Explainer: Effort to Encourage Doctor-Patient Conversations on Addiction

Latest push focuses on young patients but must overcome Assembly opposition

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A growing number of addicts in New Jersey — and across America — stumbled into their disease after they became hooked on prescription pain medication issued by a physician. Some advocates believe that, given their role as gatekeepers, doctors should take more responsibility when providing these powerful drugs.

The back story: Lawmakers here have tried for several years to pass a bill that would require physicians to talk about the potential for addiction when prescribing opiates and other addictive drugs. Pending now is a less comprehensive proposal that would only cover minors.

The opposition: Assemblyman Herb Conaway, (D-Gloucester), a physician himself who chairs the Assembly health committee, has refused to hold hearings on the proposal, which he has said would unnecessarily interfere with the doctor-patient relationship. In the past, the Medical Society of New Jersey, which represents physicians, has also raised concerns about government mandates that dictate these conversations.

Repeated calls for passage: Elaine Pozycki, chair of the Partnership for a Drug-Free New Jersey, reiterated a call for such legislation on Monday, following an addiction forum the group helped host with U.S. Sen. Robert Menendez, Sen. Corey Booker, and Surgeon General Vivek H. Murthy. “I call on the Assembly to pass this legislation without further delay,” Pozycki said.

When asked about the Garden State proposal during a press conference following the event, Murthy said, “We do need doctors to have these conversations.” Conaway did not respond to a request for comment Monday afternoon.

Letter of the law: The latest version of the bill (S-2156) sponsored by Sen. Joseph Vitale, longtime chair of the Senate health committee, and Majority Leader Loretta Weinberg, would only apply to physicians who are treating minors with the meds. Introduced in May, the measure awaits a hearing; an Assembly version currently lacks any sponsors. Assemblyman Joe Lagana, (D-Bergen) has championed the measure in the past.

As drafted, the legislation requires doctors who are considering prescribing a controlled substance to those under 18 to talk with their parents or guardians about the addiction risks associated with that drug. If appropriate, the physician should also discuss options that are less addictive. Prescribers must then have the family sign a form acknowledging the conversation, which is to be kept in the patients file.

Last year, the Senate passed a broader bill with near-unanimous support, but the measure never got traction in the Assembly. That bill would have applied to all patients under consideration for controlled substances, regardless of age. Advocates have said that people who become dependent on prescription painkillers are 40 times more likely to get hooked on heroin, which has chemical similarities.

While addiction experts have sought to make the mandate more inclusive, they said caution is particularly important when it comes to teens and youth. Youngsters who are prescribed opiates are one-third more likely to become addicted in the future, according to research from the University of Michigan cited by the Partnership. With teens, their developing brains make them attracted to drugs, but they lack the reasoning skills to make a safe, informed decision, the group said.