Prescription Monitoring Programs - Legislative Trends and Model Law Revision

Transcription

1 Prescription Drug Monitoring Programs Training and Technical Assistance Center Webinar Series National Alliance for Model State Drug Laws: Legislative Round-Up July 22, 2015 Prescription Monitoring Programs - Legislative Trends and Model Law Revision Heather Gray Legislative Director National Alliance for Model State Drug Laws (NAMSDL)

2 LEGISLATIVE YEAR IN REVIEW Through July 15, 2015, 47 PMP related-bills passed and 15 regulations enacted in 31 states Areas of primary focus for the bills/regulations that passed: Mandatory use of PMP Mandatory registration Allowing the use of delegates Increasing or modifying the types of authorized recipients Provision of unsolicited reports or proactive alerts Changing the data collection interval to make the information more timely

3 MANDATORY USE OF PMP VT WA OR NV CA AK ID AZ UT MT WY CO NM ND MN SD WI NE IA IL KS MO OK AR MS TX LA NY MI PA OH IN WV VA KY NC TN SC GA AL FL ME D.C. NH MA RI CT NJ DE MD 26 states require use in certain circumstances HI 2 states passed such a requirement since December 2014 (AR & CT) 9 states modified or added mandatory access provisions (AZ, KY, LA, MN, ND, OK, RI, VT, VA)

4 MANDATORY USE LEGISLATION NEW PROVISIONS AR SB 717 provides that a prescriber with a prescription drug violation shall be required to access prescription information before writing a prescription for an opioid AR SB 717 also provides that a prescriber treating a patient for chronic, non-malignant pain shall check the PMP for the patient at least once every six months CT HB 6856 requires mandatory use of the PMP prior to prescribing a greater than 72-hour supply of any controlled substance to a patient and not less than once every 90 days when prescribing continuous or long term treatment with controlled substances

5 MANDATORY USE LEGISLATION RELATED TO MEDICAL MARIJUANA AZ HB 2036 makes it unprofessional conduct for a naturopathic physician to fail or refuse to include a copy of a patient s PMP report in the patient s medical record when providing a certificate of debilitating condition for medical marijuana LA SB 143 requires prescribers and dispensers of marijuana, tetrahydrocannibinols, or chemical derivatives of tetrahydrocannibinols to review a patient s information in the PMP prior to such prescribing or dispensing

6 MANDATORY USE LEGISLATION ADDITIONAL PROVISIONS OF INTEREST OK HB 1948 registrants or their delegates are required to check the PMP prior to prescribing or authorizing a refill (if 180 days have elapsed since the previous check) for opiates, benzodiazepines, or carisoprodol OK previously only required it for registrants that prescribed, administered, or dispensed methadone

7 MANDATORY USE LEGISLATION ADDITIONAL PROVISIONS OF INTEREST RI ADC :3.0 requires practitioners treating a patient for pain management to review the PMP prior to starting an opioid and at least every 12 months thereafter if the patient is continued on the opioid for a period of six months or longer RI ADC :3.0 also requires practitioners to check prior to refilling or authorizing therapy with an intrathecal pump Previously only required it for opioid treatment programs

8 MANDATORY REGISTRATION WITH PMP VT WA OR NV CA AK ID AZ UT MT WY CO NM ND MN SD WI NE IA IL KS MO OK AR MS TX LA HI NY MI PA OH IN WV VA KY NC TN SC GA AL FL ME D.C. NH MA RI CT NJ DE MD 23 states require practitioners to register with the PMP 2 states passed such a requirement since December 2014 (AR & TX) 7 states added new or modified current requirements (AZ, CO, ID, NH, OH, RI, VA)

9 MANDATORY REGISTRATION LEGISLATION NEW PROVISIONS AR SB 717 provides that a prescriber with a prescription drug violation shall be required to register with the PMP TX SB 195 allows the board to adopt rules providing that a person authorized to access information in the PMP directly be enrolled in electronic access at the time he or she obtains or renews his/her professional or occupational license or registration

10 MANDATORY REGISTRATION LEGISLATION ADDITIONAL PROVISIONS OF INTEREST AZ SB 1370 provides that a medical practitioner regulatory board shall notify the Board of Pharmacy monthly of any initial licensures for practitioners who intend to apply for registration under the controlled substances act and any renewals for the purpose of registering the practitioner with the PMP (essentially going to automatic registration)

