CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Joint Resolution No. 19Introduced by Assembly Member ArambulaJune 05, 2017 Relative to opioid awareness and dependency prevention. LEGISLATIVE COUNSEL'S DIGESTAJR 19, as introduced, Arambula. Opioid awareness and dependency prevention.This measure, the California Opioid Awareness and Dependency Prevention Resolution, would urge public and private health care payers, state and federal regulators, agencies, and departments, the President of the United States, and the Congress of the United States to support physician and surgeon choice of treatment to prevent opioid dependency and would urge the President of the United States and the Congress of the United States to move forward with legislation to establish multimodal therapy guidelines for managing postsurgical acute pain.Digest Key Fiscal Committee: NO Bill TextWHEREAS, Opioid dependency has become a health care epidemic in California and the United States of America; and WHEREAS, According to the Journal of Pain & Palliative Care Pharmacotherapy, 95 percent of postsurgical patients receive an opioid, expanding the effects of opioid dependency on socioeconomic stress and the overall cost of treatment and care; andWHEREAS, Peer-reviewed survey results in Anesthesia & Analgesia and JAMA Internal Medicine state that one in 15 surgical patients becomes a chronic opioid user after his or her procedure, and each day, 46 people in the United States die from an overdose of prescription pain killers; andWHEREAS, According to Hospital Pharmacy, with over 70 million surgical procedures performed annually in the United States, if one in 15 surgical patients becomes dependent on opioids after surgery, then approximately four million people annually will need care. Strategies for helping patients achieve pain relief and minimize use of opioids such as Vicodin, OxyContin and Percocet are needed now more than ever; andWHEREAS, In 2013, there were 230 million prescriptions for opioids, according to data from IMS Health; andWHEREAS, In March 2016, Annals of Surgery noted that after common surgical procedures, a recent study found only 28.7 percent of the pills that were prescribed were taken; 90 percent of patients had received opioid pills with a range of zero to 120 pills; and in dental procedures, 54 percent of patients had leftover pills after surgical tooth extraction and there are after such extractions an estimated 100 million unused medications as stated by Drug and Alcohol Dependence; andWHEREAS, According to a study published by the Oxford University Press in 2014, dependency on these opioid medications has risen sharply, with patients given opioids within seven days of discharge being almost 50 percent more likely to still be on them one year after surgery and opioid-related adverse drug events being the most common postdischarge complication; andWHEREAS, As acknowledged in a recent FAIR Health, Inc. white paper entitled The Impact of the Opioid Crisis on the Healthcare System, health insurers spent $446 million on opioid treatment in 2015, and health insurers have seen their payments to hospitals, laboratories, treatment centers, and other providers skyrocket 1,375 percent from 2011 to 2015 for patients diagnosed with an opioid dependence or opioid abuse disorder, and health insurers also saw treatment costs rise from $32 million to $446 million over the same period, with the average yearly cost per patient rising from $3,435 to over $19,000 to battle opioid dependence; andWHEREAS, The cost of opioid misuse and abuse has risen from $55.7 billion in 2007 to $78.5 billion in 2013 as reported by Medical Care in 2016; andWHEREAS, Multimodal pain control is the use of different medications that control pain at different receptor sites in the body, beginning with local anesthetics, and this strategy reserves the use of opioid medications for breakthrough pain; andWHEREAS, The Joint Commission recommends an individualized, multimodal treatment plan should be used to manage pain upon assessment, the best approach may be to start with a nonnarcotic; andWHEREAS, The United States Centers for Disease Control and Prevention recommends that health care providers should only use opioids in carefully screened and monitored patients when nonopioid treatments are insufficient to manage pain; andWHEREAS, The American Society of Anesthesiologists recommends a multimodal approach to pain management, often beginning with a local anesthetic where appropriate; andWHEREAS, Patients undergoing a surgical intervention deserve to be educated that the use of opioids can lead to dependency and that all patients deserve to have open, unrestricted access to nonopioid alternative medications for their postsurgical pain; now, therefore, be itResolved by the Assembly and the Senate of the State of California, jointly, That the Legislature urges inclusion of medications like liposomals, bupivacaine, intravenous acetaminophen and other nonopioid alternatives to hospital-based pain management formularies; and be it furtherResolved, That the Legislature urges public and private health care payers, state and federal regulators, agencies, and departments, the President of the United States, and the Congress of the United States to support physician and surgeon choice of treatment to prevent opioid dependency; and be it furtherResolved, That the Legislature urges the President of the United States and the Congress of the United States to move forward with legislation to establish multimodal therapy guidelines for managing postsurgical acute pain; and be it furtherResolved, That this measure shall be known as the California Opioid Awareness and Dependency Prevention Resolution; and be it furtherResolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the President and Vice President of the United States, to the Speaker of the House of Representatives, to the Minority Leader of the House of Representatives, to the Majority Leader of the Senate, to the Minority Leader of the Senate, and to each Senator and Representative from California in the Congress of the United States.
CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION Assembly Joint Resolution No. 19Introduced by Assembly Member ArambulaJune 05, 2017 Relative to opioid awareness and dependency prevention. LEGISLATIVE COUNSEL'S DIGESTAJR 19, as introduced, Arambula. Opioid awareness and dependency prevention.This measure, the California Opioid Awareness and Dependency Prevention Resolution, would urge public and private health care payers, state and federal regulators, agencies, and departments, the President of the United States, and the Congress of the United States to support physician and surgeon choice of treatment to prevent opioid dependency and would urge the President of the United States and the Congress of the United States to move forward with legislation to establish multimodal therapy guidelines for managing postsurgical acute pain.Digest Key Fiscal Committee: NO
CALIFORNIA LEGISLATURE 20172018 REGULAR SESSION
Assembly Joint Resolution No. 19
Introduced by Assembly Member ArambulaJune 05, 2017
Introduced by Assembly Member Arambula
June 05, 2017
Relative to opioid awareness and dependency prevention.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AJR 19, as introduced, Arambula. Opioid awareness and dependency prevention.
