Health care legislation projectH.R. 1925

Prescription drug abuse prevention and treatment Act of 2011

Prescription drug abuse prevention and treatment Act.

H.R. 1925Title: Prescription Drug Abuse Prevention and

Treatment Act of 2011. Introduced in May 13, 2011in 112th Congress

(2011-2012) in House of Representatives.Sponsor: Rep. Rahall, Nick J.(D- WV-3)Co- sponsors: Rep. Keating, William (D-MA-10) Rep. McGovern, James P (D-MA-3) Rep. Michaud, Michael M (D-ME-2) Rep. Tonko, Paul (D- NY-21)

H.R.1925To provide for federal oversight of

prescription opioid treatment and assistance to states in reducing opioid abuse, diversion and, deaths.

Prescription Drug Abuse Prevention Prescription drugs abuse is the nation’s

fastest growing problem and the CDC has classified prescription drugs abuse as an epidemic, “We are in the midst of an epidemic,” said CDC director Thomas Friedan, M.D., M.P.H

Drugs / medication Abuse Marijuana Prescription drugs Cocaine Heroin Methamphetamine Others

Prescription Drug Abuse Types of Drugs

Opioid Analgesics (Methadone, OxyContin, Vicodin) Tranquilizer Stimulants Sedatives

Reason for use

Chronic pain or cancers ADHD Anxiety Escalated use for “high”

Trend in Prescription Drug AbuseIn 2009, approximately 7.0 million people

were current nonmedical users of prescription drugs (2.8 percent of US population).

Nonmedical use of prescription drugs is the second most commonly abused drug after marijuana and ahead of cocaine.

25% of emergency department visits are associated with non-medical use of prescription drugs abuse and overdose.

Source : National Institute of drug abuse info-facts 2008: High school and youth trend.

High-risk group for Prescription drug Abuse Young adults age 15 to 2565 and olderMenNon-Hispanic white Medicaid populationsRural populationMentally ill, especially people with depression

SOURCE: CDC/NCHS, National Health and Nutrition examination survey SOURCE; National vital statistics system, Drug Abuse Warning Network. Hall AJ, et al. JAMA 2008

Prescription Drug Overdose and DeathsPrescription drugs overdose deaths have tripled in US since

1990.Overdose kills 15000 people each year ( 40 people per day)Methadone related deaths increased 11 folds in younger

people ( age 15 to 24)Highest drug overdose death rates in 2008 were found in

New Mexico and West VirginiaLowest drug overdose death rates in 2008 was found in

Nebraska.

SOURCE : CDC . Press release November 1, 2011 prescription overdose at epidemic level.

Methods of DiversionInappropriate prescribingIllegal salesEmployee theftPrescription ringsDoctor shoppingFraudulent prescriptionsPharmacy theftForeign diversion and smuggling into U.S.

Federal and State effort Office of National Drug Control Policy (ONDCP),

FDA, and DEA official release a federal action plan to address prescription drug abuse ( April 19, 2011)

White House Director of National Drug Control Policy, Gil Kerlikowske, released the Administration’s 2011 National Drug Control Strategy (July 14, 2011)

H.R.1925 is the House companion measure to the Senate bill S. 507, authored by Rockefeller (D-WV)who is the Chairman of the Senate Finance Subcommittee on Health Care

Strategies to Control Prescription Drug Abuse H.R.1925 Prescription Drug Abuse

Prevention and Treatment Act addressed the following strategies:

EducationPrescription drug monitoring programClinical standards for controlled substancesComprehensive reporting of opioid-related

deaths

1- EDUCATIONEducation for parents and patients Increase awareness Safe medication use, storage, and disposalEducation for health care providers Appropriate prescribing Adverse events and drug interactions Identify those at risk for abuse Counseling on proper storage and disposal Prescribers must comply 16 hours training

requirement every 3 year to get DEA registration

2- Prescription Drug Monitoring Programs (PDMPs)

Support access to legitimate medical use of controlled substances

Identify and prevent drug abuse and diversion

Drug interactions and therapeutic duplicationH.R. 1925 would provide $25 million a year

to establish PDMPs within each state.

3- Controlled Substance Clinical Standards CommissionH.R.1925 proposed to established Controlled

Substance Clinical Standard Commission.This Commission composed of representatives

from Government, CDC, FDA, DEA, NIDA.Goals: Safe dosing guidelines for methadone Guidelines for reduction of methadone abuse Guidelines for initial pain management with

methadoneGuidelines for methadone maintenance therapy

Model Opioid Treatment Program Mortality Report H.R.1925 proposed to develop a Model

Opioid Treatment Program Mortality Report for each individual who dies while receiving treatment in the opioid treatment program.

4- National Opioid Death RegistryH.R.1925 also proposed to establish National Opioid

Death Registry to track opioid related deaths. Goal is to create a uniform reporting system that

contain the following information: Dosage level Drug formulation Age and sex of the individual Disclosure of whether the individual was in an

opioid treatment program Disclosure of whether the medication involved can

be traced back to a physician’s prescription.

FEDERAL PARTNERSHIPSONDCP ( Office of National Drug Control

Policy)FDA ( Food and Drug Administration)DEA ( Drug Enforcement administration)SAMHSA (CDC ( Centers for Disease Control)NIDA ( National Institute of Drug Abuse)

Barriers to ImplementationInattentive behaviorMedical confidentiality and patient privacy,

Insufficient database for tracking the dosages and disposal of narcotics analgesics

Lack of methadone and other opioid overdose death monitoring system

Status of H.R.1925H.R.1925 which is referred to the Committee

on Energy and Commerce, and Committee of Judiciary, is in the first step of legislation process. This bill is in line with the strategies outlined by the White House Office of National Drug ControlPolicy

CONCLUSIONPrescription drug abuse is the fastest

growing problem in U.S.Comprehensive approach for education,

prevention and enforcement to reverse this epidemic.

Success can be achieved with the coordination and collaboration of federal, state, and local organisations.