11 MANDATORY REGISTRATION LEGISLATION ADDITIONAL PROVISIONS OF INTEREST NH SB 31 provides that practitioners who prescribe but don t dispense must register as prescribers, practitioners who dispense but don t prescribe must register as dispensers, and those who do both must register as both VA HB 1841 requires all dispensers to register with the PMP (previously just prescribers were required to register)

12 USE OF DELEGATES VT WA OR NV CA AK ID AZ UT MT WY CO NM ND MN SD WI NE IA IL KS MO OK AR MS TX LA NY MI PA OH IN WV VA KY NC TN SC GA AL FL ME D.C. NH MA RI CT NJ DE MD 38 states + DC allow the use of delegates HI 4 states passed such a statute or regulation since December 2014 (AR, CT, OK, WY) 4 states added/modified their delegate provisions (AZ, NM, TX, UT)

13 USE OF DELEGATES NEW PROVISIONS AR SB 717 provides PMP information may be provided to an agent or employee of a prescriber or dispenser to whom the prescriber or dispenser has delegated the task of assessing the data, but only if the agent or employee has been granted access by a delegate account CT HB 6856 allows receipt of PMP data by a practitioner s agent who is a licensed health care professional OK HB 1948 allows receipt of PMP data by registrants or members of their medical or administrative staff WY SF 100 allows receipt of PMP information by practitioner or pharmacist appointed delegates

14 USE OF DELEGATES ADDITIONAL PROVISIONS OF INTEREST AZ SB 1370 adds the county medical examiner or alternate medical examiner as individuals who can appoint a delegate AZ SB 1370 also amends the definition of delegate to allow dispensers to appoint a delegate and includes a forensic pathologist, medical death investigator, or other qualified person assigned duties in connection with a death investigation as delegates NM ADC modifies delegate provisions to provide that the delegating practitioner must also maintain an active account

15 USE OF DELEGATES ADDITIONAL PROVISIONS OF INTEREST TX SB 195 modifies the delegate provision to allow provision of PMP data to an employee or other agent of the practitioner as long as such person is authorized to do so under HIPAA UT SB 158 modifies delegate provisions to allow a pharmacy intern to be a delegate and allow a pharmacist-in-charge to delegate up to five employees

16 INCREASED TYPES OF AUTHORIZED RECIPIENTS VT WA OR NV CA AK ID AZ UT MT WY CO NM ND MN SD WI NE IA IL KS MO OK AR MS TX LA NY MI PA OH IN WV VA KY NC TN SC GA AL FL ME D.C. NH MA RI CT NJ DE MD 13 states added additional types of authorized recipients of PMP data (AZ, AR, IL, IN, MD, NH, NM, OK, TX, UT, VA, WA, WV) HI 9 states modified access provisions already in place (AR, ID, MD, NV, NM, OK, TX, UT, WV)

17 TYPES OF AUTHORIZED RECIPIENTS NEW PROVISIONS AR SB 129 allows the Department of Human Services to petition a circuit court to allow an investigator to access the PMP for a record concerning a person Must show probable cause that: 1) the person is or was in possession of one or more prescription drugs; 2) the person recently gave birth to a baby; and 3) that the person or the baby tested positive for one or more prescription drugs at the time of birth of the baby WV ADC allows a practitioner whose patient is a newborn child or a child being fed human breast milk to obtain PMP information on the child s mother, wet nurse, or other direct source of human breast milk

18 TYPES OF AUTHORIZED RECIPIENTS NEW PROVISIONS IL 77 ADC allows a hospital emergency department or a freestanding healthcare facility providing healthcare to walk-in patients to obtain access to the PMP system IN SB 168 allows receipt by person with a temporary medical permit MD SB 757 on approval of the secretary for the purpose of furthering a bona fide individual case review, the following entities may receive PMP information: state or local child fatality review team, local overdose fatality review team, the maternal mortality review program, or a medical review committee

19 TYPES OF AUTHORIZED RECIPIENTS NEW PROVISIONS NH SB 31 allows provision of de-identified PMP data for program analysis and evaluation, statistical analysis, public research, public policy, and educational purposes NM ADC allows provision of PMP data to state drug courts

