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GUEST BLOG: CA Bills Provide Hope to Stem Overdose Tide

a portrait of Ramon Castellblanch, PhDby Ramon Castellblanch, PhD
Quality Healthcare Concepts, Inc.

Two desperately-needed bills that would be steps in the direction of reducing California’s opioid overdose death toll, AB 2384 (Arambula) and AB 2487 (McCarty), are on the State Senate floor and are moving toward the Governor’s desk. In 2016, over 2,000 Californians died of opioid overdoses. According to the Centers for Disease Control, California’s drug overdose rate rose in 2017. It likely is still rising. The death toll is worst for older Californians, as our state’s age group with the highest number of opioid overdose deaths is 55 and older.

an opioid pill bottle just waiting to kill grandma

Given this staggering and probably still rising death toll, the highest priority in fighting the opioid epidemic is breaking the opioid habits of as many Californians with opioid use disorder (OUD) as possible. The first step in that process is usually what is called medication-assisted treatment (MAT), i.e., using medications, in combination with counseling and behavioral therapies, to treat OUD.

According to the Urban Institute, up to nearly a quarter million Californians in need of MAT have no access to it. One of the major reasons access is denied is that insurers often won’t pay for it. Another is that physicians needed to prescribe the medicines for MAT won’t prescribe. Many physicians know little of what’s involved in treating OUD and assume that treating people with OUD would disrupt their practices.

AB 2384 would do something about insurers who won’t cover MAT. It would mandate coverage for at least one MAT drug for OUD; and prohibit health plans and insurers from using prior authorization, fail first or step therapy and other utilization management requirements for at least one version of each MAT. It is opposed by the insurance industry and the Chamber of Commerce.

AB 2487 would do something about physicians who won’t prescribe MAT. It would amend a California requirement that physicians take the course that often minimized the risk of OUD and promoted overprescribing of opioids. In lieu of that course, physicians could take a course that educates them on treating OUD and how they could smoothly integrate treatment for people with OUD into their practices.