Series of opioid bills get public hearing in House Public Health Committee

On Wednesday morning, the House Public Health Committee held a public hearing on a series of opioid and prescription drug-related legislation. The bills touch on a broad range of issues including prescription limits, prescriber and patient education, and electronic documentation.

Several of the bills heard in committee came about as a result of work done by the House Select Committee on Opioids and Substance Abuse during the interim. At the end of 2018, the select committee released its 108-page report, outlining policy recommendations for the 86th Legislature.

 

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According to the report, nearly 3,000 Texans died due to drug overdose in 2017, and 464,000 Texans abused illicit drugs. The report notes that nearly 8 of every 100 Texans (approximately 1.6 million adults and 1.1 million children and adolescents) have a substance use disorder.

During the public hearing, Representative John Zerwas, who sponsored one of the opioid bills, also highlighted a Castlight report that included four Texas cities in the top 25 cities for opioid misuse.

“Texarkana, Amarillo, Odessa and Longview are among the top 25 cities for opioid misuse,” testified Rep. Zerwas. “This is an epidemic issue that we need to address, obviously. And for us as policy-makers, we need to step forward and do something in this regard, and I think that’s what the effort of these bills are.”

Notable bills heard during the committee meeting include:

HB 1710 – This bill would require prescribers to discuss the risks of addiction, dependence, and overdose with their patients when prescribing opioids or Schedule II controlled substances.

HB 1866 – For the initial treatment of acute pain, this bill would limit opioid prescriptions to seven days or less. Before issuing the first opioid prescription, the prescriber would also be required to review the patient’s complete medical history — including any history of substance abuse and the patient’s experience with non-opioid medications. The bill would not apply to acute pain related to a fracture, tumor, infections, or immediate post-surgical recovery.

The proposed 7-day prescription limit was brought up during testimony on several of the opioid bills.

Dr. Carl Nunziato, an orthopaedic surgery resident at Dell Medical School, testified that a 7-day limit wouldn’t be appropriate for the patients he sees.

“The patients that have the misfortune to meet me at the hospital usually have multiple life-changing injuries, and the 7-day limit for opiates just wouldn’t be appropriate for their care,” said Nunziato.

Instead, he recommended extending the limit to 14-days or creating additional exemptions for trauma.

HB 2454 – This bill would require health professionals to complete a minimum of two hours of continued medical education related to pain management and opioid abuse as part of their license renewal. These training requirements would also apply to registered nurses, physician assistants, and dentists.

HB 2811 – This bill would add a new section on acute pain treatment to Texas Occupation Code Title 3, Subtitle A. The new chapter outlines the specific requirements for prescribing controlled substances which include: the development of a written treatment plan, informed consent, periodic reviews of the pain treatment plan, and detailed medical record documentation.

HB 2174 – This bill was requested by the Attorney General’s office and includes several of the policies listed above — including education requirements and prescription limits. The legislation also outlines new electronic prescribing requirements.

Following testimony, all five bills were left pending in committee.