20 TYPES OF AUTHORIZED RECIPIENTS NEW PROVISIONS OK HB 1948 & SB 140 allows receipt of PMP information by the following new recipients: medical practitioners employed by the Department of Veterans Affairs, the US military, or other federal agencies treating patients in OK; designated legal, communications, and analytical employees of the Bureau; and allows the provision of de-identified data to the Department of Mental Health and Substance Abuse Services for statistical, research, substance abuse prevention, or educational purposes

21 TYPES OF AUTHORIZED RECIPIENTS NEW PROVISIONS UT HB 395 & SB 119 allows receipt of information by a physician employed as the medical director for a licensed worker s compensation insurer or approved self-insured employer VA SB 817 allows provision of PMP information to probation and parole officers WA HB 1637 allows local, state, and federal officials and officials of federally recognized tribes to have access to PMP data WA SB 5027 allows receipt of PMP information by personnel of a test site pursuant to an agreement between the test site and the patient s prescriber or dispenser

22 TYPES OF AUTHORIZED RECIPIENTS NEW PROVISIONS AZ SB 1370 & TX SB 195 added provisions to allow the medical examiner to receive PMP information TX SB 195 also allows provision of information to optometrists

23 TYPES OF AUTHORIZED RECIPIENTS ADDITIONAL PROVISIONS OF INTEREST Five states modified their law enforcement access provisions 1) AR changed to provide that data will be provided to a certified law enforcement prescription drug diversion investigator with a qualified law enforcement agency and who provides identification credentials assigned by the department and a case number 2) NV amended to provide that law enforcement may have internet access to the PMP if the officer s primary responsibility is drug investigations, the officer has been approved by his or her supervisor, has completed the required training course, and employer has submitted a certification for the officer to the board

24 TYPES OF AUTHORIZED RECIPIENTS ADDITIONAL PROVISIONS OF INTEREST Five states modified their law enforcement access provisions 3) TX law enforcement and prosecutorial officials may only receive PMP information after submitting a request to the department and is reviewed by the department and proper need has been shown 4) UT now requires law enforcement to have a search warrant 5) WV replaces requirement that law enforcement have completed DEA diversion training and Nat l Assn. of Drug Diversion training with one requiring law enforcement to complete training approved by the board

25 TYPES OF AUTHORIZED RECIPIENTS ADDITIONAL PROVISIONS OF INTEREST Four states modified their provisions related to providing PMP data to licensing/regulatory boards (MD, NV, OK, WV) WV modified its provision regarding access to PMP information by prescribers to allow a practitioner or his/her delegate to access PMP information of a prospective patient for the purpose of determining whether to accept the patient and provide treatment

26 UNSOLICTED REPORTS/PROACTIVE ALERTS VT WA OR NV CA ID AZ UT MT WY CO NM ND MN SD WI NE IA IL KS MO OK AR MS NY MI PA OH IN WV VA KY NC TN SC GA AL ME D.C. NH MA RI CT NJ DE MD AK TX LA FL HI 6 states have modified or added unsolicited reports/proactive alerts provisions since December 2014 (AR, IL, IN, NV, OK, WV)

27 UNSOLICITED REPORTS/PROACTIVE ALERS NEW & MODIFIED PROVISIONS AR SB 717 provides that, once a licensing board has notified the department of the parameters for triggering a notification, the department may notify the licensing board for a prescriber or dispenser who is identified as prescribing or dispensing in a manner that may represent misuse or abuse AR SB 717 requires the department to develop an algorithm to alert a practitioner if his/her patient is being prescribed opioids by more than 3 physicians within any 30 day period AR SB 698 provides that if information of misuse or abuse is identified, the department will notify the Office of Diversion Control of the US DEA, in addition to other parties

28 UNSOLICITED REPORTS/PROACTIVE ALERS NEW & MODIFIED PROVISIONS IL 77 ADC 2080 adds potential misuse criteria as persons who have been identified as having 6 or more prescribers, 6 or more pharmacies, or both, within a 30-day period for the issuance of unsolicited reports to prescribers and authorizes the PMP to develop operational push reports with compatible electronic medical records IN SB 199 provides that boards that regulate health care providers must establish prescribing norms and dispensing guidelines that, if violated, justify the unsolicited dissemination of reports

