It may soon get tougher for people with drug addictions to seek opioid drugs from multiple doctors or pharmacies.
Legislation that’s been two years in the making would require doctors and others who can prescribe dangerous drugs to check the New Jersey Prescription Monitoring Program (PMP), a database of all prescriptions issued in the state, before first prescribing these drugs to patients, and to check the database every three months after the first prescription.
This would help detect “doctor shopping,” a term for seeking different doctors to get more prescriptions for opioids like oxycodone or morphine.
The measure is a centerpiece of a 21-bill package that the Legislature has been enacting in the face of an epidemic of overdoses from both prescription opioids and heroin. Some people seek heroin after first becoming addicted to prescription painkillers.
New Jersey would join 22 other states that mandate checking of PMP registries.
Legislators are hoping it will be as successful as an initiative in New York, which saw a decline in opioid prescriptions and “doctor shopping” after it mandated PMP checks.
Both law-enforcement officials – including senior officials in the state attorney general’s office — and advocates for curbing addiction, including members of a task force formed by the Governor’s Council on Alcoholism and Drug Abuse, had sought the mandate.
Some groups representing the state’s doctors had opposed a mandate, citing both the time it would take doctors to check the database and concerns about government intrusion into the practice of medicine. Some doctors have also expressed concerns that making it too difficultl to acquire opioid prescriptions might hurt those who really need pain relief.
But a representative of the largest doctors group, the Medical Society of New Jersey, said it welcomes the final version of bill, which includes several amendments sought by doctors.
In addition to requiring doctors to use the database, the bill will also require the Division of Consumer Affairs to check for patterns of potential misuse, abuse or diversion of dangerous drugs on the part of either patients or prescribers, and to notify law enforcement or professional licensing boards.
Assembly sponsor Joseph A. Lagana (D-Bergen and Passaic) said the bill had been a priority for him even before he was sworn into office last year.
He said the legislation seeks to build on recommendations in the State Committee of Investigation’s July 2013 report “Scenes from an Epidemic,” which told of doctors bilking Medicaid by wrongfully handing out prescription painkillers, including one who served as a front for organized crime.
Lagana said he understood the concern about having to comply with yet another government mandate, but he asserted that the measure would ultimately serve doctors’ interests by reducing the misuse of opioids.
In addition, the bill would allow doctors to designate other licensed or certified healthcare workers to access the PMP on the doctors’ behalf. It also exempts emergency-department doctors who prescribe no more than five days’ worth of the drugs, or those who prescribe less than a 30-days supply for people undergoing an operation or treatment for acute trauma.
“We’ve made this as easy and as workable as possible,” Lagana said.
The Senate last week passed an earlier version of the bill, sponsored by state Sen. Loretta Weinberg (D-Bergen) and state Sen. Joseph F. Vitale (D-Middlesex).
Since the Assembly Budget Committee heavily amended the legislation yesterday, both the full Assembly and the Senate must sign off on the new version before sending it to Gov. Chris Christie’s desk.
Lagana said the bill was changed to address points raised by the Christie administration, and he’s hopeful that the governor will sign it.
While doctors using the PMP remain in the minority, the number has been rising.
Christie warned the medical society in a speech last year that despite his philosophical opposition to government mandates, he would sign a bill requiring use of the PMP. In the same speech, the governor talked about a longtime friend who had recently died from an overdose after a long battle with addiction.
Medical Society of New Jersey chief operating officer Mishael Azam said the bill includes several provisions sought by doctors, including limiting the mandate to medically appropriate cases; requiring pharmacies to provide timely prescription data; encouraging sharing information with other states’ PMPs, and requiring the state to notify doctors of potential drug misuse by patients.
Azam said the society has been encouraging doctors to use the PMP through continuing education courses being held throughout the state.
“We know that they’re already improving their practices,” she said.
One prominent doctor – Assemblyman Herb Conaway Jr. (D-Burlington) – opposed an earlier version of the mandate. But he wasn’t in position to stop the bill, which was first assigned to the Assembly Judiciary Committee instead of the Health and Senior Services Committee, which Conaway chairs and which hears most healthcare-related bills.
Republican members of the Assembly Budget Committee expressed concerns yesterday about the many late amendments to the bill with concern yesterday. Assemblyman Chris J. Brown (R-Atlantic, Burlington and Camden) said they were given only a few minutes to review nearly 50 pages of legislation.
“I’m just not in favor of this type of government,” Brown said.
Assemblyman Declan O’Scanlon agreed, but added that the PMP was in need of reform, and that optional use of the database “invites abuse.”
Brown, O’Scanlon and the two other committee Republicans abstained from voting on the bill, which was approved by all seven Democrats who voted.