Health Organization for Pudendal Education

A Bill, AB1998 has recently been introduced in the California State Assembly. The bill is currently wending it's way through the Assembly committee process. The bill states in part:

This bill would require, when a prescription is for an amount larger than that needed for 3 days or when the prescription is the 4th prescription without the dosage decreasing, the practitioner to report, in detail, why the excess or additional prescription was needed, what other medications were considered, the patient’s injury or illness, and the milligram dosage of the prescription. The bill would also require a practitioner who fails to submit the report required to be referred to the appropriate licensing board for administrative action, as deemed appropriate by that board. By creating a new crime, this bill would impose a state-mandated local program.

Full information on this bill is available at http://leginfo.legislature.ca.gov/faces ... 0180AB1998

This would likely make prescription and purchase of these drugs even more onerous than it already is, likely making it impossible for a doctor to prescribe them for patients such as my wife. Even if a doctor were willing to make such prescriptions on a continuing basis, getting them filled every three days would be a practical impossibility. Obviously, this would impact many members of this forum in a profound way. We must do everything in our power to stop progress of this bill. The sooner and more forcefully we act, the more likely we are to be successful. The next hearing on this Bill is scheduled for 17 April 2018. That's only 6 days away !!! If you are a resident of California, I urge you to mail, email, and/or phone your local representative to the California State Assembly to let them know what the effect passage of such a bill will mean to you as a person.

a) find the contact information for your representative starting at the page at http://ahea.assembly.ca.gov
b) communicate your concerns to your representative via email, regular mail, phone and/or personal visit to their local district office.
c) If you live near Sacramento, you might want to attend the next Health Committee hearing scheduled to consider this bill. According to http://ahea.assembly.ca.gov/hearings this hearing is scheduled for 1:30 p.m. - State Capitol, Room 4202. Be sure to verify this as scheduling is subject to change.

Annegret and Robert Ramey

Spinner
i am so sorry for you n your wife. i heard some others saying this kind of reform is coming. i do not live in calf but feel your pain. They r even weird about my Lyrica and only let me get a month at a time , where as i use to get 3 months at a time. Again, Good luck to u both.
Sadie

Spinner,

Thank you for alerting us to this. It is clear that people writing these bills have absolutely no understanding of chronic pain. Thank you for your work on this, and do keep us posted.

April

Most of us have probably heard the saying, "As goes California, so goes the Nation."

So, I think this topic is important to all of us. If you have friends or relatives in California it would be a good idea to make them aware of this information.

Violet

Important update!

I've been informed that the Bill in question has been totally re-written. This replacement was published on 12 April 2018 in time to be considered at the committee hearing for 17 April 2018. http://leginfo.legislature.ca.gov/faces ... 0180AB1998

The new bill seems OK from our perspective. I would prefer no Bill at all as I don't believe that this problem is going to solved with more legislation. But I also understand that there is huge momentum as "something must be done" that no one is going to stop.

I have no idea what motivated this change. I had made good contacts with staff on the committee and sent letters to the author of the bill, the committee chairman and other committee members. I had concluded that if we traveled to Sacramento we would be allowed to testify. Also there was an array of five lobbyists arrayed against the bill. Mostly these consisted of physicians organizations. I'm guessing that these were influential. Remember that next time you want to blame lobbyists for everything. The two lobbyists supporting the Bill where an organization of advocates for AIDS patients and one for Tort Lawyers.

Anyway, There is still a problem at federal level. Legislation CARA 2.0 sponsored by Senator Rob Portman proposes more micro management of the Dr./Patient interaction as it regards pain killers. I don't have time to the describe the details, but this is also worthy of attention. It is much more sophisticated than the California Assembly version and would require much more effort to address. But not doing so could lead to more suffering.

There is running information on the twitter account: #opioidcrisis which is interesting.

Twitter feeds:

#CARA2
#opioidcrisis

I just glanced at the bill and noticed that in bullet 7 it states that Physicians caring for chronic pain patients would be exempt from following this spp. At least that's the way it looks like to me. Anyone care to confirm my observations of the bill? I've been wrong before. Thanks Skip

By "bill" I'm not sure which bill you're referring to.

But no matter. As it relates to prescription requirements, it seems that both the bill in the California Assembly and the US Senate are similar if not identical. Clearly the intent is to distinguish between cases such as our managed by "serious" practitioners and the prescription just to supply addicts. So they do seem concerned about cases such as ours. My problem is that I don't think trying to make such a separation can be very effective. And Doctors subjected to extra scrutiny, paperwork and risk of investigation or accusations will decide to opt out of this kind of treatment. Of course that's my opinion and the legislators will say that they've made provision for this so it won't be a problem. I'm skeptical. but I don't know how to address this.

Unfortunately their bills often become slippery slopes where they just get more and more intrusive into our lives with each new bill so I think stopping it before they go any farther is the key. Thanks for the updates, Spinner. If it's a federal bill being introduced then I think all of us need to contact our congressmen.

Violet