This year the presidential primaries in New Hampshire are bringing to national attention the crisis of Opioid addiction. In a small state like New Hampshire their rate of 400+ overdose deaths a year, brings the issue to the forefront. At New Hampshire town hall meetings candidates are asked hard questions about issues related to Opioid abuse.
The New Hampshire State House has proposed legislation that would require all state regulatory boards governing opioid prescribers to update their rules in light of the recent New Hampshire opioid epidemic. Such an update would have a wide-ranging effect, from anesthesiologists to veterinarians.
The Board of Medicine is currently working on “emergency rules” to better control the amount of opioids that are being prescribed to patients. However, under the new legislation sponsored by Representative Cindy Rosenwald, other boards covering nurses, dentists, ophthalmologists, and others would have to update their rules to reflect the best practices for prescribing prescription medications, especially opioids.
Senate Majority Leader Jeb Bradley is a co-sponsor of the bill and chair of the Joint Task Force for the Response to the Heroin and Opioid Epidemic in New Hampshire. Mr. Bradley believes these proposed changes will have to be in conjunction with prescribers so they can consider the needs of all patients. Mr. Bradley is planning to continue with this legislation that will place a new burden on many in the medical field, stating that “this will require a lot of give and take negotiations with physicians and everyone else.”
Representative Thomas Sherman noted that only the Board of Medicine currently has emergency rules in place and suggested other boards begin to do the same. Sherman, a physician, is concerned that if other regulatory boards do not move forward now, the prescribers that they oversee will be working under the old rules while physicians will be under the new rules.
The Task Force reviewed Senator Bradley’s proposal to require prescribers to take an online test on the safe prescribing of opioids and other controlled drugs when they renew their licenses. This would ensure that if a physician failed the test, he or she would have to take a continuing medical education program and then retake the test. Since each specialty and subspecialty is different, each regulatory board would need to work to develop their own test, or Senator Bradley posited, they could work together to create one master test.
Senator Bradley believes that this proposal is a compromise with some lawmakers who would like to mandate continuing medical education programs on opioids, a move many physicians and regulator boards oppose. As Louise Lavertu, executive director of the Joint Board of Licensure and Certification stated, the agencies do not have the technology for online tests. Lavertu commented that “it would have to be put out for bid” and that costs are a concern for such a requirement.
Sarah Blogett, the director of the board’s Health Professions, indicated that other states do require continuing medical education programs, not a separate test. As such, Senator Bradley requested that the medical society and the dental society work together with their regulatory boards to attempt to reach an agreement on either a mandatory continuing medical education requirement, or additional testing.
The Task Force has convened to “look at a range of possible solutions to the state’s substance abuse crisis, including harsher penalties on the distribution of fentanyl, establishing a statewide drug court program and requiring more involvement in the state’s prescription drug monitoring program.”
The state’s Task Force will continue their work and issue a preliminary report by December 22, 2015, and a final report by January 6, 2016. The Task Force is working to determine which bills have broad agreement and will be able to be fast-tracked to the governor’s, Maggie Hassan, desk by mid-January 2016, and which bills will take further discussion and a longer period of time to complete the legislative process.
Gov. Hassan is eager to find a resolution to the state’s heroin/opioid epidemic that has claimed over 600 lives in the past two years alone. She called for a special session in November 2015, but the House and Senate were unwilling to act on Gov. Hassan’s proposed legislation, creating the Task force instead.