This measure, the California Opioid Awareness and Dependency Prevention Resolution, would urge public and private health care payers, state and federal regulators, agencies, and departments, the President of the United States, and the Congress of the United States to support physician and surgeon choice of treatment to prevent opioid dependency and would urge the President of the United States and the Congress of the United States to move forward with legislation to establish multimodal therapy guidelines for managing postsurgical acute pain.
This measure, the California Opioid Awareness and Dependency Prevention Resolution, would urge public and private health care payers, state and federal regulators, agencies, and departments, the President of the United States, and the Congress of the United States to support physician and surgeon choice of treatment to prevent opioid dependency and would urge the President of the United States and the Congress of the United States to move forward with legislation to establish multimodal therapy guidelines for managing postsurgical acute pain.
## Digest Key
## Bill Text
WHEREAS, Opioid dependency has become a health care epidemic in California and the United States of America; and
WHEREAS, According to the Journal of Pain & Palliative Care Pharmacotherapy, 95 percent of postsurgical patients receive an opioid, expanding the effects of opioid dependency on socioeconomic stress and the overall cost of treatment and care; and
WHEREAS, Peer-reviewed survey results in Anesthesia & Analgesia and JAMA Internal Medicine state that one in 15 surgical patients becomes a chronic opioid user after his or her procedure, and each day, 46 people in the United States die from an overdose of prescription pain killers; and
WHEREAS, According to Hospital Pharmacy, with over 70 million surgical procedures performed annually in the United States, if one in 15 surgical patients becomes dependent on opioids after surgery, then approximately four million people annually will need care. Strategies for helping patients achieve pain relief and minimize use of opioids such as Vicodin, OxyContin and Percocet are needed now more than ever; and
WHEREAS, In 2013, there were 230 million prescriptions for opioids, according to data from IMS Health; and
WHEREAS, In March 2016, Annals of Surgery noted that after common surgical procedures, a recent study found only 28.7 percent of the pills that were prescribed were taken; 90 percent of patients had received opioid pills with a range of zero to 120 pills; and in dental procedures, 54 percent of patients had leftover pills after surgical tooth extraction and there are after such extractions an estimated 100 million unused medications as stated by Drug and Alcohol Dependence; and
WHEREAS, According to a study published by the Oxford University Press in 2014, dependency on these opioid medications has risen sharply, with patients given opioids within seven days of discharge being almost 50 percent more likely to still be on them one year after surgery and opioid-related adverse drug events being the most common postdischarge complication; and
WHEREAS, As acknowledged in a recent FAIR Health, Inc. white paper entitled The Impact of the Opioid Crisis on the Healthcare System, health insurers spent $446 million on opioid treatment in 2015, and health insurers have seen their payments to hospitals, laboratories, treatment centers, and other providers skyrocket 1,375 percent from 2011 to 2015 for patients diagnosed with an opioid dependence or opioid abuse disorder, and health insurers also saw treatment costs rise from $32 million to $446 million over the same period, with the average yearly cost per patient rising from $3,435 to over $19,000 to battle opioid dependence; and
WHEREAS, The cost of opioid misuse and abuse has risen from $55.7 billion in 2007 to $78.5 billion in 2013 as reported by Medical Care in 2016; and
WHEREAS, Multimodal pain control is the use of different medications that control pain at different receptor sites in the body, beginning with local anesthetics, and this strategy reserves the use of opioid medications for breakthrough pain; and
WHEREAS, The Joint Commission recommends an individualized, multimodal treatment plan should be used to manage pain upon assessment, the best approach may be to start with a nonnarcotic; and
WHEREAS, The United States Centers for Disease Control and Prevention recommends that health care providers should only use opioids in carefully screened and monitored patients when nonopioid treatments are insufficient to manage pain; and
WHEREAS, The American Society of Anesthesiologists recommends a multimodal approach to pain management, often beginning with a local anesthetic where appropriate; and
WHEREAS, Patients undergoing a surgical intervention deserve to be educated that the use of opioids can lead to dependency and that all patients deserve to have open, unrestricted access to nonopioid alternative medications for their postsurgical pain; now, therefore, be it
Resolved by the Assembly and the Senate of the State of California, jointly, That the Legislature urges inclusion of medications like liposomals, bupivacaine, intravenous acetaminophen and other nonopioid alternatives to hospital-based pain management formularies; and be it further
Resolved, That the Legislature urges public and private health care payers, state and federal regulators, agencies, and departments, the President of the United States, and the Congress of the United States to support physician and surgeon choice of treatment to prevent opioid dependency; and be it further
Resolved, That the Legislature urges the President of the United States and the Congress of the United States to move forward with legislation to establish multimodal therapy guidelines for managing postsurgical acute pain; and be it further
Resolved, That this measure shall be known as the California Opioid Awareness and Dependency Prevention Resolution; and be it further
Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the President and Vice President of the United States, to the Speaker of the House of Representatives, to the Minority Leader of the House of Representatives, to the Majority Leader of the Senate, to the Minority Leader of the Senate, and to each Senator and Representative from California in the Congress of the United States.