BILL NUMBER: S5867

SPONSOR: RIVERA
 
TITLE OF BILL:  An act to amend the public health law, in relation to
treatment alternatives for pain causing conditions

 
SUMMARY OF PROVISIONS OF BILL:

Section 1 of the bill amends section 3331 of the public health law to
require a practitioner to discuss nonpharmacological treatment alterna-
tives with a patient before prescribing an opioid, provided such
requirement shall not apply for certain patients such as cancer,
hospice, post-surgery or medical emergencies.

Section 2 provides an effective date.

 
JUSTIFICATION:

According to the 2018 New York State Opioid Annual Data report prepared
by the New York State Department of Health, "(o)pioid overdose deaths
among New York State residents increased sharply in 2015 and 2016. The
              

rate of overdose deaths involving any opioid in New York State was
almost three times higher in 2016 (15.1 deaths per 100,000 population)
than it was in 2010 (5.4 per 100,000). The 2016 statewide rate of over-
dose deaths involving heroin was 6.5 per 100,000 population, while the
rate of deaths involving "opioid pain relievers" was 11.7 per 100,000."
Nationally, opioid overdoses are the leading cause of death for people
under 50 years of age (64,000, 2016). The statistics are staggering to
comprehend, but behind these charts and numbers are human suffering,
families torn apart, disrupted communities, and loss of precious life.

An estimated 1 out of 5 patients with non-cancer pain or pain-related
diagnoses are prescribed opioids in office-based settings. Opiate
prescriptions are common for neuromusculoskeletal complaints. Pain medi-
cation is aimed at alleviating the painful portion of the condition,
however, for most neuromusculoskeletal concerns, there is often a way to
resolve the cause of the symptoms rather than just provide pain relief.
Treatment for neuromusculoskeletal conditions can benefit from other
early treatment options. These early treatment options include treatment
provided by conservative care providers including acupuncture, chirop-
ractic, massage therapy, physical therapy and occupational therapy.

Numerous studies have shown that these conservative care therapies can
prevent a patient from needing an opioid prescription. If the patient
never needs a prescription, their chance of opioid dependence diminishes
greatly. This legislation is a needed step in finding alternative ways
to combat the opioid epidemic in New York.

 
LEGISLATIVE HISTORY:

New Bill

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None

 
EFFECTIVE DATE:  Immediately

                                
 
BILL NUMBER: S5867A

SPONSOR: RIVERA
 
TITLE OF BILL:  An act to amend the public health law, in relation to
consideration and prescription of non-opioid treatment alternatives for
treatment of neuromusculoskeletal conditions

 
SUMMARY OF PROVISIONS: OF BILL:

Section 1 adds a new Public Health Law § 3331, subdivision 9. It
requires that a practitioner treating a patient with a neuromusculosk-
eletal condition that causes pain consider, discuss, and, if appropri-
ate, refer or prescribe non-opioid treatments before prescribing an
opioid. This requirement would not apply in a medical emergency, immedi-
ate post-surgical care, hospice or other end-of-life care, or cancer
treatment, though it does not preclude non-opioid treatment options in
those circumstances.

Section 2 is the effective date.

 
JUSTIFICATION:
              

Opioid prescriptions have become a common solution for treating pain of
all kinds, from acute injuries to chronic pain. According to the CDC,
low back pain is one of the most common conditions being treated with
opioids, and as many as one in four primary care patients on longterm
opioid therapies struggles with an opioid use disorder.

Although opioids are prescribed to mask neuromusculoskeletal pain, other
treatments may actually resolve the cause of the pain itself.  A large
and growing body of medical literature supports the use of treatments
such as physical therapy, chiropractic care, acupuncture, massage thera-
py, and occupational therapy to manage and alleviate pain. The CDC
Guideline for Prescribing Opioids for Chronic Pain calls for considering
conservative therapies such as these, as well as exercise, cognitive
behavioral therapy, and non-opioid medications, before starting opioids.

This bill does not limit a patient or doctor's options for pain treat-
ment, but rather requires that both parties consider the alternatives
available before choosing an opioid prescription. More and more studies
show that these conservative care therapies can improve a patient's pain
and prevent the need for an opioid prescription, which is the best way
to prevent opioid dependence and overdose.

 
LEGISLATIVE HISTORY:

New Bill

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None

 
EFFECTIVE DATE:
Immediately