29 UNSOLICITED REPORTS/PROACTIVE ALERS NEW & MODIFIED PROVISIONS NV SB 114 provides that the board may report any activity it suspects may indicate the inappropriate use by a patient of a controlled substance to the licensing board of each practitioner who has prescribed controlled substances for the patient OK HB 1948 requires that the Director provide the various licensing boards with a list of the top 20 prescribers each month and notify the relevant board if the prescriber is prescribing outside the limitations of their licensure or outside of drug registration rules or state laws, and that such notice will be treated as a complaint by the board for purpose of investigations WV ADC provides for unsolicited alerts to prescribers and dispensers whose patients exceed set parameters

30 DATA COLLECTION INTERVAL VT WA OR NV CA ID AZ UT MT WY CO NM ND MN SD WI NE IA IL KS MO OK AR MS NY MI PA OH IN WV VA KY NC TN SC GA AL ME D.C. NH MA RI CT NJ DE MD AK HI TX LA FL 6 states have decreased or will decrease their data collection interval since December 2014 (CT, ME, NM, OR, UT, WY)

31 DATA COLLECTION INTERVAL CT: weekly daily (7/1/2016) ME: weekly daily NM: weekly daily OR: weekly 72 hours (1/1/2016) UT: weekly daily or real-time WY: weekly daily (1/1/2016) Daily reporting went from 15 states in 2014 to 20 states in 2015 (including those with later effective dates)

32 PMP MODEL LAW REVISIONS Added a definition of designee which provides that a delegate may be either a licensed or registered health care professional or an unlicensed employee of the prescriber or dispenser if a licensed health care provider isn t available Added provision to require dispensers to report identifying data on persons who pick up a prescription who are not the patient for whom the prescription was written Changed data collection interval from weekly to within 24 hours

33 PMP MODEL LAW REVISIONS Added a second option to the law enforcement access provision that requires law enforcement and prosecutorial officials to have a subpoena, court order, or search warrant Added Medicaid or state health insurance representative as authorized recipient Added new section to provide that all prescribers with DEA or state registration numbers shall be registered with the PMP Added new section to require prescribers to query the PMP prior to initially prescribing or personally dispensing a controlled substance to a patient and periodically thereafter if the patient s course of treatment continues for more than 90 days

34 CONTACT INFORMATION Website: HEATHER GRAY, Legislative Director NAMSDL Headquarters 420 Park Street Charlottesville, VA Phone: , ext

35 Prescription Drug Monitoring Programs Training and Technical Assistance Center Webinar Series National Alliance for Model State Drug Laws: Legislative Round-Up July 22, Legislation Addressing the Medicinal Use of Marijuana Jon Woodruff Legislative Attorney National Alliance for Model State Drug Laws (NAMSDL)

36 CATEGORIES OF MARIJUANA LAWS Personal, non-medicinal use Legalization Decriminalization Medicinal use Limited use of low THC products Broader use for treating debilitating medical conditions

37 CATEGORIES OF MARIJUANA LAWS Personal, non-medicinal use Legalization Decriminalization Medicinal use Limited use of low THC products Broader use for treating debilitating medical conditions

38 Medicinal Use of Marijuana Laws as of January 1, 2015 WA NH CA OR NV ID UT MT WY CO ND SD NE KS MN IA MO WI IL MI IN KY OH WV VT NY PA VA ME DE MD DC RI CT NJ MA AZ NM OK AR TN SC NC AK HI TX LA MS AL GA FL Allows medicinal use of marijuana for debilitating medical conditions. Allows only limited medicinal use of low THC products The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 420 Park Street, Charlottesville, VA

39 2015 LEGISLATION BY THE NUMBERS 250 number of bills and resolutions introduced to date 50 % of all marijuana legislation related to medicinal use 46 states (including D.C.) where legislation introduced 19 states with proposals to allow use of marijuana to treat debilitating medical conditions (enacted in LA) 13 states with proposals to allow the limited use of low THC products (enacted in DE, GA, NE, OK, TX, VA, WY) 5 state resolutions urging Congress/DEA to reschedule marijuana (adopted in GA, HI, OR) 5 pending Congressional bills that include rescheduling 5 states with legislation introduced to reschedule

