "opioid analgesics" as the medicines buprenorphine, butorphanol, codeine, hydrocodone, hydromorphone, levor- phanol, meperidine, methadone, morphine, nalbuphine, oxycodone, oxymor- phone, pentazocine, propoxyphene, as well as their brand names, isomers and combinations Public Health Law, which defines an opioid antagonist as an FDA- approved drug that, when administered, negates or neutralizes in whole or in part the pharmacological effects of an opioid in the body. The opioid antagonist is limited to naloxone or other medications approved by the department for this purpose.
Read the full memo (777 words)
Section 2. Adds a new subdivision 5 to Section 3309 of the Public Health Law. Subdivision 5 provides that every first opioid analgesic prescription of the year, which is equal to or greater than 50 morphine milligram equivalents, shall be accompanied with a prescription for an opioid antagonist.
Section 3. Contains the effective date.
Justification
Drug poisoning is the leading cause of death from injuries in the United States. In New York State and New York City, between 1999 and 2008 the leading cause of accidental death was overdose, ahead of accidental falls and motor vehicle accidents. The vast majority of these overdose deaths occurred inside the home.
According to studies by the Centers for Disease Control and Prevention, drug poisoning deaths involving opioid analgesics, also known as prescription pain relievers, such as codeine and oxycodone, have more than tripled nationally since 1999, and between 2000 and 20 11, the rate of drug poisoning deaths involving opioid analgesics in NYC increased by 267%. In 2012, prescription opioid analgesics were involved in 28% of overdose deaths in NYC. Between 2015 and 2016 the opioid overdose death rate in New York State increased by 40 %. Additionally, eighty percent of heroin users have reported that they used opioid analgesics before switching to heroin. As of March 2018, more than 115 people in the United States die every day from overdosing on opioids, according to the CDC.
The CDC has stated that higher dosages of opioids are associated with higher risks of overdosing. Furthermore, higher dosages have not been shown to reduce pain over the long term. The CDC maintains the threshold of "higher dosages" begins at 50 morphine milligram equivalents (MME) per day, instructing clinicians to treat the prescription of 50 MME or more as a risk factor for overdose. Dosages o f 50 MME at least double the risk of overdose from the risk at less than 20 MME.
Opioid antagonists, such as naloxone, are drugs that reverse the effects of opioids, and are effective in preventing overdose deaths. The avail- ability of an opioid antagonist is crucial in ensuring that overdose deaths do not occur. However, an opioid antagonist can only be effective as an antidote if it is readily accessible when an overdose is happen- ing. Additionally, opioid antagonists are non -habit forming and non- toxic. On April 5th, 2018, the United States Surgeon General issued the first national advisory in over a decade, urging all Americans to carry naloxone.
Currently, opioid antagonists can only be used if they are prescribed. A co-prescribing mandate would expand access to these life-saving drugs by requiring that for the first prescription for an opioid analgesic, which is equal to or greater than 50 morphine milligram equivalents, in each year, the provider would also be required to prescribe an opioid antagonist. A recent NYC Department of Mental Health and Hygiene study supported a co-prescribing mandate to increase the availability of opioid antagonists. This legislation, by increasing access to opioid antagonists, may be able to save the lives of those at risk for opioid analgesic overdoses.
Prior legislative history
2013-2014: A.9365 - Referred to Health.
2015-2016: A.661 - Referred to Health.
2017-2018: S.5868-A/A.1531-A - HEALTH/Health
Fiscal implications
None.
Effective date
This act shall take effect on the ninetieth day after it shall have become a law; provided, however, that effective i mmediately, the addi- tion, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date is authorized to be made and completed by the commissioner of health on or before such effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.