The United States is in the midst of an unprecedented epidemic of prescription drug overdose deaths. More than 38,000 people died of drug overdoses in 2010, and most of these deaths (22,134) were caused by overdoses involving prescription drugs. Three-quarters of prescription drug overdose deaths in 2010 (16,651) involved a prescription opioid pain reliever (OPR), which is a drug derived from the opium poppy or synthetic versions of it such as oxycodone, hydrocodone, or methadone. The prescription drug overdose epidemic has not affected all states equally, and overdose death rates vary widely between states.
States have the primary responsibility to regulate and enforce prescription drug practice. Although state laws are commonly used to prevent injuries and their benefits have been demonstrated for a variety of injury types, there is little information on the effectiveness of state statutes and regulations designed to prevent prescription drug abuse and diversion.
The CDC’s Public Health Law Program (PHLP) released several menus assessing state prescription drug overdose laws: Menu of State Prescription Drug Identification Laws, Menu of Pain Management Clinic Regulation, and Menu of State Laws Related to Prescription Drug Overdose Emergencies. These resources are designed to provide a picture of some of the legal and regulatory strategies states have used to address prescription drug misuse, abuse, and overdose. These menus were created through a partnership between the CDC’s PHLP and the National Center for Injury Prevention and Control.
Laws that require patients to show personal identification to pharmacists before receiving prescription drugs were included in the Menu of State Prescription Drug Identification Laws because of their potential role in decreasing the diversion of controlled substances. Statutes and regulations were included as identification laws only if they expressly state that a pharmacist must or may request identification before dispensing prescription drugs.
One type of law aimed at preventing inappropriate prescribing is regulation of pain management clinics, often called “pill mills” when they are sources of large quantities of prescriptions. Pill mills have become an increasing problem in the prescription drug epidemic, and laws have been enacted to prevent these facilities from prescribing controlled substances inappropriately. A law was included in this resource as a pain management clinic regulation if it requires state oversight and contains other requirements concerning ownership and operation of pain management clinics, facilities, or practice locations. For example, a law may specify operational and personnel requirements, inspection and complaint investigations, license procedures, health and safety requirements, standards of care, or patient billing procedures. As of August 31, 2010, three states had such pain management clinic laws; as of September 28, 2012, eight states did. This menu is a first step in assessing pain management clinic laws by creating an inventory of state legal strategies in this domain.
The emergency laws included in the Menu of State Laws Related to Prescription Drug Overdose Emergencies grant either immunity from prosecution or mitigation in prosecution or at sentencing for people who call 911 in the case of an overdose emergency. These laws were researched because of their potential to eliminate barriers to appropriate overdose treatment, which can reduce the case-fatality rate when overdoses occur. Several studies have shown that while there is usually time for overdose intervention, both those who consume drugs and those who witness their use often do not call 911 for fear of being arrested and charged with drug-related crimes. By creating an inventory of state legal strategies, this assessment accomplishes the first step in evaluating the effectiveness of prescription drug-related emergency laws.
See the CDC Public Health Law Program Announcement
See also Medical Law Perspectives, January 2014 Report: Prescription Painkillers: Risks for Patients, Pharmacists, and Physicians
See also Medical Law Perspectives, May 2013 Report: Drugs, Dosage, and Damage: Physician Liability for Prescribing or Administering Medication