Vice Speaker Telena Cruz Nelson on Friday introduced Bill No. 388-35, which would heighten health providers’ scrutiny of patients' prescription drug history and mandate advice to patients of associated opioid health risks, among other new requirements.

“We all know someone we love, whether a friend or family member, who suffers from substance abuse and addiction. We probably know one too many,” Nelson stated in a press release.

“For the many families who have been through the ups and downs of a loved one’s addiction, this measure will provide an additional layer of scrutiny prior to opioids being prescribed and educate patients about the health risks many of us are too familiar with,” Nelson added. “This is the first step to addressing the abuse of drug prescriptions and the opioid crisis we see today.”

In meetings with health care professionals, Nelson learned that of 381 health care providers registered with the Controlled Substance Program at the Department of Public Health and Social Services, only 48 are registered with the Prescription Drug Monitoring Program.

Under Guam law, health care providers are required to register with CSP at Public Health in order to prescribe medication, but have the option of registering with PDMP at no cost. PDMP is a federally funded program that provides access to a local database of patients with a prescription drug history. The vice speaker’s measure would mandate that health care providers obtain prescription monitoring information as it relates to a patient under the prescriber’s care by registering with the PDMP.

“Especially during these times of distress and at a time when more families than ever are bearing the mental and emotional cross of substance abuse and addiction, we must take every avenue toward ensuring the integrity of drug prescriptions and the well-being of our island’s patients,” Nelson stated. “Our mission is to meet the complexities of the opioid crisis not only with the strength and discipline it demands, but also the compassion and kindness our community and humanity expects.”

The measure also introduces provisions that reinforce patient prescription education, control refillable prescription periods, and mandate recurring review of the patient’s prescription drug history.

If a health provider prescribes a Schedule II, Schedule III, or Schedule IV controlled substance to the patient, the legislation proposes that after the initial nonrefillable seven-day supply, the practitioner shall review the patient utilization report, via the PDMP, at least once every three months thereafter if the substance is to remain as part of the treatment of the patient. Prior to issuing a prescription for a Schedule II, Schedule III, or Schedule IV controlled substance, health providers would be required to:

• Inform the patient of the risks associated with the Schedule II, Schedule III, or Schedule IV controlled substance prescribed; and

• Advise the patient regarding the quantity of the Schedule II, Schedule III, or Schedule IV controlled substance and the patient’s option to fill the prescription in a lesser quantity.

The number of fatal drug overdoses in the United States hit a record high in 2019, according to the Centers for Disease Control and Prevention, with public health experts fearing an escalation in the national opioid epidemic amid the COVID-19 pandemic. The number of U.S. overdose fatalities increased by 4.6% and reached a new high of 70,980 deaths, the CDC stated.

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