New York State Assemblyman John T. McDonald III (D) is co-sponsoring a bill that would enact co-prescription of an opioid and an opioid overdose reversal drug like naloxone in New York, following a trend of similar laws enacted in California, New Jersey, and nine other states.
Co-prescription would permit doctors to prescribe the two drugs to the same patient at the same time. And considering the nation’s ongoing opioid crisis, McDonald says there’s strong medical advice encouraging the co-prescription of naloxone – the only FDA-approved opioid overdose reversal agent – when treating patients with significant risk factors.
Currently, however, Bill No. A05603B, which McDonald introduced in February 2019 with bill sponsor New York State Assemblyman Edward Braunstein (D) and 14 other colleagues, remains stalled in the Assembly’s Ways and Means Committee, where it’s been since January.
“Not sure,” why the bill has been held up, McDonald recently wrote Homeland Preparedness News in an email. “Cost may be a concern, but this bill does not mandate that patients take the medication, just that they be given an Rx so the pharmacist can review it with the patient to determine if it’s needed or not.”
If enacted, McDonald’s bill would amend the state’s public health law to permit the co-prescription of an opioid antagonist with a patient’s first opioid prescription in a given year, according to the text of the proposal.
“The bill is simple in that it encourages, not mandates, patients to consider having naloxone on hand in case of an overdose,” McDonald wrote in an op-ed published on Dec. 1 by the Times Union. “With measures to contain COVID-19 leading to a surge of addiction and overdose across the state, passing co-prescription will be one of my priorities going forward.”
Specifically, the prescriber may prescribe an opioid antagonist when any of the following risk factors are present: a history of substance abuse disorder; high dose or cumulative prescriptions that result in over 50 morphine milligram equivalents per day; or the concurrent use of opioids and benzodiazepine or nonbenzodiazepine sedative hypnotics, according to the bill.
New York has almost 800,000 people who meet the definition of at-risk for an opioid overdose, while approximately 10,000, or roughly 1.5 percent, also were prescribed naloxone, according to McDonald, citing data from the U.S. Centers for Disease Control and Prevention (CDC).
“These at-risk patients are defined by the CDC as those under past or present treatment for a substance use disorder, are receiving a significant opioid dosage, or are also taking a benzodiazepine prescription, such as Xanax or Valium,” McDonald wrote.
Throughout the state right now, he said that New York police departments, fire departments and EMS personnel all are provided naloxone to administer if it’s needed during an emergency situation.
In addition to its immediate life-saving abilities during an active overdose, McDonald pointed out that being administered naloxone is often a catalyst for those struggling with substance abuse to pursue professional treatment.
“This is becoming standard practice in the medical field to raise awareness and discussion,” McDonald said. “As a practicing pharmacist, I see many individuals on combined medications of opioid and benzodiazepines who may be at risk of overdose. Requiring prescribers to have this conversation is a good education piece.”