Legislature(2017 - 2018)SENATE FINANCE 532
05/25/2017 09:00 AM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB79 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 79 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE BILL NO. 79
"An Act relating to the prescription of opioids;
establishing the Voluntary Nonopioid Directive Act;
relating to the controlled substance prescription
database; relating to the practice of dentistry;
relating to the practice of medicine; relating to the
practice of podiatry; relating to the practice of
osteopathy; relating to the practice of nursing;
relating to the practice of optometry; relating to the
practice of veterinary medicine; related to the duties
of the Board of Pharmacy; and providing for an
effective date."
9:03:37 AM
SENATOR CATHY GIESSEL, announced that she had listened to
the committee's questions from the previous meeting. She
wanted to share her thoughts based on her experience.
9:07:08 AM
Senator Giessel shared a story of a violent person who
acted in an extreme manner.
9:10:39 AM
Senator Giessel discussed the history of the Prescription
Drug Monitoring Program (PDMP).
9:12:17 AM
Senator Giessel explained the history of the Alaska Opioid
Policy Task Force.
9:13:01 AM
Senator Giessel referenced a presentation titled, "The
Science of Opioid Use Disorder" (copy on file).
9:26:01 AM
Senator Giessel noted that the bill addressed dosage, or
rather only addressed duration. She shared a statement from
the Tennessee Board of Nursing. She announced that the
morphine milligram equivalent (MME) was used to prescribe
opioids. She stated that all clinicians have access to the
information.
9:35:18 AM
Co-Chair MacKinnon remarked that there was an assertion
from the Board of Pharmacy that the manufacturer of the
medication had set dosage guidelines. She wondered how that
dosage was determined. Senator Giessel replied that
Co-Chair MacKinnon remarked that there was an assertion
that there was a reliance on the drug company's suggested
dosage. She remarked that some may not understand the
possibility of overprescribing. Senator Giessel replied
that there was a need for continuing education to inform
the clinicians.
9:39:49 AM
Senator Hughes wondered whether the size of a person was
considered in the dosage amount. Senator Giessel replied
that size was not considered.
Senator Hughes queried the alignment with the bill and the
task force's recommendations. Senator Giessel replied that
many recommendations were in the bill, but did not know
whether the recommendations were the basis of the bill. She
deferred to Dr. Butler.
9:41:58 AM
JAY BUTLER, CHIEF MEDICAL OFFICER, DEPARTMENT OF HEALTH AND
SOCIAL SERVICES, ANCHORAGE (via teleconference), announced
that the recommendations of the task force were an
important informative factor in the drafting of the bill.
Co-Chair MacKinnon queried the seven-day limit decision.
Dr. Butler replied that, in general, the discussion in the
task force focused on the guidelines from the Center for
Disease Control (CDC).
Co-Chair MacKinnon remarked that the CDC had a recommended
dosage. She wondered why that recommendation was not
included in the bill. Dr. Butler replied that the CDC had
guidelines. He did not want to be too specific in the
dosage. He stressed that the focus was on the size of the
prescription.
Senator Hughes wondered whether the state boards had
adopted CDC guidelines. Senator Giessel replied in the
affirmative.
9:50:21 AM
SARA CHAMBERS, DEPUTY DIRECTOR, DIVISION OF CORPORATIONS,
BUSINESS, AND PROFESSIONAL LICENSING, DEPARTMENT OF
COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT, explained
that the legislature had recently requested opioid
guidelines from all boards. She stated that the CDC
guidelines had recommended the state of Washington's
Interagency Guideline on Opioid Prescriptions, with
lowering the morphine equivalent to 90.
Senator Hughes wondered whether the board were creating a
similar regulation. Ms. Chambers replied that the boards
were at different stages of regulation development. She
stated that the bill would accommodate the flexibility.
Co-Chair MacKinnon queried additional comments. Dr. Butler
shared that one in twenty people were still on opioids one
year after their first dose.
10:00:10 AM
Co-Chair MacKinnon remarked that the bill addressed end of
life issues that allowed doctors to keep patients on long
term opioid prescriptions. She noted that there were many
medications left after someone that she knew had died, and
then taken by law enforcement. She wondered whether there
was a way to track the opioids. Dr. Butler replied that
leftover pills were often put into the community. He stated
that there were not mechanisms for tracking dispensed
opioids. He remarked he had worked with hospice to provide
activated charcoal to neutralize the opioid safe for
disposal in a landfill.
10:05:46 AM
Co-Chair MacKinnon remarked that there were intermittent
drug disposal opportunities in her community. She queried
disposal recommendations, and whether that was addressed in
the bill. Dr. Butler replied that it was not specifically
addressed in the bill. He supported drug take-back
activities.
10:11:06 AM
Vice-Chair Bishop wondered whether the damage could be
reversed. Senator Giessel replied that Vivitrol may be able
to reverse the effects of addiction.
Co-Chair MacKinnon wondered whether the effects of
addiction could be reversed. Dr. Butler replied that it was
unknown whether the effects of addiction could be reversed.
10:16:19 AM
Senator Olson remarked that many studies noted that the
receptors were scarred after drug abuse.
Vice-Chair Bishop wondered whether was a way to make a
first prescription a lower equivalent. Senator Giessel
replied that there should be a clarification that 90
milligrams a day of morphine level equivalent is the
maximum dosage.
Co-Chair MacKinnon recalled that there was a working day
issue, and wondered whether there was adequate language for
the expectation of a possible dispensary day closure. Ms.
Chambers replied that the Board of Pharmacy allowed some
pharmacies to opt-out, because they were not engaging in
activity that required reporting. She stated that the opt-
out option would extend to the pharmacy's day off from the
week.
10:22:19 AM
Co-Chair MacKinnon wondered whether the language in the
bill was sufficient. Ms. Chambers replied in the
affirmative.
Co-Chair MacKinnon announced that there was a series of
questions that had been submitted to the administration.
Senator Olson appreciated the perspective of Senator
Giessel's presentation.
Co-Chair MacKinnon wanted to involve the boards in the
process.
10:26:58 AM
Co-Chair Hoffman shared that the main issue in rural Alaska
was mail order drugs. He wondered how other states and
countries approached the issue. Dr. Butler replied that
there should be a multifaceted approach.
Senator Giessel stated that the drugs were going into the
villages through air freight, and there was a bill that
addressed the issue currently in the legislature.
SB 79 was HEARD and HELD in committee for further
consideration.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 79 Sonkiss science of opioid use disorder February 13 2017.pdf |
SFIN 5/25/2017 9:00:00 AM |
SB 79 |
| SB 79 Federation of State Medical Boards - Opioid Guidelines As Adopted April 2017_FINAL.pdf |
SFIN 5/25/2017 9:00:00 AM |
SB 79 |
| SB 79 AK Opioid Policy Task Force Final Recomendations.pdf |
SFIN 5/25/2017 9:00:00 AM |
SB 79 |
| SB 79 MMWR CDC Guidelines for Prescribing Opioids for Chronic Pain in the U.S. 2016.pdf |
SFIN 5/25/2017 9:00:00 AM |
SB 79 |
| SB 79 CDC Guidelines for Care Providers Infographic.pdf |
SFIN 5/25/2017 9:00:00 AM |
SB 79 |
| SB 79 2016 NCSBN Discipline Case Management Conference.pdf |
SFIN 5/25/2017 9:00:00 AM |
SB 79 |