Please see information from Lori our Government Affairs person on SB482. The bill was signed by the Governor yesterday. Christine Baker, head of the Department of Industrial Relations, is especially to be applauded for her work on this bill.
Small Business California
2311 Taraval Street San Francisco, CA 94116
Congratulations to You, SB Cal’s Board and its members on the great news that the Governor signed SB 482 (Lara), sponsored by Small Business California. This bill would require all prescribers issuing Schedule II, III and IV drugs to consult California’s Controlled Substance Utilization Review and Evaluation System (CURES) before prescribing. Small Business California partnered with labor organizations, the CA Medical Association and several attorney groups to negotiate this bill that will help physicians make better informed decisions on the opioids they are prescribing.
Currently, 49 states have prescription drug monitoring programs in place (1). In 1996, California enacted the first, what is today known as the CURES system, managed by the Department of Justice (DOJ). The system tracks the prescription of Schedule II and III narcotics, the strongest pain killers on the market. Current law requires all practitioners with licenses to dispense Schedule II and III drugs, including doctors, nurses, optometrists, among others, to enroll in CURES by January 1, 2016 or on their license renewal date. The DOJ completed its upgrade of the system to accommodate the new users earlier this year. Historically, physicians consulting the CURES system has been voluntary with many prescribers not checking the database before prescribing Schedule II, III and IV drugs.
Other states that have required prescribers to check their drug monitoring systems have seen significantly improved public health outcomes. In 2012, Tennessee required prescribers to check the state’s prescription drug monitoring program before prescribing painkillers. Within one year, they saw a 36% drop in patients who were seeing multiple prescribers to obtain the same drugs (2). In Virginia, the number of doctor shoppers fell by 73% after use of the database became mandatory. In Oklahoma, which requires mandatory checks for methadone, overdoses fell about 21% in a single year.
According to the Centers for Disease Control and Prevention, drug overdoses are the top cause of accidental death in the United States (3). Nearly 23,000 people died from an overdose of pharmaceuticals in 2013 nationally – more than 70% of them from opiate prescription painkillers. The CURES database is an invaluable investigative, preventive, and educational tool for law enforcement and the healthcare community.
According to the California Attorney General's Office, if doctors and pharmacies have access to controlled substance history information at the point of care, it will help them make better prescribing decisions and cut down on prescription drug abuse in California. The current voluntary approach has not been able to attract sufficient participation to make it truly effective.
Senate Bill 482 requires all prescribers to consult the CURES system before issuing Schedule II, III and IV drugs. This will enable prescribers to make informed decisions about their patient’s care and limit the number of people who doctor shop and over use prescription drugs. This bill will only become operative once the AG’s office certifies the system update is fully operative. Additionally, prescribers will not be held liable if at the time of the prescription CURES is unavailable.
This bill is of significant importance to reducing the amount of prescription medications in our workers’ compensation system. Currently, 44% of all medical treatment disputes result from the prescribing of opioid drugs in high dose amounts and for long durations. The overuse and overprescribing of these drugs result in higher premium costs to employers and delays in return-to-work for the injured workers. Last year, SB Cal worked closely with the stakeholders to develop AB 1244 (Perea), signed by the Governor and effective January 1, 2016, that provides for a workers’ compensation drug formulary that would require a physician to follow treatment guidelines, in determining the safest and most appropriate treatment. In many cases, opioids were determined to be overused and overprescribed.
Together, SB 482 and AB 1244 will ensure responsible prescription of opioid drugs to all patients, including our injured workers. Other states that have implemented similar legislation have seen a dramatic drop in the prescribing patterns which has resulted in lower costs to business and better outcomes for the patients.
Congratulations once again!
Kammerer & Company, Inc.
1215 K Street, 17th FL
Sacramento, CA 95814
Ofc: (916) 441-5674
Cell: (916) 716-5674