40 Medicinal Use of Marijuana Laws as of July 17, 2015 WA NH CA OR NV ID UT MT WY CO ND SD NE KS MN IA MO WI IL MI IN KY OH WV VT NY PA VA ME DE MD DC RI CT NJ MA AZ NM OK AR TN SC NC AK HI TX LA MS AL GA FL Allows medicinal use of marijuana for debilitating medical conditions. Allows only limited medicinal use of low THC products The National Alliance for Model State Drug Laws (NAMSDL). Headquarters Office: 420 Park Street, Charlottesville, VA

41 BROADER MEDICINAL USE LEGISLATION Legislation introduced in 2015: Alabama Florida Georgia Indiana Kansas Kentucky Louisiana Missouri Nebraska North Carolina North Dakota Pennsylvania South Carolina Tennessee Texas Utah Virginia West Virginia Wisconsin

42 BROADER MEDICINAL USE LEGISLATION Legislation introduced in 2015: Alabama Florida Georgia Indiana Kansas Kentucky Louisiana Missouri Nebraska North Carolina North Dakota Pennsylvania South Carolina Tennessee Texas Utah Virginia West Virginia Wisconsin Enacted Legislature still in session as of July 17, 2015 Legislature adjourned

43 BROADER MEDICINAL USE LEGISLATION Legislation introduced in 2015: Alabama Florida Georgia Indiana Kansas Kentucky Louisiana Missouri Nebraska North Carolina North Dakota Pennsylvania South Carolina Tennessee Texas Utah Virginia West Virginia Wisconsin North Carolina HB 78 reported unfavorably from committee Pennsylvania SB 3 in House committee; passed Senate (40-7) Wisconsin AB 224 in House committee

44 ENACTED MEDICINAL USE LEGISLATION Louisiana SB 143 (eff ) Allows state-licensed physicians to prescribe marijuana in any form allowed by regulation (but not inhalation) Treatment for glaucoma, symptoms resulting from the administration of chemotherapy cancer treatment and spastic quadriplegia Home cultivation not allowed Prescriber must first review Louisiana PMP data Marijuana to be produced by one authorized facility and dispensed by up to 10 authorized pharmacies First regulations due by January 1, 2016

45 ENACTED MEDICINAL USE LEGISLATION Colorado SB 14 (eff ) requires the state medical board to implement rules providing guidelines for physicians in recommending marijuana to treat pain; requires primary caregivers to register with State Licensing Authority. Colorado SB 115 (eff ) extends sunset provision in law from July 1, 2015 to September 1, 2019 and requires State Licensing Authority to adopt marijuana seed-to-sale tracking system. Colorado SB 260 (eff ) sets marijuana testing standards similar to retail marijuana system and creates a medical marijuana testing facility license.

46 ENACTED MEDICINAL USE LEGISLATION Delaware SB 90 (eff ) adds intractable epilepsy to the list of debilitating medical conditions; allows persons under age 18 access to low THC products. District of Columbia LBs 159/160 (eff ) temporarily increases the number of living plants that a cultivation center may possess at any one time to 1,000. Hawaii HB 321 (eff ) establishes a licensing system for marijuana dispensaries; prohibits primary caregivers from cultivating marijuana (subject to exception) after ; allows persons authorized for the medicinal use of marijuana in other states to be treated similarly in Hawaii after

47 ENACTED MEDICINAL USE LEGISLATION Maryland HB 490 (eff ) among other things eliminates provisions for academic medical centers ; role of physicians revised from being approved to being registered ; provides for registration of independent testing laboratories; allows physicians to issue a written certification for more than a 30-day supply if such amount would be inadequate for a particular patient; authorizes entities to process marijuana, such as producing extracts for various routes of administration. New Hampshire HB 476 (eff ) adds epilepsy, lupus, Parkinson s disease and Alzheimer s disease to the definition of qualifying medical condition.

48 ENACTED MEDICINAL USE LEGISLATION Oregon HB 3400 (eff ) requires cardholders, growers, processors and dispensaries to register with OHA; sets limits on amount of marijuana that can be possessed; requires OHA to develop a tracking system for growers, processors and dispensaries; requires OHA and OLCC to set requirements for testing, packaging and labeling. Washington SB 5052 (eff ) regulates medicinal use similar to personal use; creates authorization database and patients/providers who do not register are subject to more stringent limits and no arrest protection; retailers may obtain endorsement to sell marijuana for medicinal use; collective gardens no longer permitted after but four-person cooperatives allowed.

