BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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                                 THIRD READING


          Bill No:  AB 2268
          Author:   Chesbro (D)
          Amended:  4/20/10 in Assembly
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  5-0, 6/9/10
          AYES:  Alquist, Cedillo, Leno, Negrete McLeod, Pavley
          NO VOTE RECORDED:  Strickland, Aanestad, Cox, Romero

           ASSEMBLY FLOOR  :  71-0, 4/26/10 - See last page for vote


           SUBJECT  :    Alcohol and drug abuse

           SOURCE  :     Department of Alcohol and Drug Programs


           DIGEST  :    This bill authorizes physicians and surgeons in  
          California who are registered with the U.S. Attorney  
          General, pursuant to specified federal law, to provide  
          addiction treatments that are allowed under federal law.

           ANALYSIS  :    Existing law:

          1.Establishes the Department of Alcohol and Drug Program  
            (DADP) to license treatment facilities that provide a  
            broad range of services in a supportive environment to  
            adults who are addicted to alcohol or drugs. 

          2.Requires DADP to license and inspect narcotic treatment  
            programs (NTPs), which use replacement narcotic therapy  
            (RNT) in the treatment of addicted persons whose  
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            addiction was acquired or supported by the use of a  
            narcotic drug or drugs, not in compliance with a  
            physician and surgeon's legal prescription. 

          3.Authorizes the following controlled substances for use in  
            RNT by licensed NTPs:  methadone, Levo-alphacetylmethadol  
            (LAAM), buprenorphine products or combination products  
            approved by the federal Food and Drug Administration  
            (FDA) for maintenance or detoxification of opioid  
            dependence, and any other federally approved controlled  
            substances used for the purpose of RNT. 

          4.Requires DADP to establish a program for the operation  
            and regulation of office-based opiate treatment (OBOT)  
            programs that are required to hold a primary NTP license  
            or be affiliated and associated with a primary licensed  
            NTP. 

          5.Defines an OBOT program as a program in which interested  
            and knowledgeable physicians provide addiction treatment  
            services, and in which community pharmacies supply  
            necessary medication both to these physicians for  
            distribution to patients and through direct  
            administration and dispensing services. 

          6.Requires physicians in OBOT programs to dispense or  
            administer pharmacologic treatment for opiate addiction  
            that has been approved by the FDA. 

          This bill authorizes physicians and surgeons in California  
          who are registered with the U.S. Attorney General, pursuant  
          to specified federal law, to provide addiction treatments  
          that are allowed under federal law.

           Background
           
          Buprenorphine is used to treat addiction to opioids by  
          preventing withdrawal symptoms so that a person can stop  
          taking the opioid drug to which he or she is addicted.  In  
          October 2002, the FDA approved two buprenorphine products,  
          Subutex and Suboxone, for use in opioid addiction  
          treatment. Subutex and Suboxone were the first narcotic  
          drugs available for the treatment of opiate dependence that  
          can be prescribed in an office setting under the federal  







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          Data Addiction Treatment Act (DATA) of 2000.  Prior to  
          DATA, opiate dependence treatments like methadone could be  
          dispensed in a limited number of clinics that specialize in  
          addiction treatment.  Under DATA, medications for the  
          treatment of opiate dependence are subject to less  
          restrictive controls.  Buprenorphine can be prescribed in  
          an office-based setting by specially qualified physicians,  
          and patients can obtain a 30-day supply from a pharmacy. 

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No    
          Local:  No

           SUPPORT  :   (Verified  6/10/10)

          Department of Alcohol and Drug Programs (source)
          California Association of Alcoholism and Drug Abuse  
          Counselors
          California Medical Association
          City and County of San Francisco
          Drug Policy Alliance 

           ARGUMENTS IN SUPPORT  :    DADP writes that this bill will  
          eliminate the legal risk to over 1,200 qualified physicians  
          in California who are already prescribing buprenorphine in  
          their offices, not knowing that state law does not conform  
          to DATA.  DADP states that this bill will clarify that  
          qualified physicians in California are authorized to treat  
          opioid dependence in their private practices as they would  
          any other illness, subject to the requirements of DATA, and  
          would substantially increase access to treatment for  
          underserved populations in rural areas that do not have  
          NTPs or clients who use public transit and must travel  
          hours to the nearest NTP.  Supporters, including the  
          California Medical Association, Drug Policy Alliance and  
          the California Association of Alcoholism and Drug  
          Counselors, add that this bill will increase access for  
          patients in need of detoxification and maintenance  
          treatments and enable physicians to treat their patients  
          with the full complement of services at their disposal. 


           ASSEMBLY FLOOR  :  
          AYES: Adams, Ammiano, Anderson, Beall, Tom Berryhill,  
            Blakeslee, Block, Blumenfield, Bradford, Brownley,  







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            Buchanan, Caballero, Charles Calderon, Carter, Chesbro,  
            Conway, Cook, Coto, Davis, De La Torre, De Leon, DeVore,  
            Emmerson, Eng, Evans, Feuer, Fletcher, Fong, Fuentes,  
            Fuller, Gaines, Galgiani, Garrick, Gilmore, Hagman,  
            Harkey, Hayashi, Hernandez, Hill, Huber, Huffman,  
            Jeffries, Jones, Knight, Lieu, Logue, Bonnie Lowenthal,  
            Ma, Mendoza, Miller, Monning, Nava, Nestande, Niello,  
            Nielsen, Norby, Portantino, Ruskin, Saldana, Silva,  
            Skinner, Smyth, Solorio, Audra Strickland, Swanson,  
            Torlakson, Torres, Torrico, Tran, Villines, Yamada
          NO VOTE RECORDED: Arambula, Bass, Bill Berryhill, Furutani,  
            Hall, V. Manuel Perez, Salas, John A. Perez


          CTW:nl  6/10/10   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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