Early Legislative Activity on Opioids

January 04, 2018|1:33 p.m.| ASTHO Staff

As 2018 begins, several state and territorial legislatures are convening and commencing debates and deliberations. Throughout the year, ASTHO will provide real-time legislative tracking on a range of public health issues, including vaccinations, tobacco control, marijuana, and antimicrobial resistance. ASTHO’s legislative tracking for opioids, substance use, and addiction will be organized around the four key strategies identified in ASTHO’s Preventing Opioid Misuse in the States and Territories framework: monitoring and surveillance, prevention and education, reducing and managing access, and treatment and recovery. Less than a week into the New Year, it is clear that responding to the opioid epidemic remains a priority for lawmakers with several legislative proposals addressing the framework’s strategies. Examples for each strategy include:

Monitoring and Surveillance. In Indiana, SB 139 aims to improve the information collected on death certificates for accidental and intentional overdoses of controlled substances by requiring county coroners to undertake specific actions, such as checking the states prescription drug monitoring program and testing the decedent for controlled substances. Improving the information collected and reported through vital statistics programs ensures more accurate surveillance of fatal overdoses.

Prevention and Education. A bill in Florida (SB 1434) provides additional funding to K-12 schools to establish or expand comprehensive school-based mental health programs. To receive funding, schools must develop plans that include components such as “strategies to improve the early identification of social, emotional, or behavioral problems or substance use disorders and to improve the provision of early intervention services” and “a collaborative effort or partnership between the school district and at least one community program or agency involved in mental health to provide or to improve prevention, diagnosis, and treatment services for students.” Successful primary prevention and early intervention programs can mitigate against a variety of negative outcomes, including self-harm and substance misuse.

Reducing and Managing Access. In Missouri, HB 1310 requires the department of health and senior services to promulgate rules consistent with the CDC Guideline for Prescribing Opioids for Chronic Pain. Although opioids prescribed per capita in the United States has fallen from its high of 782 morphine milligram equivalents (MME) in 2010 to 640 MME in 2015, responsible opioid prescribing practices remain essential, and guidelines can help to modify prescribing patterns.

Treatment and Recovery. A Vermont bill (S 225), among other things, requires health insurance companies to provide monthly payments to physicians and advance practice registered nurses who provide medication-assisted treatment outside of an authorized treatment program. This payment funds licensed alcohol and drug counselors and other medical professionals who may provide counseling and behavioral therapies. Improving payment and reimbursement policies can encourage primary care and other non-specialist providers to offer the full spectrum of evidence-based treatment and recovery services.

As the year continues, more bills that address opioids, substance use, and addiction are expected to be introduced and potentially signed into law. ASTHO will follow these bills and others in order to support state and territorial health agencies develop and implement sound public health policies and programs.