Opioid Legislation Update: Second Circuit

June 27th, 2017 by CHHS RAs

By CHHS RA Bach Nguyen

Note: This is part of an ongoing series of posts covering recent state legislative efforts to address the nationwide opioid epidemic. The posts are organized by federal judicial circuit, with this post covering the Second Circuit. As a reminder, in the federal court system, a circuit court hears appeals from a group of states, usually based on geographical region, though some exceptions exist. In this case, the Second Circuit is composed of Connecticut, New York, and Vermont.

Much like the Fourth Circuit, Second Circuit states are also passing legislation to address the opioid epidemic. One commonality among the states are legislative efforts to limit prescriptions of opioids, though the specifics of each state’s plan varies, with some states limiting by number of days, number of pills, and by other means. There are unique challenges among the states, however, in part because New York is a much larger jurisdiction than Connecticut and Vermont, though the impact is often felt more strongly in smaller states. As reported last month, the Connecticut Medical Examiner’s Office recently lost full accreditation status due to the influx of opioid-related autopsies straining the smaller office’s resources beyond recommended limits. The office has requested increased funding to hire more medical staff.

On the legislative front, Connecticut HB 7052 recently passed in the legislature and is expected to be signed by the governor. Key provisions of the bill include increased information sharing to prevent overprescribing drugs, a reduction of the maximum number of days an opioid may be prescribed to minors, requiring physicians to discuss the risks of opioids with patients, and creating a creating a process by which patients can request not to be prescribed opioids. The bill follows legislative efforts in 2015 and 2016 to address the opioid crisis, including a law that allows the creation of voluntary non-opioid directives. These directives are similar to an advanced directive in which a patient will have listed in his or her medical record that he or she does not wish to be prescribed opioids.

New York has also passed large legislative packages in 2014 and 2016 to combat the opioid crisis in the state. In April of this year, Gov. Cuomo signed legislation investing over $200 million to combat the heroin and opioid epidemic. This legislation builds off the 2016 legislation, which “increase[d] access to treatment, expand[ed] community prevention strategies, and limit[ed] the over-prescription of opioids in New York.” The bulk of the 2017 funding will go towards community providers, with significant funding going towards state-operated providers, Naloxone kits and training, and additional programs. Additionally, another package of bills is being considered by the legislature, and is likely to pass. Senate bill S.5949 limits the prescription of opioids to minors, much like the aforementioned Connecticut bill, and has passed in the Senate. Another bill, S.5670, has also passed the Senate, and requires healthcare providers to consult with their patients about the patient’s opioid prescriptions and options to take lower doses. Lastly, “Laree’s Law,” named after a victim of overdose and seeks to create harsher penalties for drug dealers where the product kills, has also passed the State Senate. Where the majority of state legislative efforts are still focused on prevention and treatment, this bill represents one of a few criminal law options being considered and enacted around the country.

Law enforcement in Vermont are also finding ways to collaborate with other organizations to combat the opioid epidemic, holding twice-monthly meetings with prosecutors and social workers, as opioid overdose deaths are set to surpass the previous year’s total. Vermont has a number of cutting-edge treatment programs, including methadone-assisted treatment both in less stigmatized office settings and in jails in prisons (and was the first state to do the latter), and maximizing Naloxone access in a number of critical intervention points and at-risk communities. This year, new opioid prescribing rules are set to take effect on July 1st. Similar to the New York and Connecticut bills, these rules govern informed consent and discussion of alternatives to opioids, and have been generally well received despite some criticisms of redundancy and conflict with existing rules and practices.

Many states in the Second Circuit have been legislating to combat the opioid epidemic for several years, although as harms continue to rise, legislators are continuing to add more measures in hopes of protecting the health of its citizens. As fatalities continue to rise, however, it may be many years before the impact of this legislation is felt.

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