49 ENACTED MEDICINAL USE LEGISLATION Washington HB 2136 (eff ) subjects marijuana cooperatives to buffer distances similar to marijuana licensees; sales and use tax exemption on retail products designated as beneficial for medical use if purchased by a registered patient or caregiver.

50 PENDING MEDICINAL USE LEGISLATION California AB 26, AB 34, AB 243, AB 266, SB 643 statewide regulation of the cultivation, sale and use of marijuana. Delaware SB 138 (enrolled) allows for scientific study to assess the safety, effects and efficacy in treating medical conditions. Illinois SB 33 (enrolled) adds PTSD to the definition of debilitating medical condition. New Jersey AB 3726 (in Senate committee) authorizes use of marijuana for patients with PTSD. Oregon SB 844 (enrolled) establishes task force to study and report on developments to medicinal use industry.

51 LOW THC PRODUCT LEGISLATION Legislation introduced in 2015: Connecticut Delaware Georgia Idaho Indiana Kansas Nebraska New York (North Carolina) Ohio Oklahoma (Tennessee) Texas Virginia Wyoming

52 LOW THC PRODUCT LEGISLATION Legislation introduced in 2015: Connecticut Delaware Georgia Idaho Indiana Kansas Nebraska New York (North Carolina) Ohio Oklahoma (Tennessee) Texas Virginia Wyoming Enacted Legislature still in session as of July 17, 2015 Legislature adjourned

53 LOW THC PRODUCT LEGISLATION Legislation introduced in 2015: Connecticut Delaware Georgia Idaho Indiana Kansas Nebraska New York (North Carolina) Ohio Oklahoma (Tennessee) Texas Virginia Wyoming New York (various) in committee Ohio HB 33 in House committee

54 LOW THC PRODUCT LEGISLATION Georgia HB 1 (eff ) allows both: (1) a registry of authorized users; and (2) a clinical research program for minors conducted by the University System of Georgia or any authorized clinical trial or research study in Georgia. Nebraska LB 390 (eff ) clinical research program for adults and minors through the University of Nebraska Medical Center and Nebraska Medicine Research Pharmacy. North Carolina HB 766 (eff ) increases maximum THC concentration and reduces minimum cannabidiol content; allows use as alternative treatment without pilot study. Oklahoma HB 2154 (eff ) establishes a clinical research program for minors.

55 LOW THC PRODUCT LEGISLATION Tennessee SB 280 (eff ) law providing for clinical trials changed; law now allows oil containing cannabidiol to be brought into Tennessee by patients diagnosed with certain conditions by a Tennessee-licensed physician. Texas SB 339 (eff ) establishes registry of authorized patients, prescribers and dispensing organizations. Virginia HB 1445 (eff ) allows physician to provide written certification allowing use. Wyoming HB 32 (eff ) establishes a registry of authorized patients.

56 CONTACT INFORMATION Website: JON WOODRUFF, Legislative Attorney NAMSDL Headquarters 420 Park Street Charlottesville, VA Phone: , ext

57 Prescription Drug Monitoring Programs Training and Technical Assistance Center Webinar Series National Alliance for Model State Drug Laws: Legislative Round-Up July 22, 2015 Naloxone and Good Samaritan Laws - Legislative Trends Heather Gray Legislative Director National Alliance for Model State Drug Laws (NAMSDL)

58 LEGISLATIVE YEAR IN REVIEW As of June 30, 2015, 10 states have passed new naloxone access legislation (AL, AZ, AR, ID, MS, NV, ND, SC, SD, WV) bringing the number of states with naloxone access laws to 41 Nine states have passed one or more amendments to existing statutes (CO, CT, IN, KY, LA, MD, NH, NJ, VA) As of June 30, 2015, 6 states have passed new Good Samaritan overdose protection legislation (AL, AR, MS, NV, ND, WV) bringing the total number of states to 28

