LINCOLN – Wednesday, Governor Pete Ricketts signed a new measure aimed at opioid abuse prevention into law. LB 931 provides new requirements for opiate and controlled substance prescriptions distributed in the State of Nebraska.
“The work of the attorney general, state senators, and many other stakeholders has helped Nebraska become a leader in preventing opioid abuse,” said Ricketts. “LB 931 will help prevent over prescription of these drugs and require photo identification to receive opioids. This legislation supports our ongoing efforts to avoid the crisis here in Nebraska that is affecting so many families in other states.”
The governor was joined at a ceremony by Attorney General Doug Peterson, State Senator Sara Howard of Omaha, State Senator John Kuehn of Heartwell and State Senator Brett Lindstrom of Omaha. LB 931 was introduced by State Senator Sara Howard of Omaha. It was passed by the Unicameral Legislature, 48-0-1, on March 29.
“Thank you to my colleagues who worked with us on LB 931, as well as Governor Ricketts for his support of this measure,” said Senator Howard. “With this package of bills, Nebraska continues to lead on opioid abuse prevention. Together, we are preventing families from experiencing the terrible tragedy of loss to opioid abuse and addiction that mine did.”
Senator Howard’s LB 931 contains three measures, including provisions amended into the bill from LB 933 from Senator Lindstrom and LB 934 from Senator Kuehn. Among other things, the final package:
• Creates a seven-day duration cap on a prescription for an opiate issued to a person under the age of 19.
• Directs physicians to discuss the risk of addiction with patients who are receiving opiates.
• Requires photo ID for persons receiving dispensed opiates.
“I want to thank the state senators for their proactive steps to pass this important legislation,” said Attorney General Doug Peterson. “The national opioid crisis took over 20 years to develop and has had devastating effects on individuals and families across the U.S. It will take all of our efforts as Nebraskans to stop this epidemic within our state. This legislation will go a long way in accomplishing that goal.”
Facts about prescription drug deaths in Nebraska
In 2016, 128 people died of a drug overdose, and at least 38 of those deaths were opioid-related. In 2015, 149 people died of a drug overdose, and at least 54 of those deaths were opioid-related.
Nebraska’s drug overdose death rate has increased over the last decade — 6.9 overdose deaths for every 100,000 people in 2016, up from 3.6 in 2004. The U.S. drug overdose death rate per 100,000 people was 16.3 in 2015, up from 9.3 in 2004.
Nebraska’s leadership in opioid abuse prevention
Over the past few years, Governor Pete Ricketts, Attorney General Doug Peterson, state senators and numerous stakeholders have taken an aggressive stance on combatting the growing opioid crisis in America. Several of their initiatives are outlined below.
Access and Awareness of Naloxone: DHHS held a campaign to raise awareness about expanded access to naloxone, a drug that can be given to people experiencing an opioid overdose. DHHS is working with pharmacists, physicians and EMS providers to create educational resources and training on naloxone as well as an information campaign geared toward the public about access and use of the medication. Naloxone kits are actively being dispensed to individuals in recovery who are at a high risk of opioid overdose.
Dose of Reality Public Information Campaign: In 2017, Governor Pete Ricketts and Attorney General Doug Peterson launched the “Dose of Reality” public information campaign, intended to alert Nebraskans to the dangers of misusing opioid pain medications. More information about the campaign can be found at https://doseofreality.nebraska.gov/.
Nebraska Pain Management Guidance Document: This document promotes consistent, safe and effective management standards for Nebraska prescribers. It includes information on treating acute pain, chronic pain, non-opioid options for pain treatment, treating pain in special populations and opioid tapering/discontinuation. An educational training video on the DHHS website complements the content of this document to assist in training Nebraska’s providers in safe pain management.
Opioid Response Funding: A $2 million grant from the Substance Abuse and Mental Health Services Administration provides critical funding for targeted training on the complexities of opioid use and for investments in evidence-based prevention and treatment interventions. These solutions will arm Nebraska to prevent opioid misuse in the state. As of February 2018, prevention activities have reached an estimated 71,058 Nebraskans and 411.3 pounds of medications have been collected at drug take-back events across the state. Nebraska’s Pain and Substance Use Disorder Extension for Community Health Care Outcomes (Project ECHO) is training healthcare providers on working with individuals with an opioid use disorder and consistently attracts approximately 30 participants per session. Thirty-seven peer support specialists have been trained in offering Medication-Assisted Recovery Support to their peers who express interest in Medication Assisted Treatment (MAT). Funding is also supporting reimbursement.
Opioid Abuse Summit & Strategic Initiative Report: In October 2017, the Nebraska Coalition to Prevent Opioid Abuse, led by Attorney General Doug Peterson, took steps to proactively address opioid addiction and abuse in Nebraska. This report followed a 2016 summit hosted by the Attorney General and the University of Nebraska Medical Center to identify prevention, treatment and public safety strategies through direct collaboration with the public health, medical and law enforcement communities in Nebraska.
Prescription Drug Monitoring Program (PDMP): On January 1, 2018, Nebraska became the first state in the nation to require reporting of all dispensed prescription drugs to the PDMP. The PDMP is a comprehensive tool, allowing medication providers to more easily review a patient’s medication history. In July 2018, veterinary prescriptions for controlled substances will also be added to the PDMP.
Routine Monitoring of Prescription Medications by Medicaid:
Patients identified as receiving more than 150 doses of a short-acting opioid, such as oxycodone (commonly known as Percocet) or hydrocodone (Vicodin) in a 30-day period (excluding cancer patients) are flagged, and every physician who has prescribed opioids for that patient is contacted.
On October 1, Nebraska Medicaid claims for more than 150 doses of short-acting opioids in 30 days started being rejected at pharmacies.
Medicaid is tracking the number of members receiving opioid and medication assisted treatment drug prescriptions from Nebraska Medicaid by month.
Abuse-deterrent formulations of pain medications were added to the preferred drug list (Butrans and Hysingla ER) and an unsafe, inexpensive pain medication was removed from the preferred list (methadone).