Bills would allow patients to opt-out of opioids as part of "advance directive" | Florida

At least 13 opioid-related bills, including two aimed at allowing patients to refuse an opioid by signing an "advance directive," had been tabled before Thursday, indicating that the "opioid crisis" in Florida will occupy new lawmakers when the 2019 session will begin March 5.

Last year, legislators approved a series of opioid laws, including legislation limiting opioid prescribing, strengthening the state's Prescription Drug Monitoring Program (PDMP) by making participation mandatory for all health care providers and allocated $ 53.5 million to treatment programs.

According to reports from the National Institute on Drug Abuse, there would have been 2,798 opioid-related overdose deaths in Florida in 2016, a rate of 14.4 deaths per 100,000 population.

The Florida Law Enforcement Department reported 5,725 opioid-related deaths in 2016, or about 16 residents per day, up from 200 in 2013.

Incomplete and unofficial statistics indicate that the "crisis" has slightly eased, but opioid addiction remains a matter of life and death for far too many Floridians, according to lawmakers, and resolving it remains a problem. priority.

The Senate Bill 630, sponsored by Senator Keith Perry of R-Gainesville, is among the bills introduced in 2019 that would give patients the right to refuse an opioid drug in a doctor's office or hospital by expressing their wish in an "advance directive".

Representative Scott Plakon, R-Longwood, tabled a complementary bill in the House, Bill 451.

The bills require the state health department to develop a "voluntary guideline form for non-opioids," allowing patients to seek alternative non-opioid badgesics from health care providers and:

• Release pharmacists from any liability if they are performing an opioid drug prescription transmitted electronically, even if the patient has signed a "non-opioid voluntary guideline form".

• Subject regulators to disciplinary action in the event of non-compliance with the patient's form, but only to civil or criminal liability if you refuse to prescribe, order or administer an opioid according to the wishes of the patient. patient.

• Release emergency room providers from responsibility for prescribing, ordering or administering an opioid to a person if they do not know the patient's referral form.

Citing research showing that many people with opioid addiction have been exposed for the first time on legitimate prescription to treat pain resulting from injury or surgery, the SB 630 complements efforts of previous years by providing patients and providers with the tools they need to make decisions about their treatment options. "

"We hope this bill will change the lives of Floridians and families of loved ones who suffer from a substance use disorder," said Plakon. "There are alternatives to opioids and patients should have the right to decide for themselves the type of pain treatment they receive depending on their situation."

The 13 opioid-related bills among the 736 filed by Thursday at noon include two prohibitions to issue opioids without a warning label and two aimed at relieving palliative care providers treating terminally ill patients. PDMP notification obligation. Among others:

• HB 491, "Prescription of Controlled Substances," sponsored by Dianne Hart, D-Tampa, who would exclude sickle cell pain from the definition of acute pain to limit opioid prescriptions.

• SB 398, "Prior Authorization for Opiate Alternatives", sponsored by Senator Gary Farmer, D-Ft. Lauderdale, which would prohibit health insurance policies from requiring treatment with opioid badgesic drugs will fail before allowing the use of nonopioids.

• SB 528, "Mental Health and Substance Use Disorders", sponsored by Senator Darryl Rouson, D-St. St. Petersburg, which would require more "peer expert" testing of mental health programs and facilities and that the Department of Children and Families develop a training program for peer educators.