59 NALOXONE ACCESS PROFESSIONAL IMMUNITY Professional immunity a person acting in his or her professional capacity will not be held liable for prescribing, distributing, or administering naloxone or other opioid antagonist to a layperson 39 states provide some sort of professional immunity 9 provide civil immunity only (which includes immunity from professional discipline) 30 provide civil and criminal immunity

60 NALOXONE ACCESS LAYPERSON IMMUNITY Layperson immunity a person who does not have professional or specialized knowledge in dispensing, distributing, or administering naloxone or other opioid antagonist will not be held liable to someone who is overdosing if that person administers naloxone or other opioid antagonist to the person suffering from the overdose

61 NALOXONE ACCESS LAYPERSON IMMUNITY 37 states + DC provide some sort of layperson immunity 4 provide civil immunity only 6 provide criminal immunity Primarily immunity from criminal prosecution for practicing medicine without a license 27 + DC provide both civil and criminal immunity

62 NALOXONE ACCESS THIRD PARTY PRESCRIPTIONS Third party prescriptions a healthcare provider may prescribe, dispense, distribute, or administer naloxone or other opioid antagonist to an at-risk person s family member, friend, or other person in the event of an opioid-related overdose 33 states allow for the provision of third party prescriptions

63 NALOXONE ACCESS THIRD PARTY PRESCRIPTIONS WA NH CA OR NV ID AZ UT MT WY CO NM ND SD NE KS OK MN IA MO AR WI IL MI IN KY TN OH VT NY PA WV VA NC SC DE MD DC ME RI CT NJ MA MS AL GA TX AK LA FL HI

64 NALOXONE ACCESS PHARMACIST MAY DISPENSE WITHOUT STANDING ORDER WA NH CA OR NV ID AZ UT MT WY CO NM ND SD NE KS OK MN IA MO AR WI IL MI IN KY TN OH VT NY PA WV VA NC SC DE MD DC ME RI CT NJ MA MS AL GA TX AK LA FL HI

65 GOOD SAMARITAN LAWS IMMUNITY FROM OTHER LAWS Immunity from other laws - A person who experiences an overdose, or seeks or provides assistance for another person who experiences an overdose, will not be held liable for civil damages, criminal prosecution, probation and parole violations, or the like 27 states + DC offer some sort of immunity from other laws

66 GOOD SAMARITAN LAWS IMMUNITY FROM OTHER LAWS Immunity includes immunity from prosecution for misdemeanor controlled substance violations; possession or use of controlled substances; violations of conditions of pretrial release, condition of probation, or condition of parole based on possession of a controlled substance; possession of drug paraphernalia; possession of marijuana or alcohol by an underage person Immunity extends to: 1) person aiding another individual who is experiencing an overdose; and/or 2) the person experiencing the overdose

67 GOOD SAMARITAN LAWS MITIGATING FACTOR Mitigating factor - in any criminal prosecution or sentencing for a drug or alcohol-related offense for which a person has not been found to be immune, a court may take into consideration the fact the defendant made an effort to obtain or provide medical assistance for an individual experiencing a drug-related overdose 14 states + DC allow the use of a mitigating factor

68 GOOD SAMARITAN LAWS MITIGATING FACTOR Mitigating factor language allows a court to take into consideration that a criminal defendant sought medical assistance for another person who was experiencing a drug overdose contemporaneously with the commission of the offense Some states also allow the court to minimize or withhold a sentence in cases where a defendant was providing medical assistance to another

69 GOOD SAMARITAN LAWS MITIGATING FACTOR Several states allow the mitigating factor for crimes for which they don t also provide immunity under the Good Samaritan law Several states limit the applicability of the mitigating factor to certain crimes only New York, for example, limits it to the criminal sale of a controlled substance or marijuana

70 NALOXONE MODEL January 29-30, 2015 NAMSDL hosted a working group made up of representatives from law enforcement, prosecutors offices, the treatment and addiction communities, legislative offices, the research arena, and community groups Created report based on the recommendations of the working group which was then subjected to review by the working group members and other stakeholders Drafted model naloxone law which is currently undergoing review by NAMSDL s Update and Drafting Committee Hope to have the model released by the end of the summer

71 CONTACT INFORMATION Website: SUSAN WEINSTEIN, Director of State and Federal Affairs NAMSDL Headquarters 420 Park Street Charlottesville, VA Phone: , ext

72 Telephone: (781) Website: